Prevalence and magnitude of distance walking fatigability in people with multiple sclerosis

Abstract

Background: To facilitate successful implementation of evidence into occupational therapy (OT) clinical practice, it is important to assess the facilitators and barriers for this process. Objective: To identify key determinants for implementing occupational therapy evidence into multiple sclerosis practice. Method: Through an explorative literature review in five databases (Pubmed, Cinahl, Embase, Eric, OTDbase) and a clinician survey, barriers and facilitators related to the implementation of OT evidence, specific to MS are explored, and strategies to transform barriers into facilitators are outlined. Results: Of 303 screened titles, none explored implementing evidence specifically for OT in multiple sclerosis. Instead, we selected indirect evidence, implementing evidence on OT for any indication. When looking at the broader focus on using OT evidence in general practice, we found relevant indirect evidence (n=11), which is categorized in barriers and facilitators related to innovation , individual professional, patient, social context, organizational context, and economic and political context. Subsequently, a survey was developed based on the identified barriers and facilitators and on existing questionnaires [Evidence Based Practice Questionnaire and short version of Evidence-based Practice Implementation Scales (competencies, beliefs, attitudes-organisations , implementation, self-efficacy)]. The survey was launched in Spring 2024 among occupational therapists working with people with MS. This survey will contextualize the findings of the explorative review to the OT practice with people with MS and allows for prioritizing important implementation determinants and selecting pertinent strategies to address these through a newly developed implementation plan. Conclusion: This study represents a first step in the implementation plan, striving for the empowerment of occupational therapists to enhance their knowledge and align their practices with evidence based interventions, strategically bridging the gap between research findings and practical, real-world application of effective and impactful approaches in occupational therapy settings for individuals with multiple sclerosis. Introduction: Distance walking fatigability (DWF) is a common motor impairment among people with multiple sclerosis (pwMS). It is characterized by a 10% decline in the distance walked during the last minute of the 6-minute walking test (6MWT) compared to the first minute. Despite this known motor impairment, there is still a need for a deeper understanding of the prevalence and extent of DWF in pwMS. Objective: To investigate the magnitude and prevalence of DWF in pwMS. Methods: Two-hundred and two pwMS (EDSS: 4 [0-6.5]) performed the timed 25-foot walking test (T25FW) and; the 6MWT as fast and safe as possible. Minute-by-minute distance walked