Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

Chen, Shanshan; Sierra, Salvador; Shin, Yongyun; Goldman, Myla D.

doi:10.3389/fneur.2021.698599

Cited by 14 publications

(17 citation statements)

References 19 publications

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“…On the other hand, in healthy people, we observed a rebound pattern as already described in the literature [ 12 , 25 , 28 ], but we highlighted here that the ST variables’ changes between 6MWT intervals were negligible, i.e., healthy people could maintain their rhythm throughout the 6MWT. Healthy people seemed to conserve abilities to maintain velocity by modulating their two components of velocity: cadence and stride length ( Table 2 ).…”

Section: Discussionsupporting

confidence: 82%

“…Moreover, we observed that PwMS had a different ST walking pattern compared to healthy people (e.g., PwMS had a “constant decline” pattern, i.e., a monotonous decrease in velocity was observed during the 6MWT, whereas a “rebound” pattern was found in the healthy group). These results corroborate and complete previous studies in which only walking velocity was analyzed in PwMS [ 12 , 28 ]. Because the first reliability step was checked and to complementarily confirm the clinical pertinence of our previous results, this study aimed to focus on the analysis of the difference between the ST walking pattern of PwMS and healthy people during specific intervals in the 6MWT.…”

Section: Introductionsupporting

confidence: 91%

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Locomotor Strategy to Perform 6-Minute Walk Test in People with Multiple Sclerosis: A Prospective Observational Study

Hadouiri

Monnet

Gouelle³

et al. 2023

Sensors

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Two-thirds of people with Multiple Sclerosis (PwMS) have walking disabilities. Considering the literature, prolonged tests, such as the 6 min walk test, better reflect their everyday life walking capacities and endurance. However, in most studies, only the distance traveled during the 6MWT was measured. This study aims to analyze spatio-temporal (ST) walking patterns of PwMS and healthy people in the 6MWT. Participants performed a 6MWT with measures of five ST variables during three 1 min intervals (initial: 0′–1′, middle: 2′30″–3′30″, end: 5′–6′) of the 6MWT, using the GAITRite system. Forty-five PwMS and 24 healthy people were included. We observed in PwMS significant changes between initial and final intervals for all ST parameters, whereas healthy people had a rebound pattern but the changes between intervals were rather negligible. Moreover, ST variables’ changes were superior to the standard measurement error only for PwMS between initial and final intervals for all ST parameters. This result suggests that the modification in PwMS’ walking pattern is effectively due to their walking ability and not to a measurement, and suggests that PwMS could not manage their walking efficiently compared to healthy people, who could maintain their rhythm throughout the 6MWT. Further studies are needed to detect these patterns changes in the early evolution of the disease, identify clinical determinants involved in PwMS’ walking pattern, and investigate whether interventions can positively impact this pattern.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionsupporting

confidence: 91%

Locomotor Strategy to Perform 6-Minute Walk Test in People with Multiple Sclerosis: A Prospective Observational Study

Hadouiri

Monnet

Gouelle³

et al. 2023

Sensors

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“…Patients with MS walk slower and their speed declines faster over time than that of healthy controls ( 59 , 60 ). In contrast, some, although not all studies that assessed isolated muscle fatigability did demonstrate significant differences in force decline during voluntary contractions between MS patients and healthy controls ( 52 , 57 , 61 ).…”

Section: Current Concepts Of Motor Fatigue In Ms: Definitions Assessm...mentioning

confidence: 99%

The pathophysiology of motor fatigue and fatigability in multiple sclerosis

Patejdl

Zettl

2022

Front. Neurol.

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Multiple Sclerosis (MS) is a heterogeneous immune mediated disease of the central nervous system (CNS). Fatigue is one of the most common and disabling symptom of MS. It interferes with daily activities on the level of cognition and motor endurance. Motor fatigue can either result from lesions in cortical networks or motor pathways (“primary fatigue”) or it may be a consequence of detraining with subsequent adaptions of muscle and autonomic function. Programmed exercise interventions are used frequently to increase physical fitness in MS-patients. Studies investigating the effects of training on aerobic capacity, objective endurance and perceived fatigability have yielded heterogenous results, most likely due to the heterogeneity of interventions and patients, but probably also due to the non-uniform pathophysiology of fatigability among MS-patients. The aim of this review is to summarize the current knowledge on the pathophysiology of motor fatigability with special reference to the basic exercise physiology that underlies our understanding of both pathogenesis and treatment interventions.

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“… 5 It has been previously reported that quadriceps dysfunction results in a series of consequences such as aggravated dyspnea symptoms, reduced muscular capacity and endurance. 6 , 7 Various clinical features are commonly used to evaluate the physical performance of a given patient, including the Six-Minute Walk Test (6MWT) 8 to assess muscular endurance, the Five-Repetition Sit-to-Stand Test (5STS) 9 to reflect the muscle strength, the COPD Assessment Test (CAT) 10 and the modified British Medical Research Council score (mMRC) to evaluate the patient’s overall health and dyspnea. Although the translated CAT and mMRC questionnaires are simple and easy to fill in, there are still subjective differences in the understanding of breathing difficulties and physical condition between different patients.…”

Section: Introductionmentioning

confidence: 99%

SWEmean of Quadriceps, a Potential Index of Complication Evaluation to Patients with Chronic Obstructive Pulmonary Disease

Niu¹,

Yue²,

Zheng³

et al. 2022

COPD

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To develop a potential quadriceps' index of complication evaluation for patients with chronic obstructive pulmonary disease (COPD) which is simple, convenient, and quantifiable. Patients and Methods: We conducted a prospective study of 59 patients with COPD and 56 healthy controls recruited by the Chengdu First People's Hospital. Grayscale ultrasound (US) of the rectus femoris was performed to measure thickness (RF thick ) and cross-sectional area (RF csa ). Shear wave elastography was used to determine the mean elasticity index (SWE mean ) of the rectus femoris (SWE RFmean ), vastus lateralis (SWE VLmean ) and vastus medialis (SWE VMmean ). Clinical features included dyspnea index score (modified British Medical Research Council (MMRC) score), the Five-Repetition Sit-to-Stand Test (5STS) and the Six-Minute Walk Test (6MWT). We compared the differences between US parameters and SWEmean in healthy controls and COPD patients. We also described the correlation between US parameters, SWE mean and clinical features of patients with COPD. Results: The intra-observer repeatability for the performance of using SWE to measure quadriceps stiffness was excellent (intraclass correlation coefficient (ICC)>0.75, p < 0.001). There was a statistically significant difference in the SWE mean of the quadriceps (p < 0.001), but no significant difference in terms of RF thic and RF csa (p > 0.05) between healthy controls and COPD patients. The SWE RFmean was positively correlated with the 6MWT (r = 0.959, p < 0.001), and negatively related to the mMRC (r=−0.825, p < 0.001), CAT (r=−0.993, p < 0.001) and 5STS (r=−0.936, p < 0.001). However, the RF thic , RF csa , SWE VLmean and SWE VMmean were not correlated with clinical features (p > 0.05). Conclusion: As a supplement to US, SWE reflects changes of stiffness in the quadriceps of COPD patients, and can expanding the dimension of US for assessing the quadriceps. Furthermore, SWE mean was associated with clinical features, and represents a potential index with which to reflect the clinical features of COPD patients.

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Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

Cited by 14 publications

References 19 publications

Locomotor Strategy to Perform 6-Minute Walk Test in People with Multiple Sclerosis: A Prospective Observational Study

Locomotor Strategy to Perform 6-Minute Walk Test in People with Multiple Sclerosis: A Prospective Observational Study

The pathophysiology of motor fatigue and fatigability in multiple sclerosis

SWEmean of Quadriceps, a Potential Index of Complication Evaluation to Patients with Chronic Obstructive Pulmonary Disease

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