Neurological disability and its association with walking impairment in multiple sclerosis: brief review

Neurological disability and walking impairment are two common, co-varying consequences of multiple sclerosis (MS) that can result in substantial patient burden for daily activities and quality of life. Indeed, neurological disability and walking impairment are driven by pathological changes in the central nervous system, and measurement of walking function is a common method of monitoring the progression of disease and neurological disability. The existing data indicate that the presence of walking impairments range from performance through real-world outcomes based on comparison of MS versus healthy controls, and walking impairments become worse with increasing severity of neurological disability (i.e., progression). Accordingly, researchers and clinicians have considered both pharmaceutical and rehabilitation approaches for managing walking impairment in MS. Both approaches yield beneficial effects on walking outcomes, although the majority of research has focused on exercise training rather than pharmaceutical interventions. Overall, this underscores the importance of continued efforts toward identifying approaches for preventing, forestalling and restoring walking function in persons with MS across the spectrum of neurological disability and its progression.