The walking experience of persons with multiple sclerosis: a systematic review with evaluation of the sensitivity of the ICF framework to the lived experience.

Abstract

Conduct a systematic review aimed to identify and synthesise evidence describing how walking impairment impacts the way persons with multiple sclerosis (MS) participate in activities within their homes and communities. Further, we assessed the sensitivity of the International Classification of Functioning, Disability and Health (ICF) framework to the lived walking experience for persons with MS. Seven electronic databases were searched for peer-reviewed articles on the walking experience of persons with MS. Qualitative articles were included if they included quotes from persons with MS regarding community walking. Qualitative data were synthesised using a hybrid inductive and deductive thematic analysis, guided by the ICF framework and quality was appraised using the CASP tool. We included 90 eligible studies (214 quotes, 1813 participants). Study quality was high in 54% of studies. Four themes were identified: (1) adapting to physical barriers; (2) navigating society; (3) emotion and mindset; and (4) personal relationships. The impact of walking impairment on community participation is perceived by persons with MS as negative and the cause of disconnect from those around them. Barriers are largely perceived as extrinsic to the self. Caution should be exercised when conceptualising walking experiences with MS using the ICF framework alone.