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Utility of the Six-Spot Step Test as a Measure of Walking Performance in Ambulatory Individuals With Multiple Sclerosis

Published:November 11, 2015DOI:https://doi.org/10.1016/j.apmr.2015.10.100

      Abstract

      Objective

      To examine the concurrent validity of the Six-Spot Step Test (SSST) with clinical measures of walking and spatiotemporal measures of gait in multiple sclerosis (MS), and to understand the utility of the SSST in individuals with both low and high levels of disability.

      Design

      Cross-sectional study.

      Setting

      Laboratory.

      Participants

      Individuals with relapsing-remitting MS (N=29).

      Interventions

      Not applicable.

      Main Outcome Measures

      In a single visit, demographic information (age, sex, Expanded Disability Status Scale [EDSS], symptom duration) and functional measures (SSST, timed Up and Go [TUG] test, timed 25-foot walk [T25FW] test, spatiotemporal measures of walking) were collected.

      Results

      The SSST demonstrates concurrent validity with the TUG test, T25FW test, and 2-minute walk test (2MWT) (P≤.0002). Both spatial and temporal measures of gait are significantly related to SSST performance (P<.004). In individuals with lower disability (EDSS score 1–3.5), the SSST remains strongly related to the TUG test and T25FW test performances, whereas it fails to relate to any other measures. However, in the higher disability group (EDSS score 4–6), the SSST is significantly related to the TUG test, T25FW test, 2MWT, walk velocity, and both temporal and spatial measures of gait.

      Conclusions

      The SSST is an alternative test for lower-extremity function in the clinical setting that may useful in both higher and lower EDSS groups. The SSST requires minimal training to administer and may be a time-efficient measure of real-life functional performance that would be useful in large clinical trials.

      Keywords

      List of abbreviations:

      EDSS (Expanded Disability Status Scale), MS (multiple sclerosis), SSST (Six-Spot Step Test), TUG (timed Up and Go), T25FW (timed 25-foot walk), 2MWT (2-minute walk test)
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