ADSTEP: Preliminary Investigation of a Multicomponent Walking Aid Program in People With Multiple Sclerosis.

Only 40 participants were randomized, so the study was small and not powered to draw definitive conclusions about many outcomes. The study was carried out at a single site with one physical therapist providing ADSTEP. The control condition did not control for one-to-one time. ADSTEP combined walking aid selection, fitting, and task-oriented training, so the contribution of any single component cannot be separated. Physical activity was self-reported with the IPAQsf rather than measured objectively. Participants were not excluded for having received other forms of physical therapy. The paper does not state a single primary outcome; positive results are on faller status and sitting time, while total falls, timed mobility, and patient-reported outcomes were not significant. Participants had to be right-handed, weigh under 350 pounds, and have no MRI contraindications because a subset underwent functional MRI. Nineteen ADSTEP participants completed all six sessions and one completed five sessions, so not all received the full program.

The supplied article text does not report funding or author conflicts; the publication types list U.S. government non-PHS support.

Do not conclude that ADSTEP prevents all falls or improves walking speed. The study found fewer people who fell at least once and less sitting, but total falls, timed mobility tests, and patient-reported outcomes were not significantly different, and the program's selection, fitting, and training components cannot be separated.