Gait and six-minute walk performance in persons with multiple sclerosis

The six-minute walk (6MW) has been established as a clinic-based, performance measure of walking endurance that reflects community ambulation in multiple sclerosis (MS). Consequently, identifying the contribution of variables to 6MW performance may provide targets for improving real-life walking in MS, and these variables may differ as a function of disability. This study examined cadence and stride length as gait variables that explain differences in 6MW performance between persons with MS and controls, and by level of disability. 256 community-residing persons with MS and 49 non-MS controls performed a standard 6MW test and completed 2 trials of comfortable walking on an electronic walkway for quantifying gait. Regression analyses indicated that cadence and stride length explain differences in 6MW performance between MS and controls, and by level of disability in MS. The contribution of cadence and stride length to walking endurance differed as a function of disability, such that cadence and to a greater extent stride length explained variance in 6MW performance in mild MS, whereas cadence and stride length explained approximately an equivalent amount of variance in 6MW performance in moderate-to-severe MS. We provide evidence for intervention strategies that are specific to disability level to improve walking endurance in MS. (C) 2013 Elsevier B.V. All rights reserved.