# A DELPHI STUDY TO IDENTIFY KEY GAIT PATTERNS AND THEIR POTENTIAL CAUSES IN PEOPLE WITH MULTIPLE SCLEROSIS

## TL;DR

This study identifies six common walking patterns in people with multiple sclerosis and their potential causes, aiming to improve clinical decision-making and treatment.

## Contribution

The study uses a Delphi method to reach expert consensus on gait patterns and their underlying impairments in multiple sclerosis.

## Key findings

- Six gait patterns were identified, including drop foot and enhanced gait variability.
- Expert consensus was reached with at least 69% agreement on naming and characteristics of each pattern.
- The findings may support better diagnosis and treatment of walking difficulties in multiple sclerosis.

## Abstract

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.

a 3-round Delphi study.

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.

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.

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.

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.

Around 60% of people with multiple sclerosis develop walking difficulties within 10 years of diagnosis. However, healthcare professionals may not always agree on how to diagnose or treat these problems, which can make treatment less effective. This study aimed to identify common walking patterns in people with multiple sclerosis and gather potential underlying causes of these patterns. We asked 20 experts from around the world – including physiotherapists and physicians – to review and anonymously discuss different types of walking difficulties in multiple sclerosis. After several rounds of discussion, they agreed on 6 main types of walking problems, including issues such as difficulty lifting the foot or leg and problems with balance and coordination. Understanding these common walking patterns and their potential causes can help healthcare professionals make better assessment and treatment decisions. This work is important for improving care and providing more personalized treatment for people with MS who have trouble walking.