Real-world walking in multiple sclerosis: Separating capacity from behavior.
Matthew M Engelhard, Stephen D Patek, John C Lach and 1 others
PMID 29078135WHAT IT FOUND
In multiple sclerosis, the highest step rate recorded over a week of real-world walking matched clinic walking tests more closely than daily step counts.
Habitual walking step rate and maximum step rate together may separate walking capacity from activity behaviors.
Key findings
01The maximum step rate showed the strongest association with clinical walking outcomes among all habitual activity statistics in MS.
02Habitual walking step rate was similar between controls, mild MS, and moderate MS, but much lower in severe MS.
03The sum of maximum step rate and habitual walking step rate was more closely linked to 6-minute walk step rate than either measure alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it did not show whether the new step-rate measures change patient care or predict outcomes over time. Control subjects were younger than MS subjects, which may have affected group differences and correlations. Only 8.7% of the study population had severe disability, so findings may not apply broadly to severe MS. The final analysed sample after excluding people with fewer than 6 valid wear days is not reported. Habitual walking step rate requires analysis techniques not commonly available to practitioners. The study did not identify which personal, environmental, or social factors drive activity behaviors.
The easy way to misread this
Do not treat daily step count as a direct measure of walking capacity in mild or moderate MS. The paper showed that step counts were linked to fatigue and activity behaviors, while maximum step rate was more closely related to walking tests.