Examination of Proprioceptive Reliance During Backward Walking in Individuals With Multiple Sclerosis.
Michael VanNostrand, Patrick G Monaghan, Nora E Fritz
PMID 39630282WHAT IT FOUND
Backward walking speed in people with MS depended more heavily on foot sensation than forward walking did.
Those who had fallen recently had worse sensation and walked slower backward. This suggests backward walking is a sensitive test for sensory-driven balance issues.
Key findings
01Vibration sensation thresholds correlated more strongly with backward walking times than with forward walking times, indicating a higher reliance on proprioception when walking backward.
02Participants who reported two or more falls in the past year had significantly higher vibration thresholds (worse sensation) than non-fallers.
03After adjusting for age, sex, and disability level, vibration sensation remained the largest contributor to backward walking performance, whereas disability level was the largest contributor to forward walking.
STILL TO COME
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What it does not show
The study used a cross-sectional design, so it cannot prove that improving sensation will improve backward walking or reduce falls. Fall history was based on self-report over the past year, which is subject to recall bias. Sensation was only tested at the great toe, so the results may not reflect proprioceptive deficits at other foot locations. Vestibular function and spasticity were not assessed, despite being known contributors to balance issues in MS. The sample size was moderate (50 participants), and all had mild to moderate disability, limiting generalizability to those with severe mobility impairment.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not assume that backward walking deficits are caused solely by poor proprioception. The study shows an association, but other factors like vestibular function or spasticity, which were not measured, could also contribute to the difficulty.