PTOtherJournal of rehabilitation medicine2025

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

Sjoerd T Timmermans, Marjolein M Van der Krogt, Marc B Rietberg and 2 others

PMID 40459010

WHAT IT FOUND

Twenty MS gait experts agreed on six gait patterns in multiple sclerosis: drop foot, stiff knee, knee flexion, knee hyperextension, insufficient push-off, enhanced variability, and likely causes.

This gives clinicians a shared way to describe walking problems.

Key findings

01The Delphi panel reached consensus on six gait patterns in people with MS: drop foot, stiff knee, knee flexion, knee hyperextension, insufficient push-off, and enhanced variability.

02Consensus was reached on key characteristics, additional characteristics, and key potential causes for all six patterns, but not for compensatory characteristics or additional potential causes for the knee flexion pattern.

03For the drop foot pattern, agreed key characteristics were decreased dorsiflexion in mid-swing and a mid- or forefoot strike at initial contact; for insufficient push-off, decreased ankle plantarflexion in terminal stance to pre-swing and decreased push-off power peak.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study reports expert consensus, not measurements from people with MS or outcomes after treatment. Only 20 experts participated, and 15 completed round III, so the result depends on a small selected panel. The panel was recruited from known experts, collaborators and top-publishing authors, which may limit breadth. The study was not registered prospectively. The research team grouped and re-presented answers, which could introduce interpretation bias. Consensus was set at 67%, and some items were only just above that threshold. Because MS is heterogeneous, less common gait patterns or individual impairments may be missing.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not read the six patterns as proven causes of disability or as a treatment plan that has been shown to work. The panel agreed on descriptions and likely causes, but no patient outcomes or interventions were tested.

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