Association between gait variability, falls and mobility in people with multiple sclerosis: A specific observation on the EDSS 4.0-4.5 level

BACKGROUND: We previously demonstrated that gait variability increases throughout the disease process in people with multiple sclerosis (PwMS). While gait variability tends to remain steady in the lower levels of disability, a significant increase occurs once patients reach the moderate neurological level. OBJECTIVE: To examine the relationship between variability of major spatio-temporal parameters of gait and falls, in PwMS with an expanded disability status scale score of 4.0 and 4.5. METHODS: The study included 91 PwMS, 50 women. Gait variability was studied using an electronic mat. Clinical gait measures included the Two-minute walk test, Timed Up and Go test and the Timed 25-foot walk. RESULTS: Fifty patients were classified as fallers, 41, non-fallers. The MS fallers presented a higher variability score in the step length (37.3 increase) and single support (28.2 increase) compared to participants in the non-fallers. Additionally, gait variability scores were significantly correlated with clinical walking tests. The strongest correlation scores were for variability of the step length. Pearson's rho scores for the Timed Up and Go test, 2-min walk and Timed 25-foot walk were 0.541, - 0.448 and 0.425, respectively. CONCLUSIONS: This study confirms that gait variability is a potential treatment target for PwMS moderately disabled, in order to decrease risk of falls.