Podcast Summary: The MSing Link — Episode 269

Title: MS Progress Tests You Can Do at Home: Walking, Strength & Balance
Host: Dr. Gretchen Hawley, PT, DPT, MSCS
Release Date: January 28, 2026

Episode Overview

In this engaging and practical episode, Dr. Gretchen Hawley dives into objective functional outcome measures that people living with Multiple Sclerosis (MS) can use at home to assess their walking, strength, and balance. Dr. Hawley explains how these tests provide quantifiable data to track change over time, complementing subjective measures, and empowering individuals to monitor their own functional progress between clinic visits. With a focus on safety, consistency, and motivation, she breaks down several gold-standard tests, offers clear home adaptations, and encourages a holistic and compassionate approach to progress tracking with MS.

Key Discussion Points & Insights

1. Why Objective Outcome Measures Matter

• Distinction between subjective and objective measures:

  • Subjective: Questionnaires about how you feel (e.g., your fatigue or walking).
  • Objective: Quantified results, like timed walks or repetition counts.

• Both types are critical for understanding if interventions (exercise, nutrition, etc.) are making a real difference.

  “I really like objective outcome measures because numbers don’t lie. It is quantifiable data. And also it can catch subtle changes. It can transition your mindset from ‘I think I'm walking faster’ to ‘I am walking faster.’ And that can be so motivating.” (Dr. Hawley, 06:18)

• These tests can:

  • Be done both in clinics and at home.
  • Fill gaps between infrequent clinic visits or post-insurance limits on PT.

2. General Principles for At-Home Testing

• Consistency is key: use the same location, time, aids, and conditions.

• Safety first: only perform tests you can do safely; use mobility aids as needed.

• Track all variables: date, time, how you feel that day, medication, use of aids, etc.

  “Try your best when you’re doing these at home to be in the same location, the same room, the same time of day, the same conditions, the same mobility aids… because we want consistency, so we’re comparing apples to apples.” (Dr. Hawley, 10:04)

• Compare trends over time at home and in the clinic, rather than looking for absolute numbers.

3. Featured At-Home MS Progress Tests

A. Timed 25-Foot Walk Test

• Purpose: Measures walking speed over a short distance (a gold standard in MS research and care).

• How to Do It (Clinic & Home):

  • Walk 25 feet as fast and safely as possible; time with a stopwatch.
  • In the clinic: marked hallway.
  • At home: use a measured space (e.g., between two walls); can be slightly less/more than 25 feet but keep it consistent.
  • Do it twice and average your times.
  • Use usual walking aids.

• Recording: Note the date, time, how you feel, aids, fatigue, etc.

• Result Benchmarks:

  • <5 seconds: Minimal to no walking impairment.
  • 5–10 seconds: Mild to moderate impairment.
  • ≥10 seconds: Moderate to severe impairment.
  • A 20% improvement is considered clinically meaningful.

  “Numbers don’t lie… It wasn’t just a randomly better day. The next test is called the timed up and go…” (Dr. Hawley, 15:26)

B. Timed Up and Go (TUG) Test

• Purpose: Assesses functional mobility—combines standing, walking, turning, and sitting.

• How to Do It:

  • Start seated (clinic: armless chair, home: ideally chair with armrests for safety).
  • On ‘go’, stand up, walk 10 feet (mark with tape, wall, or object), turn, return, and sit.
  • Preferably just one trial; log all variables.
  • Note use of armrests, aids, tripping, near-falls, etc.

• Result Benchmarks:

  • <10 seconds: Freely mobile/independent.
  • 10–20 seconds: Mostly independent, some limitations.
  • 20–30 seconds: Variable mobility, may need aids.

  • 30 seconds: Impaired mobility.

  “Sometimes the numbers won’t actually change, but the quality of your walking is improving. And that is just as important.” (Dr. Hawley, 22:33)

C. Five Times Sit-to-Stand Test

• Purpose: Measures lower body strength, power, and ability to rise from sitting.

• How to Do It:

  • Clinic: Standard chair without armrests; at home: use sturdy chair with armrests, pushed against a wall.
  • From seated, stand up and sit down 5 times as quickly and safely as possible.
  • Timer starts with first movement, stops when seated after fifth stand.
  • Note arm usage, balance, aids.

• Result Benchmarks:

  • ≤12 sec: Good functional mobility.
  • 12–15 sec: Moderate functional mobility.

  • 15 sec: Fall risk/significant impairment.

  • ≥30 sec: Severe impairment, definite fall risk.

D. 30-Second Sit-to-Stand Test

• Alternative:

  • Do as many full stands as possible in 30 seconds.
  • Same protocol for recording variables.

  “Regardless of which one you choose, it’s looking at your ability to stand up, your leg strength, your balance, strength, et cetera.” (Dr. Hawley, 26:54)

4. Tracking, Frequency, and Interpreting Your Progress

• Test every 4–8 weeks.

• Don’t expect linear progress: fluctuations are normal due to MS.

• Details matter: track anything that changes (medication, relapse, new workouts, etc.).

• Focus on trends, not perfection. Sometimes maintenance, not improvement, is a huge win.

  “Your worst scores at six months are actually better than your best scores initially… Success isn’t only when you’re seeing improvements… success is also maintenance.” (Dr. Hawley, 29:59)

  • Trust your lived experience over numbers if they don’t match.
  • Combining objective and subjective measures gives the full picture.

5. Resources & Continued Learning

• Free Videos & Tracking:
  • Missing Link app's "Track Your Progress" course for visual guides.
  • Journals or spreadsheets for personal tracking.
• Other Objective Tests to Consider:
  • Nine Hole Peg Test (hand function), 6-Minute/2-Minute Walk (endurance).

Memorable Quotes

• On objective testing benefits:

  “It can transition your mindset from ‘I think I’m walking faster’ to ‘I am walking faster.’ And that can be so motivating.” (06:23)

• On fluctuations and measuring real progress:

  “You likely will not have a linear path where every time you do these, the numbers are improving. But when you look over time, you are gradually getting better and better. Day to day fluctuation is normal, because MS fluctuation is normal.” (29:03)

• On defining success:

  “Sometimes with MS the goal isn’t necessarily improvements, or rather, success isn’t only when you’re seeing improvements. Success is also maintenance.” (30:38)

Timestamps for Key Segments

• [01:00] — Distinction between subjective and objective outcome measures
• [04:00] — Importance of testing at home and in clinic; variable control
• [10:04] — Tips for consistency and safety when testing at home
• [11:50] — Timed 25-Foot Walk Test: clinic and at-home protocols
• [17:23] — Recording, interpreting, and clinical significance of results
• [18:54] — Timed Up and Go (TUG) Test: rationale and procedures
• [25:43] — 5 Times Sit-to-Stand and 30-Second Sit-to-Stand protocols
• [27:46] — Frequency of testing, what to track, focus on trends
• [29:03] — Embracing fluctuations; maintenance is success
• [30:38] — Trusting lived experience over metrics

Conclusion & Encouragement

Dr. Hawley encourages listeners to start tracking their progress at home, reassuring them that progress is possible even if it sometimes feels elusive. Maintenance and improved quality, not just numerical gains, are valid markers of success with MS. She offers motivational support and invites listeners to connect and share which tests they’re eager—or nervous!—to try.

Resources Mentioned:

• The Missing Link App — Download for free videos, "Track Your Progress" course, and at-home tracking tools.

This episode leaves listeners empowered with the tools, mindset, and clarity needed to actively monitor their functional progress with MS—and the reassurance that every bit of data, and every lived experience, matters.