Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/20702
Title: Prevalence of Walking-Related Motor Fatigue in Persons With Multiple Sclerosis: Decline in Walking Distance Induced by the 6-Minute Walk Test
Authors: LEONE, Carmela 
SEVERIJNS, Deborah 
DOLEZALOVA, Vendula 
BAERT, Ilse 
Dalgas, U.
Romberg, A.
Bethoux, F.
GEBARA, Benoit 
Santoyo Medina, C.
Maamagi, Heigo
Rasova, K.
Maertens-de-Noordhout, Benoit
Knuts, K.
Skjerbaek, A.
Jensen, E.
Wagner, Joanne M.
FEYS, Peter 
Issue Date: 2016
Source: Neurorehabilitation and neural repair, 2015
Abstract: Objective. To investigate the individual occurrence of walking-related motor fatigue in persons with multiple sclerosis (PwMS), according to disability level and disease phenotype. Study design. This was a cross-sectional, multinational study. Participants. They were 208 PwMS from 11 centers with Expanded Disability Status Scale (EDSS) scores up to 6.5. Methods. The percentage change in distance walked (distance walked index, DWI) was calculated between minute 6 and 1 (DWI6-1) of the 6-Minute Walk Test (6MWT). Its magnitude was used to classify participants into 4 subgroups: (1) DWI6-1[≥5%], (2) DWI6-1[5%; –5%], (3) DWI6-1[–5%; > –15%], and (4) DWI6-1[≤−15%]. The latter group was labeled as having walking-related motor fatigue. PwMS were stratified into 5 subgroups based on the EDSS (0-2.5, 3-4, 4.5-5.5, 6, 6.5) and 3 subgroups based on MS phenotype (relapsing remitting [RR], primary progressive [PP], and secondary progressive [SP]). Results. The DWI6-1 was ≥5% in 16 PwMS (7.7%), between 5% and −5% in 70 PwMS (33.6%), between −5% and −15% in 58 PwMS (24%), and ≤−15% in 64 PwMS (30.8%). The prevalence of walking-related motor fatigue (DWI6-1[≤−15%]) was significantly higher among the progressive phenotype (PP = 50% and SP = 39%; RR = 15.6%) and PwMS with higher disability level (EDSS 4.5-5.5 = 48.3%, 6 = 46.3% and 6.5 = 51.5%, compared with EDSS 0-2.5 = 7.8% and 3-4 = 16.7%; P < .05). Stepwise multiple regression analysis indicated that EDSS, but not MS phenotype, explained a significant part of the variance in DWI6-1 (R2 = 0.086; P < .001). Conclusion. More than one-third of PwMS showed walking-related motor fatigue during the 6MWT, with its prevalence greatest in more disabled persons (up to 51%) and in those with progressive MS phenotype (up to 50%). Identification of walking-related motor fatigue may lead to better-tailored interventions.
Notes: Corresponding Author: Carmela Leone, MD, Campus Diepenbeek, University of Hasselt, REVAL Institute, Agoralaan Building A, B-3590, Diepenbeek, Belgium. Email: carmelaleone84@yahoo.it
Keywords: walking; 6-Minute Walk Test; motor fatigue; distance walked index; deceleration index
Document URI: http://hdl.handle.net/1942/20702
ISSN: 1545-9683
e-ISSN: 1552-6844
DOI: 10.1177/1545968315597070
ISI #: 000374350900009
Rights: © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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