In multiple sclerosis (MS), the body mistakenly attacks healthy cells in the central nervous system (CNS). The CNS plays a role in many of our body’s functions. The brain and spinal cord are part of the CNS and help with movement and sensation.1
When there is damage to the CNS, issues with getting around may arise. It can become harder to move in general. When a person has problems moving or walking, falls and injuries occur.1
What are mobility and gait problems?
Difficulties with moving around are called mobility issues. The term gait refers to the way a person walks. Both mobility and gait problems can cause serious issues with quality of life. Common causes of these issues include:2
- Arthritis and other degenerative conditions like rheumatoid arthritis and muscular dystrophy
- Problems with the inner ear that affects balance
- Stroke
- Problems with the feet or legs
- Neurological conditions that impact sensation or motor function, like MS
- Drug or alcohol use
- Treatment side effects
- Poor-fitting footwear
Gait problems can come in many forms. A spastic gait is common in MS. It occurs when the muscles in 1 or both legs are stiff, causing the leg or legs to drag.2
A steppage gait is common in those with foot drop. This is when the foot flops down instead of staying flat due to muscle weakness. Lifting the leg with the foot drop higher in the air occurs when walking (high stepping) to avoid dragging the foot.2
Gait issues can vary based on their underlying cause. Having a hard time walking or moving parts of the body can cause issues with completing daily tasks. This can have a big impact on quality of life.
Why do mobility and gait problems occur in MS?
As many as 50 to 70 percent of people with MS have reported falling in the last 6 months. This may be related to gait and mobility problems. About 33 percent have fallen multiple times or have had an injury after.3,4
There are many reasons why a person with MS might have issues with walking or moving. MS and related nerve damage can cause muscle weakness or severe stiffness (spasticity) in the hips, legs, or feet leading to difficulty walking.1,3-5
MS can also result in issues with balance and the way we perceive our body in space and adjust our balance (proprioception). This can lead to swaying while walking. In addition, not being able to feel where the limbs are due to numbness can make mobility and gait issues even worse.
Vision problems, MS-related fatigue, and dizziness can also make walking hard. Further, drugs used to treat MS or other health issues can cause walking problems, neurological issues, or dizziness as a side effect.1,3-5
In some cases, problems getting around may be related to using mobility aids incorrectly. While a person might have a cane or other helpful tool, if it is not being used properly, it may actually increase the risk of falling or walking issues.1,3-5
Managing mobility and gait problems
In general, physical therapy and walking aids are the main treatment options for mobility and gait issues.
Physical therapy is focused on strengthening and stretching muscles. Some physical therapy exercises involve testing balance and teaching how to respond in times when you feel unsteady. Walking or mobility aids can also be helpful. These include things like canes, walkers, wheelchairs, and more.3-5
In some cases, certain drugs can be used to help with spasticity or walking problems. You and your doctor can work together to determine the underlying cause of mobility or gait issues and create the best treatment plan.3-5
The risk of falling is higher for those with mobility or gait problems. Steps that can be taken to reduce the risk of falls include:4,5
- Strengthening exercises like those during physical therapy
- Using a walking aid or railings
- Wearing low-heeled or non-slip shoes, or non-slip socks if walking without shoes
- Wearing well-fitting clothes without tripping hazards
- Lighting all areas of the house well or remaining in well-lit areas when out
- Removing or securing all floor rugs and electrical cords near the ground
- Being aware of small pets or other objects that may be on the ground
- Placing reflective, non-slip strips on stairs
- Taking extra precautions when walking on uneven surfaces like gravel or sand