Multiple sclerosis (MS) is a central nervous system illness that affects people. It can restrict mobility, making it difficult to walk.
According to the National MS Society, the disease affects around 1 million people in the United States. One of the most prevalent mobility-related symptoms is difficulty walking.
This post discusses how MS can damage one’s ability to walk, the mobility tests used by physical therapists, and the many therapies available.
MS walking difficulties
The central nervous system, which includes the brain, spinal cord, and optic nerves, is affected by MS. Damage to this system, which controls how a person moves and reacts to stimulus, might result in mobility issues.
An immune system problem in a person with MS causes the immune system to attack healthy tissue, in this case myelin.
A fatty substance that covers and insulates nerve fibers is known as myelin. It also aids in the rapid transmission of signals via the neurons.
If myelin is injured or destroyed, the nerve it protects may lose its ability to receive impulses correctly. This means that messages traveling through the nerve may be disrupted or never reach their destination.
MS-related movement difficulties are thought to be caused by myelin loss in the cerebellum, according to experts. The cerebellum is a part of the brain that aids with movement and coordination.
These mobility issues may include:
- muscle tightness, stiffness, or spasms
- problems with balance
- severe numbness in the feet
- loss of position sense, which involves knowing where the feet are when walking
- fatigue
- muscle weakness
- trouble with vision
- cognitive issues
- unstable walking
Gait changes due to MS
The gait of a person is their walking pattern. According to a 2018 study, 50–80 percent of people with MS suffer balance and gait problems.
Other research from 2018 reports a range of gait alterations, including:
- a slow walking speed
- a reduced range of motion in the leg joints
- a smaller step length
- reduced stability
- difficulty lifting the front part of the foot, which is called “foot drop”
Gait issues can increase the risk of falling. According to the National MS Society, 50–70% of people with MS experienced falls in the two–six months before to taking the survey.
MS walking tests
A person with MS may be asked to take a walking test by a physical therapist. This entails walking a predetermined distance while the therapist assesses their gait.
The findings may aid physical therapists in more successfully treating gait disorders.
Timed 25-foot walk
This requires a 25-foot walk (ft). A person should walk as swiftly as they feel comfortable, and assistive aids such as a cane may be used.
The person’s physical therapist will time them while they walk to a distance marker and, possibly, as they return. The purpose is to assess the person’s gait speed, which is a useful indicator of walking ability.
Ambulation index
This is comparable to the timed 25-foot walk test, which has mostly supplanted it.
Walking 25 feet as quickly as possible while being timed is also part of the ambulation index. The purpose is to quantify mobility rather than gait speed in this case.
A person’s score ranges from 0 to 10. They have a score of 0 if they are totally active, and a score of 10 if they are unable to get out of bed.
Dynamic gait index
This entails assessing a person’s walking style, as well as their balance and potential for falling.
To complete this test, a person must walk and perform additional activities, such as:
- changing speed
- turning their head left and right or up and down
- avoiding obstacles
- turning on the spot
- climbing stairs
The 12-item MS walking scale
This questionnaire, often known as the MSWS-12, contains 12 statements about how MS affects one’s ability to walk.
The person being tested will be asked to rate each statement on a scale of 1 to 5 by the healthcare expert administering the test.
A “1” indicates that the person has not had the experience described in the statement. A score of 5 indicates that they have had a particularly bad experience with it.
Timed up-and-go test
This is how physical therapists time how long it takes a person to get out of a chair, walk 10 ft, and then return to the chair.
According to the Centers for Disease Control and Prevention (CDC), if it takes more than 12 seconds, the person is at risk of falling.
Treatment options and self-management techniques
Physical treatment, according to the National MS Society, can help with a variety of gait issues.
To assist a person adapt, a physical therapist may propose vestibular activities that cause imbalance. These activities could include:
- head or eye movements
- altering visual input
- walking on different kinds of surfaces
They may also encourage a person to do stretching exercises to improve:
- flexibility
- strength
- cardiovascular fitness
- balance
- coordination
- relaxation
Some prescription drugs can enhance a person’s gait by reducing muscular stiffness and speeding up walking.
People with MS may benefit from a variety of assistive equipment, such as canes, crutches, or braces.
Anyone who has difficulty walking should get medical advice on how to lessen their risk of falling. This could entail:
- not wearing high heels
- avoiding slippery surfaces
- removing obstacles and trip hazards from the home
- keeping walking areas well lit, especially at night
Conclusion
MS can make it difficult for nerves to transmit electrical signals as they should. This can lead to mobility issues, such as difficulty walking.
Physical therapists employ a variety of tests to determine how MS affects a person’s gait and to improve treatment options.
Stretching and exercising, as well as utilizing assistive equipment and maybe taking drugs, can all help with mobility issues. Anyone with MS who is having trouble walking should speak with a member of their medical team.
Sources
- https://www.sralab.org/rehabilitation-measures/12-item-multiple-sclerosis-walking-scale
- https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Ambulation-Index-(AI)
- https://www.medicalnewstoday.com/articles/ms-walking
- https://www.sciencedirect.com/science/article/abs/pii/B978044463916500015X?via%3Dihub
- https://www.nationalmssociety.org/What-is-MS/Definition-of-MS
- https://www.sralab.org/rehabilitation-measures/dynamic-gait-index
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862880/
- https://nmsscdn.azureedge.net/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-GaitOrWalkingProblems-TheBasicFacts_FINAL.pdf
- https://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Stretching-for-People-with-MS.pdf
- https://www.nationalmssociety.org/What-is-MS/How-Many-People
- https://www.msif.org/about-ms/symptoms-of-ms/movement-and-coordination-problems/
- https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Timed-25-Foot-Walk-(T25-FW)
- https://www.cdc.gov/steadi/pdf/TUG_test-print.pdf
- https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Walking-Gait-Balance-Coordination
- https://www.msif.org/about-ms/what-is-ms/
