Cut-points of the 6-min walk test, the six spot step test, and the timed-25-foot walk test discriminating impaired from non-impaired walking capacity in persons with Multiple sclerosis.

Camilla Juhl, Kasper Byskov, Lars G Hvid, Ulrik Dalgas, Uwe M Pommerich, Anders G Skjerbæk
Author Information
  1. Camilla Juhl: Exercise Biology, Department of Public Health, Aarhus University, Denmark. ORCID
  2. Kasper Byskov: Exercise Biology, Department of Public Health, Aarhus University, Denmark. ORCID
  3. Lars G Hvid: Exercise Biology, Department of Public Health, Aarhus University, Denmark. ORCID
  4. Ulrik Dalgas: Exercise Biology, Department of Public Health, Aarhus University, Denmark. ORCID
  5. Uwe M Pommerich: Hammel Neurorehabilitation Centre, University Research Clinic, Department of Clinical Medicine, Aarhus University, Denmark. ORCID
  6. Anders G Skjerbæk: Exercise Biology, Department of Public Health, Aarhus University, Denmark. ORCID

Abstract

Background: Assessing and interpreting Walking capacity in persons with Multiple sclerosis (PwMS) is essential in clinical practice and research - and thus for PwMS themselves - yet research evaluating cut-points is limited. The present study aims to establish cut-points for 6-min walk test (6MWT), six spot step test (SSST), and timed 25-foot walk test (T25FWT) in PwMS.
Methods: Classification of PwMS having Walking impairments and PwMS having limited or no Walking impairments was based on distinct benchmarks for each Walking test, as derived from the 12-item Multiple sclerosis Walking Scale (MSWS-12) on a 5-point Likert scale. Cut-points, area under the curve (AUC), sensitivity (Se), and specificity (Sp) were established using receiver operating characteristic curve analyses.
Results: A total of  = 211 ambulatory PwMS were enrolled (68% females, 54 ± 11 years, patient-determined disease step 2.9 ± 1.9 [range; 0-7], 65.1% relapse-remitting Multiple sclerosis). The following cut-points between the two groups were established: 6MWT (446 m; AUC = 0.82, Se = 0.87, Sp = 0.78), SSST (0.121 rounds/s (corresponding to 8.3 s); AUC = 0.80, Se = 0.84, Sp = 0.75), and T25FWT (1.39 m/s (corresponding to 5.5 s); AUC = 0.79, Se = 0.89, Sp = 0.69).
Conclusion: Cut-points discriminating PwMS having Walking impairments vs. PwMS having limited or no Walking impairments were identified for 6MWT (446 m), SSST (8.3 s), and T25FWT (5.5 s).

Keywords

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Created with Highcharts 10.0.0testwalkingPwMSMultiplewalksclerosiscut-pointsstepimpairmentscurvelimited6-min6MWTsixspotSSSTT25FWTCut-pointsAUC = 0Se = 0Sp = 0capacitypersonsresearch-timed25-footSclerosisWalkingScalearea446 mcorresponding83 s55 sdiscriminatingBackground:AssessinginterpretingessentialclinicalpracticethusyetevaluatingpresentstudyaimsestablishMethods:Classificationbaseddistinctbenchmarksderived12-itemMSWS-125-pointLikertscaleAUCsensitivitySespecificitySpestablishedusingreceiveroperatingcharacteristicanalysesResults:total = 211ambulatoryenrolled68%females54 ± 11yearspatient-determineddisease29 ± 19[range0-7]651%relapse-remittingfollowingtwogroupsestablished:8287780121rounds/s808475139 m/s798969Conclusion:vsidentifiedtimed-25-footimpairednon-impaired12-itemsROC

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