Oxygen cost of treadmill and over-ground walking in mildly disabled persons with multiple sclerosis

Motl, Robert W.; Suh, Yoojin; Dlugonski, Deirdre; Weikert, Madeline; Agiovlasitis, Stamatis; Fernhall, Bo; Goldman, Myla D.

doi:10.1007/s10072-010-0396-0

Cited by 53 publications

(75 citation statements)

References 14 publications

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“…In contrast, the PDDS score was not a significant predictor of gross-VO 2 , suggesting that it shared less variance with gross-VO 2 than the MSWS-12 score in the present participants. In support of this argument, PDDS scores have somewhat lower correlation with the oxygen cost per unit distance than MSWS-12 scores [21][22]. PDDS provides a single categorical rating of disease progression [19] and may be less sensitive or specific than the MSWS-12 scale in discriminating walking difficulties between persons with MS with minimal limitations such as the present participants.…”

Section: 1supporting

confidence: 50%

“…The PDDS consists of a single item for measuring self-reported functional impairment, with particular focus on ambulation [19][20]. MSWS-12 and PDDS scores have been positively associated with the energetic cost of walking in persons with MS [21][22]. Both of these scales provide easily derived measures of walking impairment that could improve the accuracy of predicting gross-VO 2 during walking in persons with MS. More accurate prediction of gross-VO 2 may allow exercise professionals to design safer and more effective walking programs for managing symptoms and improving health in persons with MS.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of oxygen uptake during walking in ambulatory persons with multiple sclerosis

2016

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Abstract-People with multiple sclerosis (MS) have an increased rate of gross oxygen uptake (gross-VO 2 ) during treadmill walking, and their gross-VO 2 may further vary with walking impairment. This study attempted to develop an equation for predicting gross-VO 2 from walking speed and an index of walking impairment in persons with MS and examine its accuracy. Gross-VO 2 was measured with open-circuit spirometry in 43 persons with MS (47 +/-9 yr; 38 women) during five treadmill walking trials, each lasting 6 min, at 2.0, 2.5, 3.0, 3.5, and 4.0 mph (0.89, 1.12, 1.34, 1.56, and 1.79 m/s). The 12-Item Multiple Sclerosis Walking Scale (MSWS-12) and the single-item Patient Determined Disease Steps scale (PDDS) provided indices of walking impairment. Multilevel modeling with random intercepts and slopes showed significant effects of speed and MSWS-12 on gross-VO 2 (p  0.014; R 2 = 0.70). PDDS was not a significant predictor. Gross-VO 2 estimated by the regression equation did not differ from actual gross-VO 2 across speeds. Mean absolute prediction error across speeds was 9.1%. The Bland-Altman plot indicated zero mean difference between actual and predicted gross-VO 2 with modest 95% confidence intervals. Therefore, speed and MSWS-12 score are jointly highly predictive of gross-VO 2 during treadmill walking in persons with MS.

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Section: 1supporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Prediction of oxygen uptake during walking in ambulatory persons with multiple sclerosis

2016

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“…Moreover, increased gait variability has clinical significance in PwMS. Motl et al (2011) demonstrated that recurrent fallers (i.e. 1 + falls/year) with MS exhibit greater variability of spatial footfall placement than nonfallers with MS [30].…”

Section: Discussionmentioning

confidence: 98%

The “butterfly diagram”: A gait marker for neurological and cerebellar impairment in people with multiple sclerosis

Kalron

Frid

2015

Journal of the Neurological Sciences

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“…The participant then sat and rested quietly for 5 minutes. After the 5 minutes of rest, the participant undertook three 6-minute periods of walking; this period of walking is consistent with walking endurance protocols used for people with MS 8,9 and is of sufficient duration to achieve steady-state V…”

Section: Protocolmentioning

confidence: 97%

“…Some data indicate that walking impairment may affect accelerometer output and energy expenditure in populations with neurologic disorders. For example, one recent study found that walking impairment was strongly and significantly correlated with oxygen cost of walking across different speeds of treadmill and overground walking in people with MS. 9 Another study indicated that accelerometer output (ie, activity counts) was strongly and significantly associated with walking impairment in individuals with MS. 10 By extension, gait disability may moderate the association between energy expenditure and accelerometer output in people with MS. This would, in turn, indicate that the cut-point for quantifying time spent in MVPA from accelerometer output would vary between groups who differ in level of gait impairment.…”

Section: Gait Disabilitymentioning

confidence: 99%

The Impact of Gait Disability on the Calibration of Accelerometer Output in Adults with Multiple Sclerosis

Weikert

Dlugonski

Suh

et al. 2011

International Journal of MS Care

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Accelerometer activity counts have been correlated with energy expenditure during treadmill walking among ambulatory adults with multiple sclerosis (MS). This study examined the effects of gait disability on 1) the association between rates of energy expenditure and accelerometer output in overground walking and 2) the calibration of accelerometer output for quantifying time spent in moderate-to-vigorous physical activity (MVPA) in people with MS. The sample consisted of 24 individuals with MS, of whom 10 reported gait disability based on Patient-Determined Disease Steps (PDDS) scores. The participants undertook three 6-minute periods of overground walking while wearing an accelerometer and a portable metabolic unit (K4b 2 , Cosmed, Rome, Italy). In the first period of walking, the participants walked at a self-selected, comfortable speed. In the two subsequent walking periods, participants walked at speeds above and below (±0.5 mph) the comfortable walking speed, respectively. Strong linear relationships were observed between rates of accelerometer activity counts and energy expenditure during walking in the overall sample (R 2 = 0.90) and subsamples with (R 2 = 0.88) and without gait disability ( Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease of the central nervous system in which the myelin sheath is irreversibly damaged and axons are transected. 1 Over time, symptoms such as muscle weakness, stiffness, and limb paralysis result from neuronal loss and brain atrophy 2 and typically result in gait disability. Gait disability is reported by approximately 75% of the MS population, 3 and nearly 30% of people with MS progress to a level of gait impairment that requires use of an assistive device within 10 years. 4 The presence of gait disability likely influences the quantification of physical activity among those with MS. 5 Motion sensors such as accelerometers have been considered the ideal tool for quantifying physical activity in the MS population. This is because data from an accelerometer are not influenced by cognitive impairment or self-report bias, which can affect survey data. 5 An accelerometer is a small, lightweight device typically worn on a belt around the waist that quantifies the acceleration of the body's center of mass and expresses bodily movement in activity counts per unit time. Activity counts seem to provide a valid, objective measure of physical activity 5 and have been significantly correlated with self-report, interview, and objective measures of physical activity in individuals with MS. 6,7 There is additional evidence of a strong linear relationship between activity counts and energy expenditure (oxygen consumption; V • O 2 ) during treadmill walking in people with MS. 8 This is important because it satisfies a major assumption of using accelerometers for measuring physical activity, namely, that rates of accelerometer output are strongly associated with rates of energy expenditure during dynamic activity such as walking. 8 It also allows for the generation of...

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Oxygen cost of treadmill and over-ground walking in mildly disabled persons with multiple sclerosis

Cited by 53 publications

References 14 publications

Prediction of oxygen uptake during walking in ambulatory persons with multiple sclerosis

Prediction of oxygen uptake during walking in ambulatory persons with multiple sclerosis

The “butterfly diagram”: A gait marker for neurological and cerebellar impairment in people with multiple sclerosis

The Impact of Gait Disability on the Calibration of Accelerometer Output in Adults with Multiple Sclerosis

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