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Gait Abnormalities in Multiple Sclerosis: Pathogenesis, Evaluation, and Advances in Treatment

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Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system characterized by episodic decline in various neurologic functions. Gait dysfunction in MS is distinguished by decreased gait speed, walking endurance, step length, cadence and joint motion, as well as increased metabolic cost of walking and increased variability of gait. Standardized clinical, timed, and patient-based measures can identify MS patients with gait dysfunction, and observational gait analysis, instrumented walkways, or three-dimensional gait analysis can help determine which problem underlies their gait dysfunction to help direct effective treatment. Exercise may ameliorate all types of gait dysfunction. In addition, gait dysfunction due to weakness may be alleviated by orthoses or functional electrical stimulation; gait dysfunction due to spasticity may be relieved by oral, intrathecal, or intramuscular medications. Assistive devices and balance training may reduce gait dysfunction from imbalance, and dalfampridine may accelerate gait in people with MS who walk slowly.

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Disclosure

Conflicts of interest: M.H. Cameron: has been a consultant for Innovative Neurotronics; has received grant support from Acorda; and has received a career development award from the Rehabilitation Research & Development Service, Department of Veterans Affairs; J.M. Wagner: none.

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Authors and Affiliations

  1. Portland VA Medical Center, Portland, OR, USA

    Michelle H. Cameron

  2. Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CR120, Portland, OR, 97239, USA

    Michelle H. Cameron

  3. Department of Physical Therapy and Athletic Training, Saint Louis University, 3437 Caroline Mall Suite 1026, St. Louis, MO, 63104, USA

    Joanne M. Wagner

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  1. Michelle H. Cameron
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Correspondence to Michelle H. Cameron.

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Cameron, M.H., Wagner, J.M. Gait Abnormalities in Multiple Sclerosis: Pathogenesis, Evaluation, and Advances in Treatment. Curr Neurol Neurosci Rep 11, 507–515 (2011). https://doi.org/10.1007/s11910-011-0214-y

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  • DOI: https://doi.org/10.1007/s11910-011-0214-y

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