The significant change for the Timed 25-Foot Walk in the Multiple Sclerosis Functional Composite

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Abstract
The Timed 25-Foot Walk is under evaluation as a clinical tool to follow patients with MS. Several approaches have been taken to define a clinically significant change in this measurement. This study was undertaken to define the range of values expected for the Timed 25-Foot Walk and to correlate prospectively the change in walk-time that occurs during an exacerbation of MS associated with subjective difficulty walking. Five results from this study are emphasized. (1) Patients who were minimally affected by MS frequently walked 25 feet between three and five seconds. (2) the walk-time variability, defined as the ratio of the longest to the shortest walk-time, minus 1, times 100%, for three consecutive trials was generally 20% or less; (3) if the two fastest walk-times obtained in three trials were compared, the walk-time variability was almost always 10% or less; (4) for clinically stable individuals, the walk-times of single trials separated by 12 months or less generally varied less than 20%; and (5) patients who complained of difficulty walking, but who did not have changes otherwise detectable by examination, generally had a prolongation of walk-time. These results suggest that an increase of more than 20% in the Timed 25-Foot Walk may indicate a significant change in gait.