Why walking speed is important
During the course of multiple sclerosis, people may feel that their physical ability is slowly getting worse. A runner may find they can no longer do that extra mile. Or it seems to take more time walking the dog around the block. Or the distance between stores at the mall now seems endless. The change can be slight and maybe no one (including your doctor) notices. But you feel that even on your best days you are not performing quite as well as a year ago.
Doctors use various methods to identify if a person’s MS is getting worse. One way that is becoming increasingly popular is called the Timed 25-Foot Walk (T25FW). As the name implies, it simply clocks the time it takes to walk 25 feet (about 7.6 metres) – which is about 10 steps (depending on the length of your legs).
A new study has looked at whether changes in walking speed can provide an early indication of worsening MS (Kalinowski et al. Mult Scler 2021; epublished June 8, 2021). The source of information was the walking speeds obtained in nine MS trials. The average age of the participants was 42 years old; most had lived with MS for about 6 years; and the average person had mild-to-moderate disability.
The researchers found that walking times varied considerably by age. In younger people (aged 18-30 years), it took about 6 seconds to walk 25 feet. For people in their 30s, the average time was 7.4 seconds; for those in their 40s it was 9.4 seconds; for those in their 50s it was 12.5 seconds; and for those 60 years or older it was 15.2 seconds.
It is important to note that these average times are not the scores to beat – an individual’s time will be influenced by many factors, such as general health, level of physical activity, smoking, other illnesses, and so on. What is important is your own personal time (your baseline) and whether those times change from year to year.
When looking at T25FW times, the usual benchmark that indicates worsening is a 20% change. So if a person can do the walk in a speedy 5 seconds, a slowing to 6 seconds would indicate a significant change. The same would apply to a 10-second walk extended to 12 seconds. However, such changes should not be based on a single poor score. Many factors can slow walking speed during a given test. Your score will be worse on a hot or humid day, at certain times of day, if you are feeling fatigue, or are just having a bad day.
It is also important that the change in walk times is sustained over 3 or 6 months. So if you chart your walk times (at the same time of day under the same conditions) periodically over a 6-month period and notice that it is now taking a second or two longer, it may be an early warning sign that your condition is getting worse.
The study found for most people with relapsing-remitting MS, there was little change in walk times year-to-year. But there was a noticeable increase in year-to-year walk times once a person developed secondary-progressive MS. In fact, a 20% change in T25FW times was often the first indication of progressive disease. While doctors often use a tool called the EDSS scale to evaluate disability, the T25FW revealed early disability before the EDSS scale did in 65% of cases. Identifying early progression is important because it may be possible to slow the rate of disability with a more effective MS treatment.
If you would like to track your times, use a tape measure to mark off a distance of 25 feet (about half the width of the lot size of many homes). This distance should be level and free of obstructions (e.g. rugs) that may trip you up. The timer needs to provide a read-out in seconds. Or use a pedometer, app or other device to measure your time and distance. Walk (do not run) the distance as quickly as possible. Jot down the time of day and your walking times in a journal or spreadsheet. Re-do the test as often as you like (daily, weekly, monthly). If you notice that your walk times are changing significantly from month to month, report your findings to your neurologist.
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