Correlation of Timed 25-Foot Walk Benchmarks with Disability and Daily Activities in MS

Robert T. Naismith, MD

The Timed 25-Foot Walk is a practical measure of ambulation in multiple sclerosis, with key times indicating disability landmarks.

The Timed 25-Foot Walk (T25FW) is a popular measure of multiple sclerosis (MS) ambulatory function, but its clinical meaningfulness has not been established. Investigators examined the relationship of the T25FW within the MS population to activities of daily living (ADLs), disability, and mobility.

For initial benchmark development, this cross-sectional study first collected questionnaires from about 160 patients on employment, instrumental ADLs, walking devices, and patient-reported outcomes. Next, an additional 95 patients were used as a validation cohort.

Significant differences in clinical outcomes were seen with walking thresholds of 6 and 8 seconds (s). Categorizing normal to mildly impaired as times <6.0 s, moderately impaired as 6.0 to 7.9 s, and severely impaired as ≥8.0 s, the chance of being employed outside the home decreased in the more severely affected patients (59% mild, 29% moderate, 15% severe) and need for government healthcare assistance increased (15% mild, 36% moderate, 62% severe). Independent activities were reduced for grocery shopping (79% mild, 61% moderate, 12% severe), doing housework (63% mild, 25% moderate, 8% severe), and preparing a meal (84% mild, 57% moderate, 30% severe). Worsening T25FW times were associated with shorter 6-minute (m) walk distance (502 m mild, 375 m moderate, 262 m severe), increased need for bilateral support (0% mild, 7% moderate, 40% severe), incurred higher oxygen costs, and decreased the number of steps in the community (5284 mild, 3441 moderate, 2407 severe).