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Published on: November 4, 2017
A Delphi study to identify key gait patterns and their potential causes in people with multiple sclerosis
Sjoerd T Timmermans1, Marjolein M Van der Krogt2, Marc B Rietberg3
1Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands; MS Center Amsterdam, Amsterdam UMC location Vrije Universiteit Amsterdam, The Netherlands. sj.timmermans@amsterdamumc.nl.
Objective:
This study aims to identify characteristic gait patterns in people with multiple sclerosis, to describe their key characteristics, and to identify their potential underlying causes.
Design:
a 3-round Delphi study.
Participants:
An international panel of 20 experts, including physiotherapists, a neurologist, rehabilitation physicians, biomechanical engineers, and movement scientists with expertise in multiple sclerosis or gait analysis.
Methods:
A comprehensive list of gait characteristics and underlying impairments was compiled and analysed to identify common gait patterns and their primary features and potential causes. Consensus was defined as 67% agreement.
Results:
Consensus was reached on 6 gait patterns in multiple sclerosis: (i) drop foot; (ii) insufficient push-off; (iii) stiff knee during swing; (iv) knee hyperextension during stance; (i) knee flexion in midstance; and (vi) enhanced gait variability. At least 69% agreement was achieved on the naming of the final gait patterns, their key characteristics, and the potential causes of each pattern.
Conclusion:
Consensus was achieved on 6 gait patterns, their characteristics, and potential underlying causes. The identification of these gait patterns may support clinical decision-making regarding diagnostic and treatment measures, and deepen understanding of impairments that underlie walking problems in people with multiple sclerosis.
