Walking Speed in MS Patients May Indicate Worsening of Disease

A dynamic research team composed of doctors and scientists recently completed and published a study that sought to gain a better understanding of walking impairment, as it is manifested in patients living with multiple sclerosis (MS), a neurodegenerative disease wherein the impulse-conducting myelin sheath is attacked by the body’s own immune system.

MS patients’ walking impairment is clinically quantified by a test called the Timed 25-Foot Walk (T25-FW). This study, led and co-authored by Dr. Jeffrey A. Cohen of Cleveland Clinic’s Mellen Center for Multiple Sclerosis Treatment and Research, correlated walking speed as evaluated by the T25-FW test with results obtained via the Physical Component Summary (PCS) score of the 36-Item Short Form Health Survey (SF-36).

Dr. Cohen and his team of researchers pooled data from 3 separate clinical trials, namely: 1) Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM), 2) Safety and Efficacy of Natalizumab in Combination With Interferon Beta-1a in Patients With Relapsing-Remitting Multiple Sclerosis (SENTINEL), and 3) International MS Secondary Progressive Avonex Controlled Trial (IMPACT). These previously completed trials involving secondary-progressive MS patients with an Expanded Disability Status Scale (EDSS) score of 3.5-6.5, and relapsing-remitting MS patients with an EDSS score of 0-5.0 made use of both the T25-FW and SF-36 tools.

After analyzing data from a total of 2,549 MS patients, and noting baseline values and subsequent changes 2 years later, the researchers discovered a strong direct relationship between the two tests outcomes. Noted worsening of SF-36 PCS test scores were reflected in a deterioration in walking speed based on T25-FW measurements, with the degree of worsening varying only between those who were on a placebo, and those who were given active treatment.

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The findings of this study confirm that any unfavorable change in walking speed measured by the T25-FW test will significantly affect SF-36 PCS scores as well. A 20%-25% reduction in walking speed may already be taken by health professionals as a meaningful sign of worsening of MS.

Walking is not the only impairment caused by MS. Some MS patients eventually experience difficulty with speech comprehension as well, prompting exemplary works of research from Dr. John Hart and Dr. Gail Tillman of the Center for Brain Health in UT Dallas. Earlier this year, the two researchers received a $690,000 three-year grant from the National Multiple Sclerosis Society to study the roots and progression of neurodegenerative communication impairment.