A Delphi study to identify key gait patterns and their potential causes in people with 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.