Walking capacity and ability are more impaired in progressive compared to relapsing type of MS

Abstract

Patients with progressive multiple sclerosis (MS) have been attributed greater walking disability than relapsing--remitting MS (RRMS) patients but quantitative data on walking speed and ability are lacking. AIM: to investigate the impact of type of MS on severity of reduced walking ability and capacity taking into account age, sex, height and disease duration. DESIGN: cross--sectional observational multi--center study SETTING: European MS centers providing either in-- or out--patient services, or both. POPULATION: This study included 502 patients: 259, 162 and 81 patients showed RRMS, secondary and primary progressive MS respectively. METHODS: Walking was evaluated by T25FW, six minute walk test and MS--Walking Scale--12. Patient characteristics were compared using a one--way ANOVA, and simple and multivariate regression analysis were applied with the walking measures. RESULTS: In adjusted (sex, age, weight, height and disease duration) analyses, walking impairments were more than 20% greater in progressive types of MS compared to RRMS. There were also indications of greater walking impairment in primary compared to secondary progressive MS patients. CONCLUSION: Clinical walking impairment was larger in progressive compared to relapsing--remitting type of MS. The biological disease mechanism, being degeneration or inflammation, impacts on disability. CLINICAL REHABILITATION IMPACT: Health care professionals must be aware of different severity of walking impairment in progressive compared to relapsing type of MS, and need for intensive treatment. Also, studies must report rehabiltiation effects according to MS type.