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 nondistracting conditions.
Design: Single time point cross-sectional analysis.
Setting: University research laboratory.
Participants: Ambulatory individuals (N=20) with MS ranging in age from 28 to 76 years.
Intervention: Not applicable.
Main outcome measures: Gait initiation time was quantified as the time to toe-off of the first step after an auditory cue. Gait initiation was performed with and without a concurrent cognitive challenge of reciting alternating letters of the alphabet. Additionally, participants underwent a test of fall risk using the Physiological Profile Assessment (PPA) and provided a self-report of the number of falls in the previous 3 months.
Results: Gait initiation times ranged from .67 to 1.12 seconds during the single-task condition and .73 to 1.84 seconds during the cognitive challenge condition. PPA scores ranged from -.80 to 3.87. Participants reported a median of 0.0 falls (interquartile range, 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=.50). There was also a correlation between cognitive distraction gait initiation times and fall history (ρ=.60).
Conclusions: The observations provide preliminary evidence that gait initiation during cognitive challenge may represent a target for fall prevention strategies in MS.
Keywords: Accidental falls; Gait; Locomotion; Multiple sclerosis; Rehabilitation.
Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.