How do walking tests help evaluate multiple sclerosis progression. What are the different types of MS walking tests available. How do doctors use walking test results to assess treatment effectiveness. What is the 12-item multiple sclerosis walking scale and how does it work.

Understanding Multiple Sclerosis and Its Impact on Mobility

Multiple sclerosis (MS) is a complex autoimmune condition that affects the central nervous system, causing a wide range of symptoms that can significantly impact a person’s mobility. As the disease progresses, it can lead to varying degrees of disability, making it crucial for healthcare providers to regularly assess patients’ functional abilities, particularly their walking capacity.

Why is walking ability so important in MS management? Walking speed and endurance are key indicators of overall mobility and independence. A decline in walking ability often correlates with increased disability and can predict long-term outcomes for individuals with MS. By regularly evaluating walking performance, doctors can:

• Track disease progression
• Assess the effectiveness of current treatments
• Identify early signs of functional decline
• Make informed decisions about treatment adjustments
• Set realistic goals for rehabilitation and therapy

The 10-Meter Walking Test: A Quick Measure of Functional Mobility

One of the most commonly used assessments for MS patients is the 10-meter walking test. This simple yet effective evaluation provides valuable insights into a person’s functional mobility and gait characteristics.

How is the 10-meter walking test conducted?

The test involves walking a distance of 10 meters (approximately 33 feet) while being timed. Patients are typically instructed to walk at their comfortable, natural pace. The use of assistive devices such as canes or walkers is allowed, but the level of assistance is documented as part of the assessment.

Doctors categorize the level of assistance required as:

• No assistance
• Minimal assistance
• Moderate assistance

By comparing the time taken to complete the 10-meter walk with normative data from individuals without disabilities, healthcare providers can gauge the extent of mobility impairment. Additionally, comparing results over time allows for the monitoring of disease progression or improvement in response to treatment.

The Timed 25-Foot Walk Test: Assessing Speed and Endurance

Another widely used assessment in MS management is the Timed 25-Foot Walk (T25FW) test. This evaluation is part of the Multiple Sclerosis Functional Composite (MSFC), a comprehensive assessment tool used to track MS progression.

What distinguishes the T25FW from other walking tests?

The T25FW focuses on both speed and short-distance endurance. Unlike the 10-meter test, patients are instructed to walk as quickly as they safely can for a distance of 25 feet (approximately 7.62 meters). The test is typically performed twice, with the patient walking 25 feet in one direction and then returning to the starting point.

Key aspects of the T25FW include:

• Measurement starts at the first step and ends when the foot crosses the 25-foot mark
• Use of assistive devices is allowed but must be consistent between tests
• Results are averaged from two trials for increased accuracy
• Changes in performance over time can indicate disease progression or treatment efficacy

The 6-Meter Walking Test: A Compact Alternative for Limited Spaces

In situations where space is limited, such as small clinical offices or home health settings, the 6-meter walking test offers a viable alternative to longer distance assessments.

How does the 6-meter test compare to other walking assessments?

The 6-meter walking test follows a similar protocol to the 10-meter and 25-foot tests but over a shorter distance. Patients are instructed to walk 6 meters (approximately 19.7 feet) as quickly as they can while being timed. This compact test can provide valuable information about functional mobility, especially when longer courses are not feasible.

A 2014 study highlighted the potential benefits of the 6-meter test, suggesting that it may be particularly useful in settings with space constraints. The shorter distance allows for quick administration while still providing meaningful data on walking speed and functional capacity.

The 500-Meter Walk Test: Evaluating Extended Endurance

For a more comprehensive assessment of walking endurance, some healthcare providers utilize the Timed 500-Meter Walk Test (T500MW). This extended evaluation is often incorporated into the Expanded Disability Status Scale (EDSS), a widely used measure of disability in MS.

What unique insights does the T500MW provide?

The T500MW assesses a patient’s ability to maintain walking speed and endurance over a longer distance. This test can reveal:

• Fatigue patterns during extended walking
• Overall cardiovascular endurance
• The impact of MS symptoms on long-distance mobility
• Functional limitations in daily activities requiring sustained walking

By evaluating performance over a greater distance, healthcare providers can gain a more comprehensive understanding of how MS affects a patient’s mobility in real-world scenarios that require prolonged walking.

The 12-Item Multiple Sclerosis Walking Scale: A Patient-Reported Outcome Measure

While objective walking tests provide valuable data, the 12-Item Multiple Sclerosis Walking Scale (MSWS-12) offers a unique perspective by incorporating the patient’s own assessment of their walking ability.

How does the MSWS-12 differ from other walking tests?

The MSWS-12 is a self-reported questionnaire that asks patients to evaluate how MS has impacted various aspects of their walking ability over the past two weeks. This comprehensive assessment covers multiple dimensions of mobility, including:

• Walking speed
• Balance while walking
• Ability to climb stairs
• Need for support or assistive devices
• Overall effort required for walking
• Limitations in running or walking long distances

Each item on the questionnaire is scored, and the combined scores provide an overall measure of how severely walking is affected by MS from the patient’s perspective. This patient-reported outcome can offer insights into the subjective experience of mobility limitations that may not be captured by objective walking tests alone.

Interpreting Walking Test Results: From Data to Clinical Decisions

The various walking tests used in MS management provide a wealth of data, but the true value lies in how this information is interpreted and applied to patient care.

How do healthcare providers use walking test results to guide treatment?

Walking test results serve multiple purposes in MS management:

1. Establishing a baseline: Initial test results provide a reference point for future comparisons.
2. Monitoring disease progression: Changes in walking speed or endurance over time can indicate worsening of MS symptoms.
3. Assessing treatment efficacy: Improvements in walking test performance may suggest that current treatments are effective.
4. Guiding rehabilitation: Test results can help physical therapists tailor exercise programs to address specific mobility challenges.
5. Informing treatment decisions: Significant declines in walking ability may prompt discussions about modifying disease-modifying therapies or exploring new treatment options.

It’s important to note that walking tests are just one component of a comprehensive MS assessment. Healthcare providers consider these results alongside other clinical measures, imaging studies, and patient-reported outcomes to form a complete picture of an individual’s MS status and progression.

Beyond Walking Tests: Complementary Assessments in MS Management

While walking tests provide crucial information about mobility, a holistic approach to MS management involves a range of additional assessments and interventions.

What other evaluations complement walking tests in MS care?

Comprehensive MS management often includes:

• Neurological examinations to assess sensory and motor function
• Cognitive assessments to evaluate mental processing speed and memory
• Magnetic Resonance Imaging (MRI) to monitor brain and spinal cord lesions
• Quality of life questionnaires to gauge the overall impact of MS on daily living
• Fatigue scales to measure the severity and impact of MS-related fatigue
• Balance and coordination tests to assess other aspects of physical function

By combining these assessments with walking tests, healthcare providers can develop a comprehensive understanding of how MS affects each individual patient. This multifaceted approach allows for personalized treatment plans that address the full spectrum of MS symptoms and their impact on daily life.

As research in MS continues to advance, new assessment tools and treatment strategies are constantly emerging. The goal remains to provide individuals with MS the best possible care, maximizing their quality of life and maintaining their independence for as long as possible. Regular walking tests, in conjunction with other evaluations, play a crucial role in achieving this objective by providing timely, actionable insights into disease progression and treatment effectiveness.

Multiple Sclerosis Walking Test: 12-Item and More

Multiple sclerosis (MS) is a condition that causes your immune system to attack the protective covering of your nerves.

The condition affects people differently, causing mild to moderate symptoms in some, and more severe symptoms in others.

Since MS can progress and become debilitating, it’s important to contact your doctor regularly, even if you have mild symptoms. This allows your doctor to monitor your health and level of disability.

A walking test is one technique doctors use to gauge MS progression and disability. This can include walking for a certain distance or time or a 12-item walking questionnaire.

The results of these tests also help doctors assess the effectiveness of therapy.

This test entails walking a certain distance with or without an assistive device. Your doctor will time how long it takes you to get from point A to point B.

Since MS affects parts of your brain and spinal cord that control mobility, you may experience a slow, gradual decline in your ability to walk. A walking test, however, is designed to identify variances in your mobility early.

Maintaining independence is important for many people living with multiple sclerosis, which often involves the ability to walk and complete other activities with minimal assistance.

A slower walking speed often indicates limited mobility, which could be a predictor for disability in the long term.

Your doctor will compare your speed with the speed that a person without a disability walks in the same span of time. Understanding your current abilities will help determine appropriate treatment.

Your doctor will also compare your results with the results of prior tests, to see the changes over time. This can help them evaluate whether treatment is effective or needs to be adjusted.

Treatment for MS focuses on reducing inflammation in your central nervous system. This can slow the progression of the condition and promote remission. This is a period when symptoms disappear.

Achieving remission often involves the use of medications that modify the condition and anti-inflammatory medications to reduce inflammation, as well as immunosuppressant medications to suppress your immune system.

Your doctor may recommend a 10-meter walking test. This allows them to assess functional mobility, as well as your gait.

These walk tests are typical with MS and other conditions like Parkinson’s disease, stroke, and spinal cord injuries.

You’ll be instructed to walk 10 meters. You can even use a cane or walker, although your doctor will document the level of assistance. They’ll note whether you need:

• minimal assistance
• no assistance
• moderate assistance

The amount of time it takes you to walk 10 meters helps your doctor better understand the extent of your condition.

Your doctor might also suggest a timed 25-foot walking test, sometimes shortened to T25FW or T25-FW.

This walking test is slightly different because it involves walking 25 feet as quickly as you can, with or without an assistive device.

For this test, you’ll start on a marked 25-foot course. The test starts once you take the first step, and stops once your foot hits the 25-foot mark. You’ll likely walk 25 feet in one direction, and 25 feet back to the starting point.

According to the National Multiple Sclerosis Society, the 25-foot timed walking test is part of the multiple sclerosis functional composite (MSFC), an assessment in three parts that providers can use to track progression.

Another test, the timed 500-meter walk (T500MW), may also be used as part of the expanded disability status scale (EDSS), according to the National Multiple Sclerosis Society.

An alternative to the 10-meter and 25-foot walk test is the 6-meter walking test.

The concept behind this walking test is the same as the others — starting at a designated marker, and walking a distance (in this case, 6 meters) as fast as you can. Your doctor tracks how long it takes to walk a shorter distance.

Likewise, this walk test measures functional mobility. If it takes you longer to walk 6 meters compared to an adult without a disability, you might have some functional decline.

A 2014 study showed that 6-meter walking test may be more useful in settings where a longer course isn’t available, like in smaller offices or home health situations.

Another method of evaluation is the 12-item multiple sclerosis walking scale (MSWS-12).

According to the Shirley Ryan AbilityLab, the MSWS-12 involves a self-report you’ll complete regarding how much MS is currently impacting your ability to walk. Questions focus not only on speed, but also on:

• climbing stairs
• balance
• the use of supports
• overall effort needed for walking

Each answer on the report receives a number value, and these are combined to give an overall score that reflects how severely walking is currently impacted.

Because MS affects people differently, a walking test is one way for doctors to determine the condition’s progression and assess whether a particular treatment is working.

An inability to quickly walk short distances also points to physical or functional limitations that might qualify you for supplemental disability insurance, or indicate a need to switch occupations or consider other rehabilitation.

Doctors can’t always gauge the condition’s progression by simply looking at you. And sometimes, mobility variances aren’t apparent until you complete a walking test.

Walking tests have the benefit of being inexpensive and easy to implement, making them a useful tool for doctors to evaluate your current status.

But although effective, a walking test isn’t the only way to measure disability and MS progression.

Doctors must take other factors into consideration, too, such as whether you have other conditions that can slow walking speed. These conditions might include arthritis or chronic back pain.

They’ll also take age into consideration. Younger adults with MS may walk at a faster speed than older adults with the condition.

The bottom line is that walking tests provide clues about mobility. But you shouldn’t rely solely on the results from conducting your own test at home. Schedule an appointment with a doctor for an accurate walking test.

Your doctor can track your progress over time. They can use your initial walk test as a benchmark, and then use subsequent tests to calculate whether your walking time increases or decreases.

Due to the progressive nature of MS, your walking speed can gradually decline without you realizing.

Alternatively, your walking speed may improve with successful treatment. Your doctor can also evaluate other factors that may impact changes to your walking test.

Walking tests don’t take a lot of time to complete. You can usually finish one in under 10 minutes, and the testing is likely covered under health insurance.

MS can be debilitating, yet the right treatment and lifestyle changes may improve your symptoms and your daily life experiences.

Schedule regular follow-up appointments with your doctor for evaluations like walking tests. This will help you work together to:

• track your symptoms
• look for signs of the condition’s progression
• adjust your treatment as necessary

Multiple Sclerosis Walking Test: 12-Item and More

Multiple sclerosis (MS) is a condition that causes your immune system to attack the protective covering of your nerves.

The condition affects people differently, causing mild to moderate symptoms in some, and more severe symptoms in others.

Since MS can progress and become debilitating, it’s important to contact your doctor regularly, even if you have mild symptoms. This allows your doctor to monitor your health and level of disability.

A walking test is one technique doctors use to gauge MS progression and disability. This can include walking for a certain distance or time or a 12-item walking questionnaire.

The results of these tests also help doctors assess the effectiveness of therapy.

This test entails walking a certain distance with or without an assistive device. Your doctor will time how long it takes you to get from point A to point B.

Since MS affects parts of your brain and spinal cord that control mobility, you may experience a slow, gradual decline in your ability to walk. A walking test, however, is designed to identify variances in your mobility early.

Maintaining independence is important for many people living with multiple sclerosis, which often involves the ability to walk and complete other activities with minimal assistance.

A slower walking speed often indicates limited mobility, which could be a predictor for disability in the long term.

Your doctor will compare your speed with the speed that a person without a disability walks in the same span of time. Understanding your current abilities will help determine appropriate treatment.

Your doctor will also compare your results with the results of prior tests, to see the changes over time. This can help them evaluate whether treatment is effective or needs to be adjusted.

Treatment for MS focuses on reducing inflammation in your central nervous system. This can slow the progression of the condition and promote remission. This is a period when symptoms disappear.

Achieving remission often involves the use of medications that modify the condition and anti-inflammatory medications to reduce inflammation, as well as immunosuppressant medications to suppress your immune system.

Your doctor may recommend a 10-meter walking test. This allows them to assess functional mobility, as well as your gait.

These walk tests are typical with MS and other conditions like Parkinson’s disease, stroke, and spinal cord injuries.

You’ll be instructed to walk 10 meters. You can even use a cane or walker, although your doctor will document the level of assistance. They’ll note whether you need:

• minimal assistance
• no assistance
• moderate assistance

The amount of time it takes you to walk 10 meters helps your doctor better understand the extent of your condition.

Your doctor might also suggest a timed 25-foot walking test, sometimes shortened to T25FW or T25-FW.

This walking test is slightly different because it involves walking 25 feet as quickly as you can, with or without an assistive device.

For this test, you’ll start on a marked 25-foot course. The test starts once you take the first step, and stops once your foot hits the 25-foot mark. You’ll likely walk 25 feet in one direction, and 25 feet back to the starting point.

According to the National Multiple Sclerosis Society, the 25-foot timed walking test is part of the multiple sclerosis functional composite (MSFC), an assessment in three parts that providers can use to track progression.

Another test, the timed 500-meter walk (T500MW), may also be used as part of the expanded disability status scale (EDSS), according to the National Multiple Sclerosis Society.

An alternative to the 10-meter and 25-foot walk test is the 6-meter walking test.

The concept behind this walking test is the same as the others — starting at a designated marker, and walking a distance (in this case, 6 meters) as fast as you can. Your doctor tracks how long it takes to walk a shorter distance.

Likewise, this walk test measures functional mobility. If it takes you longer to walk 6 meters compared to an adult without a disability, you might have some functional decline.

A 2014 study showed that 6-meter walking test may be more useful in settings where a longer course isn’t available, like in smaller offices or home health situations.

Another method of evaluation is the 12-item multiple sclerosis walking scale (MSWS-12).

According to the Shirley Ryan AbilityLab, the MSWS-12 involves a self-report you’ll complete regarding how much MS is currently impacting your ability to walk. Questions focus not only on speed, but also on:

• climbing stairs
• balance
• the use of supports
• overall effort needed for walking

Each answer on the report receives a number value, and these are combined to give an overall score that reflects how severely walking is currently impacted.

Because MS affects people differently, a walking test is one way for doctors to determine the condition’s progression and assess whether a particular treatment is working.

An inability to quickly walk short distances also points to physical or functional limitations that might qualify you for supplemental disability insurance, or indicate a need to switch occupations or consider other rehabilitation.

Doctors can’t always gauge the condition’s progression by simply looking at you. And sometimes, mobility variances aren’t apparent until you complete a walking test.

Walking tests have the benefit of being inexpensive and easy to implement, making them a useful tool for doctors to evaluate your current status.

But although effective, a walking test isn’t the only way to measure disability and MS progression.

Doctors must take other factors into consideration, too, such as whether you have other conditions that can slow walking speed. These conditions might include arthritis or chronic back pain.

They’ll also take age into consideration. Younger adults with MS may walk at a faster speed than older adults with the condition.

The bottom line is that walking tests provide clues about mobility. But you shouldn’t rely solely on the results from conducting your own test at home. Schedule an appointment with a doctor for an accurate walking test.

Your doctor can track your progress over time. They can use your initial walk test as a benchmark, and then use subsequent tests to calculate whether your walking time increases or decreases.

Due to the progressive nature of MS, your walking speed can gradually decline without you realizing.

Alternatively, your walking speed may improve with successful treatment. Your doctor can also evaluate other factors that may impact changes to your walking test.

Walking tests don’t take a lot of time to complete. You can usually finish one in under 10 minutes, and the testing is likely covered under health insurance.

MS can be debilitating, yet the right treatment and lifestyle changes may improve your symptoms and your daily life experiences.

Schedule regular follow-up appointments with your doctor for evaluations like walking tests. This will help you work together to:

• track your symptoms
• look for signs of the condition’s progression
• adjust your treatment as necessary

Walking disorders in multiple sclerosis – questions for a neurologist

– Is it possible to permanently stop the progression of multiple sclerosis and reverse its symptoms?
— Today, multiple sclerosis is a chronic disease that is associated with a defect in the immune system due to genetic predisposition and environmental influences. As a result of the combination of these two factors, a breakdown occurs in the immune system, and this leads to the fact that the immune system changes forever and it is impossible to return it to its previous state. If damage to the nervous system has occurred due to the aggression of immune cells, then these damages cannot be reversed, even taking into account the natural mechanism of regeneration and the development of methods of treatment. Therefore, while it is impossible to fully restore the lost functions.

The good news is that we have every reason to believe that modern drugs will stop the course of the disease. In a number of studies, when using certain drugs in certain groups of patients, data were obtained that some functions improve, but are not fully restored – this applies to both walking and cognitive function. In practice, we meet cases when the use of an immunomodulator leads to an improvement in the condition, but in rare situations there is a persistent deficiency, and in these cases we cannot count on a complete recovery. But that doesn’t mean we shouldn’t strive to improve the function. The fact is that it depends not only on the restoration of damaged areas, but on how the surviving areas take on the function of the damaged ones. This is precisely the essence of rehabilitation – with a preserved defect, it tries to restore the function and allows it to be significantly improved.

Which immunomodulators have the most negative effect on walking and balance?
– Sometimes after an injection of interferons there is general weakness and fever, due to which a person cannot walk as before. With newer drugs like ocrelizumab, muscle pain and weakness can occur in the first days after the infusion. These are short-term post-injection and post-infusion reactions to the general condition, but in the long run there is no such effect on the mechanisms of walking. On the contrary, these drugs slow down the course of the disease and walking disorders.

— What is ataxia and why is this word often heard from doctors in relation to walking in multiple sclerosis?
– Ataxia, in short, is unsteadiness, the inability to clearly walk in a straight line. Sometimes such a gait is even called “drunk”. If roughly divided, then ataxia is associated with the fact that sensitivity is impaired, that is, a person does not feel well on which surface he steps on or does not feel the feedback from the joints and muscles when he performs a movement. In this case, we are talking about ataxia associated with impaired sensitivity, and this may be the case if the foci of multiple sclerosis are located in the spinal cord.

But ataxia can also be due to damage to the cerebellum – signals from the brain to the spinal cord are transmitted through the cerebellum, and these signals are refined along the way. If the cerebellum does not work well, then the movements are inaccurate and this very unsteadiness appears.

– Is there any connection between the deterioration of walking and the presence of lesions in the lower part of the thoracic region on MRI?
– Yes, lesions in the spinal cord are often the cause of walking disorders, because they cause a violation of sensitivity, which I mentioned a little higher. In addition, they can cause weakness in the legs.
Why do we highlight the spinal cord like that? In the brain, sufficiently large areas are responsible for movement, and a small focus there can either cause no tangible damage at all, or little damage, because the area is large. But in the spinal cord, all the conductors are arranged very tightly, so a small focus in the spinal cord of the same size can cause much more unpleasant consequences. So we single out changes in the spinal cord separately.

– Some patients say that sometimes after running or even walking fast, everything around them can rotate. Why is this happening?
— It is rotation that most often results from damage to the connections between the vestibular apparatus and the brain. These are also foci that fall into these neural connections: the vestibular apparatus transmits information about the position of the body in space incorrectly, and as a result, the brain feels it as dizziness.
If we talk about running, then there are different moments. First, dizziness may be associated with a greater load on the vestibular apparatus during active movement. So, if you sit, lie down or walk slowly, then the signals come with a lower frequency and damage to this conduction does not affect your well-being so much. Secondly, an increase in body temperature can lead to a worsening of certain symptoms that bothered you before. Why is this happening? Because an increase in temperature in the focus zone leads to an even greater deterioration in conduction. People say that after running, their vision worsens in the eye where optic neuritis used to be, and then it is restored. The same effect may be here.

— What to do about dizziness?
— If this dizziness is absent at rest and in ordinary life, then taking any special preparations is hardly appropriate, because this condition is clearly provoked by vigorous activity. In this regard, the recommendations are as follows. The first is not to perform active activities in hot and poorly ventilated rooms, but it is better to practice outdoors without the risk of falls. Secondly, rehabilitation is needed, in particular, training aimed at improving balance. As part of rehabilitation, the brain rewires itself to include new connections that allow healthier parts of the brain to take over the poorly performing function. Therefore, in such situations, vestibular rehabilitation is a completely adequate approach.

– Can I take Betahistine for dizziness?
– It depends on the nature of the vertigo. If it is permanent, then you can try, there is evidence that the drug is effective, but in general, rehabilitation, in particular vestibular, cannot be neglected, because this is an important component of improving the condition. Betahistine can be taken during rehabilitation.

— To what extent are walking disorders in multiple sclerosis associated with spinal hernia, if it is not yet possible to diagnose it?
– In most cases, a hernia, especially one that affects walking, can be identified by a specialist during an examination – this does not require an MRI. The specialist may find sensory disturbances characteristic of nerve root compression, or weakness. It is highly likely that a hernia affects walking, even if you have MS symptoms that make it difficult to diagnose a hernia, but nevertheless, you still need to go to a neurologist.

— If unsteadiness is combined with spasticity in the legs, can a spinal hernia be the cause of such disorders?
– Unsteadiness and impaired tone are not a sign of a hernia, and the cause is most likely multiple sclerosis. As for treatment, I already said that in terms of gait, physical therapy is still quite an effective story and can significantly improve walking.

— Is it possible to start taking thioctic acid on your own in case of sensitivity disorders? And is it possible to drink it for prevention?
— Definitely not for prevention. Numbness can be caused by anything, including the already mentioned compression of the nerve root. If these are severe symptoms, then perhaps we will talk about the use of hormones, but you can drink thioctic acid as a symptomatic therapy.

– Fampira or Kinesia?
– This is a question of whether to take the generic Kinesia or the original Fampira. This is the age old question about generics. There is no evidence that Kinesia is worse. For many it is effective. This is an extremely simple active substance, it is difficult to make a mistake in the synthesis process. The original powder is very cheap. In Germany, I came across the fact that in a pharmacy you can buy this powder at a very low price.
The company that makes Fampyra created a long-release capsule because the drug itself is very short-acting. They have patented it and are selling it for a lot of money. With the production of this drug is quite difficult to make a mistake. It is not a biological drug when it comes to generics in which the substance is produced in cell culture. There is even separate legislation in the West for generics. Such drugs are much easier to manufacture and much less likely that the generic will be worse.

– How to determine the dosage and take Fampira / Kinesia – in courses or with breaks?
– There is a starting rule – start at 10mg twice a day for two to four weeks and then evaluate the effectiveness of the drug on the results of a 25-foot walking test. In fact, which test is not important. If you can walk for six minutes without stopping, then do a 6-minute walk test or a 2-minute walk test. The main thing is to somehow objectify the improvement or its absence when taking the drug. That is, you do a test, then you take the drug for two weeks, and then you do the same test again. If the result has improved by 10% or more, then the drug is working, it makes sense to take it. This drug is symptomatic and works only while you are drinking it – it acts on channels in the sheaths of nerve cells, and while you are taking it, there is an effect. With the termination of reception, the initial state returns. It can be taken for a long time, there are no contraindications to long-term use. But tolerance is also bad, like any other drug.

— Another question about vertigo — how often is benign paroxysmal positional vertigo (BPPV) caused in MS? And what to do with it?
– BPPV occurs in the general population in 3% of people, and during the year – in 1-2%. The risk of this condition does not increase in any way with multiple sclerosis. BPPV has its own diagnostic criteria, but to understand whether it is or not, you just need to go to the doctor. This is a common problem in neurological patients in general, but the risk of this problem is not increased in MS.

— After covid, walking becomes worse in many patients — unsteadiness increases, dizziness appears. Is there any therapy besides physical activity and exercise therapy?
— The question of covid is complex, there is no direct answer to it. The main answer is that covid can lead to other neurological problems, more or less serious, that require separate diagnosis and treatment, including in patients with MS, for example, polyneuropathy. Most often, people develop post-covid syndrome, which is now being actively studied and attempts are being made to cope with it.
Post-COVID syndrome is believed to have two main mechanisms. The first is a violation of blood clotting, which persists even in the post-COVID period and can lead to a variety of consequences, including thrombosis of the veins of the brain or lungs. The second mechanism is neuroinflammation, some additional processes that lead to a deterioration in well-being. And from the meaningful work that I saw, they are trying to treat post-COVID syndrome with drugs that affect blood clotting. So far, there are no noticeable results and recommendations for the use of certain drugs yet. There are separate works, but we need to discuss the risks of these drugs on an individual basis, because so far these are experimental studies. So far, I can’t say anything more specific.

— What could cause fatigue? It also affects walking.
– This is a serious condition, which is underestimated not only by relatives, but also by doctors, and is often perceived as a whim, – they say, I’m tired and I’ll go lie down. That is, it is not perceived as a symptom of the disease. Now there are two main theories about fatigue in multiple sclerosis. The first is that there is inflammation in the blood, and inflammatory cells secrete substances that cause fatigue by acting on the brain. The second is the disruption of connections in the brain, which makes it necessary to use new ones, but this work is less efficient, which is why more energy is spent by the brain. In connection with this lack of energy due to previously unforeseen work, fatigue appears. Therefore, you should not take fatigue as a whim, this is a real symptom, and you need to take it into account in your daily affairs.

— Can B vitamins help with fatigue?
– Medicines have a bad effect on fatigue, and of those that we have in the country – Amantadine. But in my experience it is not very effective. There are also works about aspirin, which states that it can slightly reduce fatigue. Basically, when we talk about fatigue, it is not easy to deal with it. And here we are talking about the organization of a special lifestyle, exercises that maintain the correct posture. Basically, questions about fatigue should be addressed to physical therapists and ergotherapists, who suggest how to arrange daily life.

— Is it true that low potassium provokes the development of spasticity?
– Low potassium can cause Crumpy’s syndrome, which is manifested, among other things, by spasms in the toes. But this is not spasticity as such in origin.

— How effective can yoga be for multiple sclerosis? You conducted a study, tell us about the results.
In our study, 36 people participated, 12 weeks we looked at how yoga affects balance, walking and quality of life. We had a yoga class, an exercise therapy group, and a control group. It turned out that yoga improves the quality of life in terms of parameters related to physical and social activity, that is, people assessed their condition better after classes. And there was no improvement in the exercise therapy group and the control group. But, unfortunately, due to covid, we were not able to do this work fully.

— Why do doctors sometimes advise patients to use a wheelchair while still walking?

– Because people sometimes can’t stand long walks and deny themselves travel, and say: “I can’t get there.” If a person can get there, then it is better to do so and be active and use the funds where they are needed. If they are needed for shorter movements, then you can not use them. We often have such a prejudice that if you sit in a stroller, you will not get up. Of course, this is not so, and the stroller should not be considered only as one of the tools, and not as some kind of sentence. You have to live life to the fullest.

Understanding MS Walking Tests – Drink-Drink

07/07/2022 DrinkDrinkAdmin

Contents

• What is MS Walking Test?
• How is the 10 meter walk test?
• How does the 25-foot timed walk test work?
• How is the 6 meter walk test?
• What is the 12-point walking scale?
• Why take a walking test?
• Track your progress
• Conclusion

Multiple sclerosis (MS) is a condition in which the immune system attacks the protective covering of the nerves.

This condition affects people in different ways, causing mild to moderate symptoms in some and more severe symptoms in others.

Because multiple sclerosis can progress and become debilitating, it’s important to see your doctor regularly, even if you have mild symptoms. This allows the doctor to monitor your health and disability levels.

The walking test is a method doctors use to assess the progression of multiple sclerosis and disability. This may include walking a specific distance or time, or a 12-item walking questionnaire.

The results of these tests also help physicians evaluate the effectiveness of therapy.

What is the multiple sclerosis walking test?

This test involves walking a certain distance with or without an assistive device. Your doctor will calculate how long it will take you to get from point A to point B.

Because multiple sclerosis affects the parts of the brain and spinal cord that control movement, you may experience a slow, gradual decline in your ability to walk. However, the walking test is designed to detect abnormalities in your mobility early.

Maintaining independence is important for many people living with multiple sclerosis, often associated with being able to walk and perform other activities with minimal assistance.

A slower walking speed often indicates limited mobility, which may be a long-term predictor of disability.

Your doctor will compare your speed to that of a non-disabled person walking in the same amount of time. Understanding your current abilities will help determine the appropriate treatment.

Your doctor will also compare your results with previous test results to see changes over time. This can help them assess whether the treatment is working or needs to be adjusted.

Treatment of multiple sclerosis is aimed at reducing inflammation in the central nervous system. This can slow the progression of the disease and promote remission. This is the period when the symptoms disappear.

Achieving remission often involves using medications that change the condition and anti-inflammatory drugs to reduce inflammation, and immunosuppressants to suppress your immune system.

How does the 10m walk test work?

Your doctor may recommend a 10 meter walk test. This allows them to evaluate functional mobility as well as your gait.

These walking tests are typical for multiple sclerosis and other conditions such as Parkinson’s disease, stroke and spinal cord injury.

You will be asked to walk 10 meters. You can even use a cane or walker, although your doctor will document the level of assistance. They will note if you need:

• minimal help
• no help
• moderate help

The amount of time it takes you to walk 10 meters helps your doctor better understand the extent of your condition.

How does the 25-foot timed walk test work?

Your doctor may also suggest a timed 25-foot walk test, sometimes abbreviated to T25FW or T25-FW.

This walking test is a little different because it involves walking 25 feet as fast as you can, with or without an assistive device.

For this test, you will start with a marked 25-foot run. The test starts when you take your first step and stops when your foot reaches the 25-foot mark. Chances are you’ll walk 25 feet in one direction and 25 feet back to your starting point.

According to the National Multiple Sclerosis Society, the 25-foot Timed Walk Test is part of the Multiple Sclerosis Functional Composite (MSFC), a three-part assessment that providers can use to track progression.

According to the National Multiple Sclerosis Society, another test, the Timed 500 Meter Walk (T500MW), can also be used as part of the Expanded Disability Status Scale (EDSS).

How is the 6 meter walk test?

An alternative to the 10m and 25ft walk test is the 6m walk test.

The concept of this walking test is the same as the others – you start at a designated marker and walk the distance (6 meters in this case) as fast as you can. Your doctor keeps track of how long it takes to walk a shorter distance.

Similarly, this walking test measures functional mobility. If it takes you longer to walk 6 meters than a non-disabled adult, you may have some functional impairment.

A 2014 study showed that the 6 meter walk test may be more useful in settings where a longer course is not available, such as in small offices or home healthcare settings.

What is the 12 point walking scale?

Another scoring method is the 12-item Multiple Sclerosis Walking Scale (MSWS-12).

According to Shirley Ryan AbilityLab, MSWS-12 includes a self-report you complete about how your ability to walk is currently affected by multiple sclerosis. The questions are not only about speed, but also about:

• climbing stairs
• (balance)
• using supports
• total effort required to walk

Each answer in the report receives a numeric value, and they are combined to give a total a score that reflects how severely walking is currently affected.

Why take a walking test?

Because multiple sclerosis affects people differently, the walking test is one way for doctors to determine disease progression and assess whether a particular treatment is working.

An inability to walk quickly for short distances also indicates a physical or functional limitation that may qualify you for additional disability insurance, or indicate a need to change careers or consider other rehabilitation.

Doctors can’t always tell if a disease is progressing just by looking at you. And sometimes differences in mobility aren’t obvious until you take a walking test.

The advantage of walking tests is that they are inexpensive and easy to use, making them a useful tool for doctors to assess your current condition.

But while effective, the walking test is not the only way to measure disability and progression of multiple sclerosis.

Doctors should consider other factors, such as whether you have other conditions that can slow your walking speed. These conditions may include arthritis or chronic back pain.

They will also take age into account. Young people with multiple sclerosis can walk faster than older people with the condition.

Track your progress

The bottom line is that walking tests provide insight into mobility. But do not rely solely on the results of your own test at home. Make an appointment with your doctor for an accurate walking test.

Your doctor can track your progress over time. They may use your initial walking test as a benchmark and then use subsequent tests to calculate whether your walking time is increasing or decreasing.

Because of the progressive nature of multiple sclerosis, your walking speed may gradually slow down, even if you don’t know it.

Alternatively, your walking speed may improve with successful treatment. Your doctor may also evaluate other factors that may affect changes in your walking test.

Walking tests do not take long. You can usually finish one in less than 10 minutes, and testing is likely covered by health insurance.