Objective:

In the realm of multiple sclerosis (MS) management, understanding the factors contributing to
significant deteriorations in mobility and dexterity is paramount. This retrospective study delves into
the intricate web of variables influencing ≥20% worsening in Timed 25-Foot Walk (T25FW) and 9-
Hole Peg Test (9HPT) outcomes over approximately one year in MS patients.

Background:

Our investigation involved a meticulous cross-sectional analysis of MS patients who underwent
T25FW and 9HPT tests approximately one year apart.

Design/Methods:

Patients were stratified into two distinct groups: those who encountered ≥20% worsening and a control
cohort devoid of such deterioration. Various parameters including demographic details, initial
Expanded Disability Status Scale (EDSS), disease type, lesion characteristics, and treatment history
were meticulously scrutinized. Binary logistic regression was then wielded to decipher the pivotal
factors impacting the decline in T25FW and 9HPT outcomes.

Results:

For the 9HPT cohort, comprising 47 individuals, 12 endured ≥20% worsening while 35 remained
stable. Intriguingly, no discernible factors emerged to elucidate the deterioration in 9HPT outcomes.
Conversely, in the T25FW cohort encompassing 91 patients, 41 manifested ≥20% worsening while 50
maintained stability. Remarkably, the presence of T1 black holes emerged as a significant contributor
to T25FW worsening (β=4.067, p=0.036), underscoring its prognostic relevance.

Conclusions:

This study offers profound insights into the determinants underpinning ≥20% deterioration in T25FW
and 9HPT outcomes among MS patients. Notably, the presence of T1 black holes surfaced as a pivotal
factor in precipitating T25FW deterioration, highlighting its clinical significance. These findings hold
promise in refining prognostic models and tailoring therapeutic interventions, thereby fostering a more
personalized approach to MS management.