Walking function worse in Black MS patients than white patients
Differences persist even after others factors are taken into consideration
Black people with multiple sclerosis (MS) walk more slowly and cover shorter distances over a certain time period than white people with the disease, a study in the U.S. finds.
While the differences were somewhat attenuated when other factors that may impact walking ability were considered, such as age, gender, physical activity, disease severity, and insurance coverage, they still remained significant.
“Our results support future research on examining mobility-focused rehabilitation modalities for improving walking performance in Black people with MS,” the study’s researchers wrote in “Walking performance is worse in Black than white people with multiple sclerosis,” which was published in Multiple Sclerosis and Related Disorders.
In MS, the immune system attacks the myelin sheath that covers nerve cells in the brain and spinal cord, causing damage. This results in symptoms that can range from poor vision and fatigue to difficulty walking owing to problems with balance and coordination.
There’s evidence that Black people experience the disease differently than white people do, with more severe symptoms and faster disability progression. Black people also seem to have more walking difficulties, but some studies show no differences in walking performance between Black and white patients, leading researchers in the U.S. to measure walking ability in people with MS and to take into account factors that can influence that outcome. For example, “there is limited research considering disability status when comparing Black and white people with MS on walking outcomes, yet this is important as Black people with MS have more severe disability upon initial diagnosis,” the researchers wrote.
Comparing walking among white, Black MS patients
Data came from the initial measurements taken during screening for a study (NCT03468868) that included 105 Black and 246 white patients with a diagnosis of MS. Each patient completed two walking tests: a 25-foot timed walk (T25FW) to measure how fast people walk 25 feet (about 7.6 meters) and a six-minute walk (6MW) to measure the distance walked in six minutes.
Black patients were an average of 4.1 years younger than white patients (48.2 vs. 52.3 years). While the difference was small, they scored significantly higher on the Extended Disability Status Scale (EDSS), indicating more severe disease (5.4 vs. 5.2 points). Black patients also walked significantly more slowly on the T25FW test and covered less distance in the 6MW test, indicating less endurance.
Specifically, on the T25FW, Black patients walked at an average speed of 1.75 feet per second, which was 1.16 feet per second slower than white patients. On the 6MW, Black patients walked about 119 feet less than white patients (842.3 vs. 961.5 feet).
After accounting for disease severity and other factors like age, gender, being employed, being covered by health insurance, or being physically active, these differences became slightly smaller, with Black patients walking 0.22 feet per second slower on the T25W test and 82.2 feet less on the 6MW test.
The differences remained significant, however, suggesting these clinical and demographic factors weren’t sufficient to explain them. This is consistent with research showing that Black people with MS perform worse on walking tests regardless of social determinants of health, such as education or income.
“The results of this study might have value for informing future research on mobility-focused rehabilitation modalities for improving walking performance in Black people with MS,” the researchers wrote. “Indeed, rehabilitation is one of the most powerful approaches for restoring walking performance in MS.”
About the Author
