Clinically meaningful performance benchmarks in MS:Timed 25-Foot Walk and the real world

Myla D. Goldman, Robert W. Motl, John Scagnelli, John H. Pula, Jacob J. Sosnoff, Diego Cadavid

Research output: Contribution to journalArticlepeer-review


Objective: Identify and validate clinically meaningful Timed 25-Foot Walk (T25FW) performance benchmarks in individuals living with multiple sclerosis (MS). Methods: Cross-sectional study of 159 MS patients first identified candidate T25FW benchmarks. To characterize the clinical meaningfulness of T25FW benchmarks, we ascertained their relationships to real-life anchors, functional independence, and physiologic measurements of gait and disease progression. Candidate T25FW benchmarks were then prospectively validated in 95 subjects using 13 measures of ambulation and cognition, patient-reported outcomes, and optical coherence tomography.Results: T25FW of 6 to 7.99 seconds was associated with a change in occupation due to MS,occupational disability, walking with a cane, and needing "some help" with instrumental activities of daily living; T25FW ≥8 seconds was associated with collecting Supplemental Security Income and government health care, walking with a walker, and inability to do instrumental activities of daily living. During prospective benchmark validation, we trichotomized data by T25FW benchmarks (<6 seconds, 6-7.99 seconds, and ≥8 seconds) and found group main effects on 12 of 13 objective and subjective measures (p < 0.05). Conclusions: Using a cross-sectional design, we identified 2 clinically meaningful T25FW benchmarks of >6 seconds (6-7.99) and >8 seconds. Longitudinal and larger studies are needed to confirm the clinical utility and relevance of these proposed T25FW benchmarks and to parse out whether there are additional benchmarks in the lower (<6 seconds) and higher (>10 seconds) ranges of performance.

Original languageEnglish (US)
Pages (from-to)1856-1863
Number of pages8
Issue number21
StatePublished - Nov 19 2013


  • 6MWT Six-Minute Walk Test
  • EDSS Expanded Disability Status Scale
  • IADL instrumental activities of daily living
  • LL-FDI Late-Life Function and Disability Inventory
  • MS multiple sclerosis
  • MSWS-12 Multiple Sclerosis Walking Scale-12
  • Ocost oxygencost of walking
  • PASAT Paced Auditory Serial Addition Task
  • PS Performance Scales
  • SDMT Symbol Digit ModalitiesTest
  • SI Symptom Inventory
  • SSST Six Spot Step Test
  • T25FW Timed 25-Foot Walk
  • TUG Timed Up and Go

ASJC Scopus subject areas

  • Clinical Neurology


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