title: Ecological validity of walking capacity tests in multiple sclerosis.
abstract: BACKGROUND
  Ecological validity implicates in how far clinical assessments refer to real life. Short clinical gait tests up to ten meters and 2- or 6-Minutes Walking Tests (2MWT/6MWT) are used as performance-based outcomes in Multiple Sclerosis (MS) studies and considered as moderately associated with real life mobility.
  
  
  OBJECTIVE
  To investigate the ecological validity of 10 Meter Walking Test (10mWT), 2MWT and 6MWT.
  
  
  METHODS
  Persons with MS performed 10mWT, 6MWT including 2MWT and 7 recorded days by accelerometry. Ecological validity was assumed if walking tests represented a typical walking sequence in real-life and correlations with accelerometry parameters were strong.
  
  
  RESULTS
  In this cohort (n=28, medians: age=45, EDSS=3.2, disease duration=9 years), uninterrupted walking of 2 or 6 minutes occurred not frequent in real life (2.61 and 0.35 sequences/day). 10mWT correlated only with slow walking speed quantiles in real life. 2MWT and 6MWT correlated moderately with most real life walking parameters.
  
  
  CONCLUSIONS
  Clinical gait tests over a few meters have a poor ecological validity while validity is moderate for 2MWT and 6MWT. Mobile accelerometry offers the opportunity to control and improve the ecological validity of MS mobility outcomes.
authors: Institute of Neuroimmunology and MS (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: J P
authors: JP
authors: Stellmann
authors: Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, Germany; Trium Analysis Online GmbH, Munich, Germany.
authors: A
authors: A
authors: Neuhaus
authors: Institute of Neuroimmunology and MS (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: N
authors: N
authors: Götze
authors: Institute of Neuroimmunology and MS (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: S
authors: S
authors: Briken
authors: Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, Germany.
authors: C
authors: C
authors: Lederer
authors: Trium Analysis Online GmbH, Munich, Germany.
authors: M
authors: M
authors: Schimpl
authors: Institute of Neuroimmunology and MS (INIMS) and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: C
authors: C
authors: Heesen
authors: Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, Germany; Trium Analysis Online GmbH, Munich, Germany.
authors: M
authors: M
authors: Daumer
mesh_terms: D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D016138:Walking