Relative aerobic load of walking in people with multiple sclerosis.
Arianne S Gravesteijn, Sjoerd T Timmermans, Jip Aarts and 4 others
PMID 38353255WHAT IT FOUND
Walking at a comfortable pace demands 60% of peak aerobic capacity for people with MS, a level considered high.
Almost one-third exceed their ventilatory threshold, meaning daily walking causes physiological exhaustion. This suggests patients may be walking too fast for their fitness.
Key findings
01The mean relative aerobic load of walking was 60.0% of peak oxygen uptake and 89.1% of the first ventilatory threshold.
0214 participants (31%) walked above their first ventilatory threshold during the comfortable walk test.
03Higher disease severity (EDSS) was significantly associated with a higher relative aerobic load expressed as %V̇O2peak.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Aerobic capacity was measured on a cycle ergometer, while walking was assessed overground. This mismatch may affect the accuracy of the relative load calculation. The study used a cross-sectional design, so it cannot determine if reducing walking speed or improving fitness actually lowers the relative load or improves outcomes. Reference values for healthy controls vary, making it difficult to precisely categorize how 'abnormal' the participants' aerobic capacity was. The sample size was small (45 participants) and drawn from two specific cohorts, which may limit generalizability. The study did not account for dual-tasking or uneven surfaces, which are common in daily life and likely increase the aerobic load further.
Declared interests
The study was part of the Exercise PRO-MS project and the Clinical Care Protocol for Gait Disorders in MS. Ethics approval was obtained for the PRO-MS study, while the clinical care cohort had a waiver. The text does not explicitly state funding sources or author conflicts of interest in the provided sentences.
The easy way to misread this
Do not assume that a patient's 'comfortable' walking speed is sustainable or easy for them. A significant portion of people with MS walk at a pace that exceeds their aerobic threshold, causing physiological strain that may not be obvious from their speed alone.