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Timed 25-Foot Walk (T25-FW)
Availability
Freely available on the NMSS website: Please click here for the Timed 25-foot Walk (T25-FW).
Classification
Core: Friedreich's Ataxia (FA)
Supplemental-Highly Recommended: Multiple Sclerosis (MS)
 
Timed 25-Foot Walk is a part of the MS Outcomes Assessments Consortium (MSOAC) Battery of tests, which is recommended as Supplemental - Highly Recommended for MS:
 
Timed 25 Foot Walk
Nine Hole Peg Test
Sloan Low Contrast Letter Acuity
Symbol Digit Modalities Test
 
Each of the measures in the Consortium can be used individually as primary or secondary endpoints.
 
Supplemental: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
The T25-FW is a quantitative mobility and leg function performance test based on a timed 25-walk. It is the first component of the Multiple Sclerosis Functional Composite (MSFC), a three part, standardized, quantitative, assessment instrument in MS clinical trials and other clinical studies. (Cutter et al., 1999)
Comments/Special Instructions
The T25-FW is widely used test to evaluate locomotion in clinical trials. (Phan-Ba et al., 2012). The assessment involves having the patient walk a 25-foot course as quickly as and safely as possible. The time is calculated from the initiation of the instruction to start and ends when the patient has reached the 25-foot mark. The task is immediately administered again by having the patient walk back the same distance. The time limit per each trail is 180 seconds (3 minutes) and the patient may use assistive devices when doing this task. (Fischer et al., 2001)
Scoring and Psychometric Properties
Scoring: The score for the T25-FWis the average of the two completed trials. This score can be used individually or used as part of the MSFC composite score. The T25-FW can also be scored to assess walking speed by dividing 25 by time, which yield feet per second. If at the upper end of the disability spectrum, this may be the preferred method.
 
Psychometric Properties: The T25-FW has high inter-rater and test-retest reliability and shows evidence of good concurrent validity. (Motl et al., 2017)
Rationale/Justification
Strengths: The T25FW is considered the "best characterized objective measure of walking disability and can be used across a wide range of walking disabilities" in MS, (Kieseier et al., 2012) based on ease of administration; application among a wide range of patients' disability levels; and evidence for reliability, validity, responsiveness, and clinical meaningfulness of scores in MS. (Motl et al, 2017)
 
Weaknesses: While the T25-FW can demonstrate change in ambulatory function validation of the T25-FW as a clinically meaningful, measure such as a time increase of 20% or greater indicates a clinically meaningful impairment in gait across the disability spectrum. (Cutter et al., 1999; Kaufman et al., 2000; Motl et al, 2017)
References
Key References:
Cutter GR, Baier ML, Rudick RA, Cookfair DL, Fischer JS, Petkau J, Syndulko K, Weinshenker BG, Antel JP, Confavreux C, Ellison GW, Lublin F, Miller AE, Rao SM, Reingold S, Thompson A, Willoughby E. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain. 1999 May;122 ( Pt 5):871-82.
 
Fischer JS, Rudick RA, Cutter GR, Reingold SC. The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Mult Scler. 1999 Aug;5(4):244-50.
 
Additional References:
Cohen JA, Fischer JS, Bolibrush DM, Jak AJ, Kniker JE, Mertz LA, Skaramagas TT, Cutter GR. Intrarater and interrater reliability of the MS functional composite outcome measure. Neurology. 2000 Feb 22;54(4):802-6.
 
Cohen JA, Krishnan AV, Goodman AD, Potts J, Wang P, Havrdova E, Polman C, Rudick RA. The clinical meaning of walking speed as measured by the timed 25-foot walk in patients with multiple sclerosis. JAMA Neurol. 2014 Nov;71(11):1386-93.
 
Fischer JS, Jak AJ, Kniker JE, Rudick RA, Cutter G. Multiple Sclerosis Functional Composite (MSFC) Administration and Scoring Manual October 2001. Available at:  https://nms2cdn.azureedge.net/cmssite/nationalmssociety/media/msnationalfiles/brochures/10-2-3-31-msfc_manual_and_forms.pdf. Accessed 31 July 2023.
 
Kaufman M, Moyer D, Norton J. The significant change for the Timed 25-foot Walk in the multiple sclerosis functional composite. Mult Scler. 2000 Aug;6(4):286-90.
 
Kieseier BC, Pozzilli C. Assessing walking disability in multiple sclerosis. Mult Scler. 2012 Jul;18(7):914-24.
 
Motl RW, Cohen JA, Benedict R, Phillips G, LaRocca N, Hudson LD, Rudick R; Multiple Sclerosis Outcome Assessments Consortium. Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis. Mult Scler. 2017 Apr;23(5):704-710.
 
Phan-Ba R, Calay P, Grodent P, Delrue G, Lommers E, Delvaux V, Moonen G, Nagels G, Belachew S. A corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients. NeuroRehabilitation. 2012;30(4):261-6.
 
Rudick RA, Cutter G, Reingold S. The multiple sclerosis functional composite: a new clinical outcome measure for multiple sclerosis trials. Mult Scler. 2002 Oct;8(5):359-65.
 
Document last updated August 2023