Between-Day Reliability of the Gait Characteristics and Their Changes During the 6-Minute Walking Test in People With Multiple Sclerosis.

BACKGROUND: Gait characteristics and their changes during the 6-minute walking test (6MWT) in people with multiple sclerosis (pwMS) have been described in the literature, which one may refer to as walking fatigability in the body function level of the International Classification of Functioning, Disability, and Health. However, whether these metrics are reliable is unknown. OBJECTIVE: To investigate the between-day reliability of the gait characteristics and their changes in pwMS and healthy controls (HCs). METHODS: Forty-nine pwMS (EDSS 4.82 ± 1.22 and 54.7 ± 9.36 years) and 23 HCs (50.6 ± 6.1 years) performed the 6MWT, as fast as possible but safely while wearing Inertial Measurement Units. Gait characteristics were measured in the pace, rhythm, variability, asymmetry, kinematics, coordination, and postural control domains and were obtained in intervals of 1 minute during the 6MWT. In addition, gait characteristics change in the last minute compared with the first minute were calculated for all gait variables using a fatigability index (ie, distance walking index). The intraclass correlation coefficient (ICC), Bland-Altman Plots, and Standard error of measurement were applied to investigate reliability. RESULTS: Reliability of gait characteristics, minute-by-minute, and for their changes (ie, using the fatigability index) ranged from poor to excellent (pwMS: ICC 0.46-0.96; HC: ICC 0.09-0.97 and pwMS: ICC 0-0.72; HC: ICC 0-0.77, respectively). CONCLUSION: Besides coordination, at least 1 variable of each gait domain showed an ICC of moderate or good reliability for gait characteristics changes in both pwMS and HC. These metrics can be incorporated into future clinical trials and research on walking fatigability.Clinical Trial Registration: NCT05412043.

Transition of Mental Health Care for Transgender Youth Aged Between 16 and 24 Years Old.

BACKGROUND: The transitional age (16-24 years old) is a clinically vulnerable period particularly important in mental health care. While several studies focus on this problem, few consider the specificity of the transgender population, a minority at risk of mental health issues. The purpose of this paper is to establish a review of the current literature addressing the transitional age and the transgender population in order to identify the issues met by this specific population in the transition of mental health care. METHODS: A systematic search of the English literature was conducted in Pubmed and ScienceDirect. The PRISMA method was used to illustrate the process of identification, selection, evaluation of eligibility and inclusion of the selected articles. RESULTS: 12 studies were selected, of which five were specifically addressing the transition of care. No specific guidelines were highlighted. The main barriers to mental health care access were the lack of trained professionals, waiting time before a first appointment, past negative experiences of care and the cost of it. CONCLUSION: Enhancing scientific research focusing on that theme is essential to improve the mental health care of this specifically vulnerable population.