Cooling Vests Improve 6-Minute Walk Test Performance in People With Multiple Sclerosis: A Randomized Crossover Trial

Background: Walking in people with multiple sclerosis (MS) is limited by thermosensitivity, as prolonged activity raises body temperature. Administering a cooling intervention prior to physical activity can improve function; however, there are few data regarding the effect of cooling on walking. The purpose of this study was to compare walking distance in uncooled (control) and cooled conditions in a sample of people with MS. We hypothesized that participants would walk greater distances on a timed walking test after administration of a cooling intervention compared with a condition in which no cooling was administered. Methods: A randomized crossover design was used. Fifteen participants (median Expanded Disability Status Scale score 4, IQR 1.5, range 3-5) underwent a 6-minute walk test (6MWT) in both cooled (CC) and uncooled (UC) conditions in a randomized test order. In CC, participants wore a cooling vest for 30 minutes prior to performing the 6MWT. In UC, participants performed the 6MWT without precooling. Participants returned 1 to 2 weeks later and repeated the 6MWT in the opposite condition. The total and per-minute distances during the 6MWTs were collected. Results: Participants walked longer distances during the 6MWT in the CC compared with the UC. Post hoc analysis of per-minute distances showed that participants accumulated greater walking distances in minutes 5 and 6 in the CC compared with the UC. Conclusions: Precooling with a cooling vest had a significant impact on 6MWT performance in this sample of people with MS. The use of a cooling vest should be considered in walking programs for people with MS.