Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional Measures in Persons with Multiple Sclerosis

Scalzitti, David A.; Harwood, Kenneth; Maring, Joyce; Leach, Sue; Ruckert, Elizabeth; Costello, Ellen

doi:10.7224/1537-2073.2017-046

Cited by 72 publications

(52 citation statements)

References 30 publications

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“…The 2-minute walk test is a validated alternative to the 6-minute walk test [ 8 ]. The distance travelled in a fixed amount of time is used as a measure of physical function [ 8 ]. An opportunity thus exists as the participant’s gait characteristics remain unexplored.…”

Section: Introductionmentioning

confidence: 99%

Gait Characteristics Harvested during a Smartphone-Based Self-Administered 2-Minute Walk Test in People with Multiple Sclerosis: Test-Retest Reliability and Minimum Detectable Change

Bourke

Scotland²,

Lipsmeier

et al. 2020

Sensors

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The measurement of gait characteristics during a self-administered 2-minute walk test (2MWT), in persons with multiple sclerosis (PwMS), using a single body-worn device, has the potential to provide high-density longitudinal information on disease progression, beyond what is currently measured in the clinician-administered 2MWT. The purpose of this study is to determine the test-retest reliability, standard error of measurement (SEM) and minimum detectable change (MDC) of features calculated on gait characteristics, harvested during a self-administered 2MWT in a home environment, in 51 PwMS and 11 healthy control (HC) subjects over 24 weeks, using a single waist-worn inertial sensor-based smartphone. Excellent, or good to excellent test-retest reliability were observed in 58 of the 92 temporal, spatial and spatiotemporal gait features in PwMS. However, these were less reliable for HCs. Low SEM% and MDC% values were observed for most of the distribution measures for all gait characteristics for PwMS and HCs. This study demonstrates the inter-session test-retest reliability and provides an indication of clinically important change estimates, for interpreting the outcomes of gait characteristics measured using a body-worn smartphone, during a self-administered 2MWT. This system thus provides a reliable measure of gait characteristics in PwMS, supporting its application for the longitudinal assessment of gait deficits in this population.

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Section: Introductionmentioning

confidence: 99%

Gait Characteristics Harvested during a Smartphone-Based Self-Administered 2-Minute Walk Test in People with Multiple Sclerosis: Test-Retest Reliability and Minimum Detectable Change

Bourke

Scotland²,

Lipsmeier

et al. 2020

Sensors

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show abstract

“…Our outcomes permit to assess that a 2-min walking test can be used to quantify the effects only if the ROM of ankle or the gait variability at the hip level are the variables of interest. As a consequence, the absence of statistical difference found in [ 23 ] in terms of blood pressure and heart rate when comparing data gathered from a 2-min walking test and a 6MWT cannot be extended also to all the kinematic parameters. Nevertheless, a shorter walking test could be asked to patients with a high level of disability, i.e., EDSS > 4, since a 6MWT could be arduous to be performed by these patients.…”

Section: Discussionmentioning

confidence: 92%

“…A one-minute walking test was also used to propose synthetic indices based on range of motion and variability able to distinguish between MS patients and healthy subjects [ 22 ]. Although a set of walking tests is available for quantifying fatigue, most of the studies elected the 6-min walking test (6MWT) as the most suitable for the assessment of walking-related fatigue [ 23 ]. Leone et al evaluated the difference related to the distance covered during the first and the last minute of the test, promoting this index as useful for depicting the walking-related fatigue [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Reliability and Repeatability Analysis of Indices to Measure Gait Deterioration in MS Patients during Prolonged Walking

Taborri

Studer

Grossi

et al. 2020

Sensors

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Gait deterioration caused by prolonged walking represents one of the main consequences of multiple sclerosis (MS). This study aims at proposing quantitative indices to measure the gait deterioration effects. The experimental protocol consisted in a 6-min walking test and it involved nine patients with MS and twenty-six healthy subjects. Pathology severity was assessed through the Expanded Disability Status Scale. Seven inertial units were used to gather lower limb kinematics. Gait variability and asymmetry were assessed by coefficient of variation (CoV) and symmetry index (SI), respectively. The evolution of ROM (range of motion), CoV, and SI was computed analyzing data divided into six 60-s subgroups. Maximum difference among subgroups and the difference between the first minute and the remaining five were computed. The indices were analyzed for intra- and inter-day reliability and repeatability. Correlation with clinical scores was also evaluated. Good to excellent reliability was found for all indices. The computed standard deviations allowed us to affirm the good repeatability of the indices. The outcomes suggested walking-related fatigue leads to an always more variable kinematics in MS, in terms of changes in ROM, increase of variability and asymmetry. The hip asymmetry strongly correlated with the clinical disability.

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“…The 6-MWT evaluates the functional capacity but can be considered stressful for pwMS, especially for people with a higher degree of disability. The 2-MWT as a shorter alternative measure, has shown good construct and discriminant validity in pwMS and offers an efficient and practical alternative to the 6-MWT (Scalzitti et al, 2018). In the 2-MWT, patients have to walk continuously for two minutes at a self-selected pace without running.…”

Section: Assessment Of Walking Endurancementioning

confidence: 99%

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

et al. 2020

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Walking impairments represent one of the most debilitating symptom areas for people with multiple sclerosis (MS). It is important to detect even slightest walking impairments in order to start and optimize necessary interventions in time to counteract further progression of the disability. For this reason, a regular monitoring through gait analysis is highly necessary. At advanced stages of MS with significant walking impairment, this assessment is also necessary to optimize symptomatic treatment, choose the most suitable walking aid and plan individualized rehabilitation. In clinical practice, walking impairment is only assessed at higher levels of the disease using e.g., the Expanded Disability Status Scale (EDSS). In contrast to the EDSS, standardized functional tests such as walking speed, walking endurance and balance as well as walking quality and gait-related patient-reported outcomes allow a more holistic and sensitive assessment of walking impairment. In recent years, the MS Center Dresden has established a standardized monitoring procedure for the routine multidimensional assessment of gait and balance disorders. In the following protocol, we present the techniques and procedures for the analysis of gait and balance of people with MS at the MS Center Dresden. Patients are assessed with a multidimensional gait analysis at least once a year. This enables long-term monitoring of walking impairment, which allows early active intervention regarding further progression of disease and improves the current standard clinical practice.

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Validation of the 2-Minute Walk Test with the 6-Minute Walk Test and Other Functional Measures in Persons with Multiple Sclerosis

Abstract: This study demonstrated good construct and discriminant validity of the 2MWT in persons with MS, providing an efficient and practical alternative to the 6MWT. Validation of the 2MWT with other functional measures further supports these findings.

Cited by 72 publications

References 30 publications

Gait Characteristics Harvested during a Smartphone-Based Self-Administered 2-Minute Walk Test in People with Multiple Sclerosis: Test-Retest Reliability and Minimum Detectable Change

Gait Characteristics Harvested during a Smartphone-Based Self-Administered 2-Minute Walk Test in People with Multiple Sclerosis: Test-Retest Reliability and Minimum Detectable Change

Reliability and Repeatability Analysis of Indices to Measure Gait Deterioration in MS Patients during Prolonged Walking

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

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