The Relationship Between Walking Speed and the Energetic Cost of Walking in Persons With Multiple Sclerosis and Healthy Controls: A Systematic Review.
Kyra Theunissen, Guy Plasqui, Annelies Boonen and 5 others
PMID 33847188WHAT IT FOUND
People with multiple sclerosis walk with a higher energetic cost than healthy controls, but their most efficient speed is similar.
Most patients in studies walked slower than this optimal speed, meaning they were working harder than necessary. Training to increase walking speed may reduce this cost.
Key findings
01The most efficient walking speed for people with MS was estimated at 1.44 m/s, which is similar to the optimal speed found for healthy controls.
02At any given speed, people with MS had a higher energetic cost of walking compared to healthy controls.
03The majority of participants in the reviewed studies walked at self-selected speeds slower than the optimal 1.44 m/s, resulting in a higher energetic cost.
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
The quality of the included studies varied, with many lacking blinding of outcome assessors and justification for sample sizes. The analysis relied on converting data from different studies, which may introduce error. The review focused on laboratory-based walking speeds, which may not reflect daily life walking speeds. Few studies included walking speeds above 1.44 m/s, limiting the certainty of the curve at faster speeds.
Declared interests
The authors declared no potential conflicts of interest. The project was funded by a special research fund for doctoral grants.
The easy way to misread this
Do not assume that increasing walking speed is a safe or feasible goal for all patients. The optimal speed of 1.44 m/s was estimated from a group average, and many patients with MS have disabilities that prevent them from reaching this speed safely or comfortably. The review also notes that higher speeds were rarely tested in patients with moderate disability.