Huynh TLT, Williams MJ, Motl RW. Walking and physical performance in black and white adults with multiple sclerosis controlling for social determinants of health.
Mult Scler Relat Disord 2024;
83:105439. [PMID:
38219300 DOI:
10.1016/j.msard.2024.105439]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND
There is evidence for reduced walking and physical performance in persons with multiple sclerosis (MS) compared with healthy controls (HCs). There is further evidence suggesting increased overall mobility disability in Black persons with MS compared with White counterparts, yet little is known about the interplay of social determinants of health (SDOH) when considering differences in walking and physical performance.
PURPOSE
This cross-sectional, comparative study examined differences in walking and physical performance in Black and White persons with MS and HCs (MS Status), statistically controlling for SDOH.
METHODS
The study sample consisted of 208 persons with MS (141 White participants and 67 Black participants) and 95 HCs (59 White participants and 36 Black participants). Walking and physical function were measured using timed 25-foot walk (T25FW), six-minute walk (6MW), timed-up-and-go (TUG), and short physical performance battery (SPPB). We examined the differences in the walking and physical functions as a function of MS Status (MS vs. HCs) and Race (Black vs. White) using Multivariate Analysis of Covariance, controlling for age, sex, marital status and SDOH (i.e., education, employment, income).
RESULTS
There were no significant interactions between MS Status and Race on the outcomes, and the main effects of MS Status and Race remained statistically significant, controlling for SDOH and covariates. The main effects indicated significant lower T25FW (F = 34.6, p < .001, Ƞp2 = 0.11), 6MW (F = 58.5, p < .001, Ƞp2 = 0.18), TUG (F = 22.1, p < .001, Ƞp2 = 0.08), and SPPB (F = 25.2, p < .001, Ƞp2 = 0.09) performance for MS than HCs, and lower T25FW (F = 15.5, p < .001, Ƞp2 = 0.05), 6MW (F = 11.6, p < .001, Ƞp2 = 0.04), and TUG (F = 4.1, p < .05, Ƞp2 = 0.02) performance in Black than White samples.
CONCLUSIONS
We conclude that MS Status and Race independently influence walking and physical performance even after accounting for SDOH, and Black persons with MS have compromised walking and physical performance, perhaps necessitating focal rehabilitation.
Collapse