OBJECTIVE: To examine the relationship between gait initiation, fall history and physiological fall risk in individuals with multiple sclerosis (MS) during both cognitive distracting and non-distracting conditions.
DESIGN: Single time point cross sectional analysis. SETTING: University research laboratory. PARTICIPANTS: Twenty ambulatory individuals with MS ranging in age from 28 to 76 years. INTERVENTION: Not applicable MAIN OUTCOME MEASURE: Gait initiation time was quantified as the time to toe off of the first step following an auditory cue. Gait initiation was performed with and without concurrent cognitive challenge of reciting alternating letters of the alphabet. Additionally, participants underwent a test of fall risk utilizing the physiological profile assessment (PPA) and provided a self-report of number of falls in the previous three months.
RESULTS: Gait initiation times ranged from 0.67s to 1.12s during the single task condition and 0.73s to 1.84s during the cognitive challenge condition. PPA scores ranged from -0.80 to 3.87. Participants reported a median of 0.0 falls (IQR = 0.0-2.75) in the previous 3 months. There was a significant correlation between PPA score and gait initiation times only in the cognitive distraction condition (ρ=0.50). There was also a correlation between cognitive distraction gait initiation times and fall history (ρ=0.60).
CONCLUSION: The observations provide preliminary evidence that gait initiation during cognitive challenge may represent a target for fall prevention strategies in MS.