Clinically meaningful performance benchmarks in MS: timed 25-foot walk and the real world.

ABSTRACT:

Objective

Identify and validate clinically meaningful Timed 25-Foot Walk (T25FW) performance benchmarks in individuals living with multiple sclerosis (MS).

Methods

Cross-sectional study of 159 MS patients first identified candidate T25FW benchmarks. To characterize the clinical meaningfulness of T25FW benchmarks, we ascertained their relationships to real-life anchors, functional independence, and physiologic measurements of gait and disease progression. Candidate T25FW benchmarks were then prospectively validated in 95 subjects using 13 measures of ambulation and cognition, patient-reported outcomes, and optical coherence tomography.

Results

T25FW of 6 to 7.99 seconds was associated with a change in occupation due to MS, occupational disability, walking with a cane, and needing "some help" with instrumental activities of daily living; T25FW ?8 seconds was associated with collecting Supplemental Security Income and government health care, walking with a walker, and inability to do instrumental activities of daily living. During prospective benchmark validation, we trichotomized data by T25FW benchmarks (<6 seconds, 6-7.99 seconds, and ?8 seconds) and found group main effects on 12 of 13 objective and subjective measures (p < 0.05).

Conclusions

Using a cross-sectional design, we identified 2 clinically meaningful T25FW benchmarks of ?6 seconds (6-7.99) and ?8 seconds. Longitudinal and larger studies are needed to confirm the clinical utility and relevance of these proposed T25FW benchmarks and to parse out whether there are additional benchmarks in the lower (<6 seconds) and higher (>10 seconds) ranges of performance.

SUBMITTER: Goldman MD 

PROVIDER: S-EPMC3821712 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature