{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:26:30Z","timestamp":1787300790789,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"France Life Imaging","award":["ANR-11-INBS-0006"],"award-info":[{"award-number":["ANR-11-INBS-0006"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Primary progressive multiple sclerosis (PPMS) involves gradual disability accumulation driven by neurodegeneration. Standard outcomes, including the Expanded Disability Status Scale (EDSS) and timed 25-foot walk (T25FW), lack sensitivity to subtle functional changes. Real-life walking speed (RWS) measured with wearable sensors may offer a more responsive marker of progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>In a prospective cohort (2012\u20132022) at the University Medical Center Hamburg-Eppendorf, adults with PPMS (18\u201365\u2009years, EDSS \u2a7d7.0) underwent repeated EDSS, T25FW, Nine-Hole Peg Test (9HPT), and Symbol Digit Modalities Test (SDMT). RWS was recorded using an accelerometer. Disease progression was defined as \u2a7e20% worsening in T25FW\/9HPT, \u2a7e8-point SDMT decline, EDSS increase (\u2a7e1.0 or \u2a7e0.5 if &gt;5), or RWS reduction &gt;0.08\u2009m\/s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 110 participants (mean age: 52\u2009years; baseline EDSS: 3.5) followed for a median of 3\u2009years, RWS showed a symmetric distribution and declined steadily with increasing EDSS, unlike the skewed T25FW distribution. Annual progression was detected in &gt;30% of participants using RWS, compared with &lt;20% for EDSS\/SDMT and &lt;10% for T25FW\/9HPT. Composite endpoints including RWS identified earlier and more frequent disease progression (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Continuous RWS monitoring is more sensitive than conventional metrics for detecting functional decline in PPMS and may strengthen progression endpoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261476543","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:43:30Z","timestamp":1787028210000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-life walking speed: A new marker of progression in a primary progressive multiple sclerosis cohort study?"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2500-1224","authenticated-orcid":false,"given":"Maeva","family":"Cotinat","sequence":"first","affiliation":[{"name":"CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, H\u00f4pital Universitaire Timone, APHM, Aix Marseille University, Marseille, France; Physical and Rehabilitation Medicine Department, H\u00f4pitaux Sud, APHM, Aix Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8131-9467","authenticated-orcid":false,"given":"Christoph","family":"Heesen","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Neuroimmunologie und Multiple Sklerose, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8252-8067","authenticated-orcid":false,"given":"Ines","family":"Boudiaf","sequence":"additional","affiliation":[{"name":"CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, H\u00f4pital Universitaire Timone, APHM, Aix Marseille University, Marseille, France; Physical and Rehabilitation Medicine Department, H\u00f4pitaux Sud, APHM, Aix Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lederer","sequence":"additional","affiliation":[{"name":"Sylvia Lawry Centre for Multiple Sclerosis Research, Human Motion Institute, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Daumer","sequence":"additional","affiliation":[{"name":"Sylvia Lawry Centre for Multiple Sclerosis Research, Human Motion Institute, Munich, Germany; Trium Analysis Online GmbH, Research, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-496X","authenticated-orcid":false,"given":"Adil","family":"Maarouf","sequence":"additional","affiliation":[{"name":"CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, H\u00f4pital Universitaire Timone, APHM, Aix Marseille University, Marseille, France; Service de Neurologie, P\u00f4le de Neurosciences Cliniques, H\u00f4pital de la Timone, Assistance Publique H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Bensoussan","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine Department, Aix Marseille University, APHM, INT, H\u00f4pitaux Sud, Marseille, France; Physical and Rehabilitation Medicine Department, UGECAM Provence-Alpes-Cote d\u2019Azur, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8073-102X","authenticated-orcid":false,"given":"Jean-Philippe","family":"Ranjeva","sequence":"additional","affiliation":[{"name":"CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, H\u00f4pital Universitaire Timone, APHM, Aix Marseille University, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Patrick","family":"Stellmann","sequence":"additional","affiliation":[{"name":"CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, H\u00f4pital Universitaire Timone, APHM, Aix Marseille University, Marseille, France; Department of neuroradiology, AP-HM, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c5b47f"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512458169"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092761"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12881"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.33.11.1444"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000313034.46883.16"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-14-58"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/112.1.133"},{"key":"e_1_3_2_10_2","unstructured":"Guideline on clinical investigation of medicinal products for the treatment of multiple sclerosis rev. 2 https:\/\/www.ema.europa.eu\/en\/documents\/scientific-guideline\/guideline-clinical-investigation-medicinal-products-treatment-multiple-sclerosis-revision-2_en.pdf (accessed 2 December 2025)"},{"key":"e_1_3_2_11_2","unstructured":"U.S. Department of Health and Human Services Food and Drug Administration. 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