Use of Walking Aids May Predict Participation Levels in Patients With MS

person using a walker
person using a walker
Investigators examined factors associated with mobility and walking restrictions in participants with multiple sclerosis.

A recent study published in Multiple Sclerosis and Related Disorders noted that the type of multiple sclerosis (MS) disease, duration of disease, level of disability, and type of walking aid were associated with modified functional walking categories.

Researchers used convenience sampling of participants at a rehabilitation center to investigate factors associated with walking and mobility restriction and the influence of various factors on community participation. The study population (N=149) included patients with multiple sclerosis divided into 5 categories based on the Modified Functional Walking Categories: unlimited/least-limited community walker (≥ 1.35 m/s, n=20), most-limited community walker (<1.35 m/s, n=25), unlimited household walker (<1.04 m/s, n=33), limited household walker (<0.48 m/s, n=39) and physiological walker and nonambulant patients with multiple sclerosis (<0.10 m/s, n=32).

The researchers found a statistical difference in age, with physiological walkers being older in comparison to unlimited community walkers. The Expanded Disability Status Score (EDSS), which measures disease duration, increased across walking categories; the investigators found an association between longer disease duration and modified functional walking categories. Statistical differences were observed between groups in walking aid (none, unilateral, bilateral, or wheelchair). Researchers note that as “walking gets slower the need of a walking aid becomes greater.” The Community Integration Questionnaire (which measures participation in 3 different domains: home, social, and productive activities) showed statistical differences in total scores between all groups. Univariate analysis showed that clinical and demographic characteristics were influential in participation levels. Researchers found some risk factors for participation restrictions to be older age, male gender, and the use of a walking aid.

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Study limitations include small sample size; lack of clarification of the relationship between EDSS, walking velocity and walking aids; and short study duration.

These findings suggest that “a walking aid may be a better predictor of overall participation in patients with multiple sclerosis.”


Bertoni R, Jonsdottir J, Feys P, Lamers I, Cattaneo D. Modified functional walking categories and participation in people with multiple sclerosisMult Scler Relat Disord. 2018; 26:11-18.