Analysis of the 25 Foot Timed Walk Test As a Predictive Factor in Multiple Sclerosis Disease Progression

Background: Patients with Multiple Sclerosis often present as Relapsing Remitting (RRMS), characterized by stable disease punctuated with intermittent flares of symptoms. Eventually, some patients progress to Secondary Progressive (SPMS), wherein their disease steadily worsens over time. Currently, a patient’s disease status is determined on a holistic basis by considering the neurological exam, radiological findings, and tests of physical function, including the 25 Foot Timed Walk (25FTW). Determination of a patient's disease status heavily informs intervention and treatment. Nonetheless, despite such extensive clinical assessment, there remains no definitive objective measure to define a patient's disease status or predict progression risk over time. Identification of specific prognostic factors in MS disease progression would be highly applicable to more precise anticipation of disease outcomes, and accordingly, improving therapeutic approaches. 

Objectives: Our goal was to determine if 25FTW performance can reflect disease state, and ultimately predict if a patient will develop SPMS.

Methods: The Multiple Sclerosis Center at the University of Massachusetts Medical School maintains a Microsoft Access Database containing over 26,000 patient encounters from over 4,000 patients. We used built in SQL coding to conduct a retrospective statistical analysis of the patient visit information database. 

Results:  We determined that patients who ultimately progressed to SPMS had significantly slower performance on the 25FTW during the RRMS phase than patients who did not progress. Moreover, we discerned that RRMS patients who had 25FTW scores of longer than 8 seconds at any point during their disease were more likely to progress to SPMS.

Conclusions: These results suggest that the 25FTW can reflect differences in RRMS patients at risk for disease progress, and might predict a patient’s general risk for disease progression.