2021 CMSC Annual Meeting

Validating the Clinical Usefulness of the Timed 25-Foot Walk in MS in Routine Clinical Practice


Background: Multiple Sclerosis (MS) is a chronic and degenerative autoimmune disease of the central nervous system which can cause disability accumulation, including quite often walking dysfunction. The Timed 25-Foot Walk (T25FW) is an objective measurement of walking disability and is considered one of the best tools available to assess this in persons with MS (PwMS). Studies have shown increases in T25FW of 20% or greater to be both statitstically significant and clinically meaningful. Additionally, PwMS with higher T25FW times were shown to have higher rates of unemployment and higher disability scores than counterparts. Objectives: To determine how a significant change in T25FW measured as >20% increase from prior correlates with the status of the neurological examination and MRI. Also, to further review how the T25FW can be used as an additional clinical tool in the management of PwMS. Methods: A retrospective analysis of all patients within our MS clinic database was performed. Clinic encounters during the abstraction period were reviewed to determine current status of neurological examination and MRI, as it compares to T25FW over time. Results: 78 of the 772 clinic encounters (N= 285 patients) had a significant change in T25FW at the clinic encounter. During the time period where the significant change in T25FW was noted, the following clinic encounters were also noted: 40% had stable neurological examination, 60% had an unstable neurological examination, 60% had stable MRI, 16% had unstable MRI. For clinic encounters without a significant change in T25FW the following was noted, 55.5% had stable neurological examination, 44.5% had unstable neurological examination, 86% had stable MRI, 14% had unstable MRI. When a significant change in T25FW was noted at the clinic encounter there was a statistically significant difference in stability of the neurological examination. A similar trend was seen with MRI status but did not reach statistical significance. Conclusions: The T25FW has long been considered one of the best clinical measures to quantify MS disability over time. Our research adds to this body of evidence by showing that a clinically meaningful change in the T25FW correlated with worsening of the neurological examination. Given its ease of use and relationship to MS-related disability, we strongly encourage the use of the T25FW in routine clinical practice for neurologist treating PwMS.