Gait Problems (Difficulty in Walking)
From The MS Information Sourcebook, produced by the National MS Society.
Problems with gait (difficulty in walking) are among the most common mobility limitations in MS. Gait problems are usually related to several factors.
- Weakness: Muscle weakness is a common cause of gait difficulty. Weakness can cause problems such as toe drag, foot drop, or other gait abnormalities such as "vaulting" (a compensatory technique that involves raising the heel on the stronger leg to make it easier to swing the weaker leg through) , compensatory hip hike, trunk lean, or circumduction (swinging leg out to the side). Weakness in both legs is known as paraparesis ; weakness in only one leg is called monoparesis . Weakness can often be compensated for with the use of appropriate exercises and assistive devices, including braces, canes, or walkers.
- Spasticity: Muscle tightness or spasticity can also interfere with gait. Antispasticity medications such as baclofen or tizanidine are generally effective in treating this symptom. Stretching exercises are also helpful.
- Loss of Balance: Balance problems typically result in a swaying and "drunken" type of gait known as ataxia. People with severe ataxia generally benefit from the use of an assistive device.
- 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."
- Fatigue: Many people will experience increased gait abnormalities/difficulties when fatigue increases.
Most gait problems can be helped to some extent by physical therapy (including exercises and gait training), by the use of appropriate assistive devices and, in some cases, by medications. Each person's gait disorder needs to be evaluated on an individual basis. Careful evaluation by a trained healthcare professional is essential to determine an appropriate therapy program for each individual.
For Healthcare Professionals
Holland NJ, Halper J (eds.). Multiple Sclerosis: A Self-Care Guide to Wellness (2nd ed.). New York: Demos Medical Publishing, 2005.
—Ch. 6 Maintaining Joint Flexibility and Mobility
Kalb R. (ed.) Multiple Sclerosis: The Questions You Have; The Answers You Need (3rd ed.). New York: Demos Medical Publishing, 2004.
—Ch. 5 Physical Therapy
Schapiro R. Managing the Symptoms of Multiple Sclerosis (5th ed.). New York: Demos Medical Publishing, 2007.
—Ch. 8 Mobility: Putting It All Together