Discriminative ability of the six-minute walk distance in identifying fallers in multiple sclerosis.

BACKGROUND

Falls are a common clinical problem in individuals with multiple sclerosis (MS).

OBJECTIVE

This study aimed to investigate the discriminative ability of the six-minute walk distance (6MWD), widely used to assess walking endurance in individuals with MS, in determining fall status.

METHODS

The sixty-seven patients diagnosed with MS (EDSS = 3.05 ± 0.89) were included in a cross-sectional study. Falls and fall status were retrospectively recorded for the past three months. Clinic variables were evaluated. Walking endurance was assessed using the 6MWT (Six-minute walk test). The discriminative ability of 6MWD to determine fall status was defined using a receiver operating characteristic (ROC) curve analysis.

RESULTS

The 6MWD was lower in the faller group compared to non-fallers (212.74 ± 98.32 m vs 343 ± 92.55 m; Cohen's d = 1.36, p < 0.001). A 1-meter increase in 6MWD was associated with a 1.5 % decrease in the odds of having fallen in the last 3 months (odds ratio: 0.985; 95 % CI: 0.973-0.993; p < 0.001). The optimal cut-off point for identifying increased fall risk was ≤299 meters in 6MWD (AUC:0.824, sensitivity: 80.00 %, specificity: 71.87 %; AUC:0.94; 95 % CI 0.712 to 0.906; p < 0.001).

CONCLUSIONS

The 6MWD is a valuable tool for distinguishing fallers from non-fallers among individuals with MS. It may provide useful information not only to assess walking capacity and fatigability but also to identify individuals at increased risk of falls. Prospective monitoring is needed to validate its predictive value in clinical practice.