Measuring Outdoor Walking Capacities Using Global Positioning System in People with Multiple Sclerosis: Clinical and Methodological Insights from an Exploratory Study

Abstract

We aimed at showing how Global Positioning System (GPS) along with a previously validated speed processing methodology could be used to measure outdoor walking capacities in people with multiple sclerosis (MS). We also deal with methodological issues that may occur when conducting such measurements, and explore to what extent GPS-measured outdoor walking capacities (maximal walking distance [MWDGPS] and usual walking speed) could be related to traditional functional outcomes (6-min total walking distance) in people with MS. Eighteen people with MS, with an Expanded Disability Status Scale score ≤6, completed a 6-min walking test and an outdoor walking session (60 min maximum) at usual pace during which participants were wearing a DG100 GPS receiver and could perform several walking bouts. Among the 12 participants with valid data (i.e., who correctly completed the outdoor session with no spurious GPS signals that could prevent the detection of the occurrence of a walking/stopping bout), the median (90% confidence interval, CI) outdoor walking speed was 2.52 km/h (2.17; 2.93). Ten participants (83% (56; 97)) had ≥1 stop during the session. Among these participants, the median of MWDGPS was 410 m (226; 1350), and 40% (15; 70) did not reach their MWDGPS during the first walking bout. Spearman correlations of MWDGPS and walking speed with 6-min total walking distance were, respectively, 0.19 (−0.41; 0.95) and 0.66 (0.30; 1.00). Further work is required to provide guidance about GPS assessment in people with MS.