{"doi":"10.1155/2020/6707414","title":"Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS","abstract":"Background . Individuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports. Methods . All measures were collected in a single session. A <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"><mml:mn>2</mml:mn><mml:mo>×</mml:mo><mml:mn>2</mml:mn><mml:mo>×</mml:mo><mml:mn>2</mml:mn></mml:math> mixed model ANOVA was used to compare differences in forward and backward walking in single- and dual-task conditions between MS and healthy controls. Spearman correlations were used to examine relationships between gait and cognitive function, falls, and balance. Results . Eighteen individuals with relapsing-remitting MS and 14 age- and sex-matched healthy controls participated. Backward walking velocity revealed significant differences between groups for both single-task (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.015</mml:mn></mml:math>) and dual-task (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.014</mml:mn></mml:math>) conditions. Persons with MS demonstrated significant differences between single- and dual-task forward and backward walking velocities (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.023</mml:mn></mml:math>; <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.004</mml:mn></mml:math>), whereas this difference was only apparent in the backward walking condition for healthy controls (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M6\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.004</mml:mn></mml:math>). In persons with MS, there were significant differences in double support time between single- and dual-task conditions in both backward (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M7\"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:math>) and forward (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M8\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.001</mml:mn></mml:math>) directions. More falls at six months were significantly associated with shorter backward dual-task stride length (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M9\"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>−</mml:mo><mml:mn>0.490</mml:mn></mml:math>; <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M10\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.046</mml:mn></mml:math>) and slower velocity (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M11\"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>−</mml:mo><mml:mn>0.483</mml:mn></mml:math>; <mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\" id=\"M12\"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.050</mml:mn></mml:math>). Conclusion . Differences in MS and age- and sex-matched healthy controls are more pronounced during backward compared to forward walking under single- and dual-task conditions. Future work with a larger sample size is needed to validate the clinical utility of backward walking and dual-task assessments and mitigate the limited sensitivity of the current dual-task assessments that primarily rely upon forward walking.","journal":"Multiple Sclerosis International","year":2020,"id":100183,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":29,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9646,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":493093,"name":"Deborah Kegelmeyer","orcid":null,"position":1,"is_corresponding":false},{"id":492149,"name":"Anne Kloos","orcid":"0000-0002-9169-6589","position":2,"is_corresponding":false},{"id":493094,"name":"Manon Nitta","orcid":null,"position":3,"is_corresponding":false},{"id":493095,"name":"Danya Raza","orcid":null,"position":4,"is_corresponding":false},{"id":493096,"name":"Deborah S. Nichols‐Larsen","orcid":null,"position":5,"is_corresponding":false},{"id":492150,"name":"Nora E. Fritz","orcid":"0000-0002-4548-1077","position":6,"is_corresponding":false},{"id":492148,"name":"Erin M. Edwards","orcid":"0000-0003-0488-3165","position":0,"is_corresponding":true}],"reference_count":51,"raw_metadata":null,"created_at":"2026-07-18T22:38:35.493878Z","pmid":"32963832","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}