Walking and physical performance in black and white adults with multiple sclerosis controlling for social determinants of health

Trinh L T Huynh; Mitzi J Williams; Robert W Motl

doi:10.1016/j.msard.2024.105439

Walking and physical performance in black and white adults with multiple sclerosis controlling for social determinants of health

Mult Scler Relat Disord. 2024 Mar:83:105439. doi: 10.1016/j.msard.2024.105439. Epub 2024 Jan 9.

Authors

Trinh L T Huynh¹, Mitzi J Williams², Robert W Motl³

Affiliations

¹ Department of Kinesiology and Nutrition, School of Applied Health Sciences, University of Illinois Chicago, 1919 W Taylor Street, Chicago, IL, USA. Electronic address: trinhhlt@uic.edu.
² Joi Life Wellness Group, Smyrna, GA, USA.
³ Department of Kinesiology and Nutrition, School of Applied Health Sciences, University of Illinois Chicago, 1919 W Taylor Street, Chicago, IL, USA.

PMID: 38219300
DOI: 10.1016/j.msard.2024.105439

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, Ƞ_p² = 0.11), 6MW (F = 58.5, p < .001, Ƞ_p² = 0.18), TUG (F = 22.1, p < .001, Ƞ_p² = 0.08), and SPPB (F = 25.2, p < .001, Ƞ_p² = 0.09) performance for MS than HCs, and lower T25FW (F = 15.5, p < .001, Ƞ_p² = 0.05), 6MW (F = 11.6, p < .001, Ƞ_p² = 0.04), and TUG (F = 4.1, p < .05, Ƞ_p² = 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.

Keywords: Mobility; Multiple sclerosis; Physical functions; Race; Social determinants of health.

MeSH terms

Adult
Black or African American
Cross-Sectional Studies
Humans
Multiple Sclerosis*
Physical Functional Performance*
Social Determinants of Health
Walking*
White