Walking (Gait) Difficulties
How Multiple Sclerosis Affects Gait and Walking
Difficulty in walking is among the most common mobility limitations in multiple sclerosis. The term “gait” refers more specifically to the manner or pattern of walking (for example unsteady gait).Difficulties in walking and abnormal gait are related to several factors:
- Ataxia: Loss of muscle control in ataxia can lead to a lack of control and balance.
- Balance: balance problems typically result in a swaying and unsteady gait.
- Fatigue: Many people will experience increased gait problems when fatigue increases.
- Foot drop: Foot drop is a specific kind of weakness that results from damage to the nerves of the muscles that flex the ankle. Foot drop can make it difficult to handle steps or uneven surfaces.
- Sensory deficit: Some people with MS have such severe numbness in their feet that they cannot feel the floor or know where their feet are. This is referred to as a sensory ataxia.
- Spasticity: Muscle tightness or spasticity can interfere with gait.
- Weakness: Weakness in your leg muscles can cause you to change your normal walking stride. This can then lead to pain, which can make your walking even more challenging.
Risk of Falling From MS
Physical Therapy and Self-Management Strategies for MS
Most gait problems can be helped to some degree by physical therapy (PT), stretching exercises, the use of appropriate assistive devices and, in some cases, medications for spasticity, fatigue, and walking speed.Your physical therapist may suggest exercises or gait training such as vestibular exercises. These exercises induce brief periods of loss of balance to help you learn to adapt. Exercises may include eye or head movements, distorting or eliminating visual input, and changing or moving weight-bearing surfaces.If you’re having difficulty walking, speak to your healthcare provider. Fall prevention is important for your mobility and accessibility, independence and safety. Falls can cause injuries and increase mobility issues while you recover.To reduce your risk of falling:
- Wear safe, low-heeled shoes.
- Be conscious of where you are walking. For instance, stay away from a freshly washed floor.
- Get exercise, including aerobic and strengthening (including core strengthening) exercises.
- Review your medications.
- Make your home safe.
- Keep the areas where you walk clear.
- Move electric cords out of the way.
- Tack down loose carpets or remove them.
- Apply no-slip strips to tile and wooden floors.
- Install hand rails in the bathroom.
- Leave lights on at night or add nightlights to the path from the bedroom to bathroom.
- Avoid walking backwards.
- Check railings for stability.
- Install grab bars in the shower, near a toilet or near the sink.
- Modify your kitchen to avoid stooping or overhead reaching.
Research from several countries suggests that 50%-70% of people with MS report falls within a 6-month period. About 30%-50% of those individuals report falling multiple times, with resulting injuries. Enhancing a person’s ability to walk comfortably and safely, while preventing falls, is critical. Not only can falls cause injuries, but the time required to recover from broken bones or strained muscles can worsen mobility problems and reduce independence.In addition, fear of falling itself has been identified as an independent risk factor for future falls. Fear of falling can also lead to avoiding activities and social isolation.People with MS typically fall in or around their homes and neighborhoods, usually while doing basic activities such as bathing, preparing meals or walking in crowded areas. Risk factors for falls are complex and include:
To reduce your risk of falling:
- Poor balance and slowed walking
- Reduced proprioception (the sensation of where your body parts are in space)
- Dizziness
- Incorrect use of assistive devices (canes and walkers) or use of inappropriate devices
- Some medications or certain combinations of medications
Physical Therapy and Self-Management Strategies for MS
Most gait problems can be helped to some degree by physical therapy (PT), stretching exercises, the use of appropriate assistive devices and, in some cases, medications for spasticity, fatigue, and walking speed.Your physical therapist may suggest exercises or gait training such as vestibular exercises. These exercises induce brief periods of loss of balance to help you learn to adapt. Exercises may include eye or head movements, distorting or eliminating visual input, and changing or moving weight-bearing surfaces.If you’re having difficulty walking, speak to your healthcare provider. Fall prevention is important for your mobility and accessibility, independence and safety. Falls can cause injuries and increase mobility issues while you recover.To reduce your risk of falling:
- Wear safe, low-heeled shoes.
- Be conscious of where you are walking. For instance, stay away from a freshly washed floor.
- Get exercise, including aerobic and strengthening (including core strengthening) exercises.
- Review your medications.
- Make your home safe.
- Keep the areas where you walk clear.
- Move electric cords out of the way.
- Tack down loose carpets or remove them.
- Apply no-slip strips to tile and wooden floors.
- Install hand rails in the bathroom.
- Leave lights on at night or add nightlights to the path from the bedroom to bathroom.
- Avoid walking backwards.
- Check railings for stability.
- Install grab bars in the shower, near a toilet or near the sink.
- Modify your kitchen to avoid stooping or overhead reaching.