Forward Walking Research Articles

Examination of Proprioceptive Reliance During Backward Walking in Individuals With Multiple Sclerosis

Background: Slowed somatosensory conduction in multiple sclerosis (MS) increases postural instability and decreases proprioception. Despite these delays, individuals with MS rely more on proprioception for balance compared to controls. This heightened reliance, combined with slowed signal transduction, increases fall risk. Backward walking (BW) increases proprioceptive reliance by reducing visual cues. However, no study has conclusively linked proprioception to BW. This study aims to assess proprioception’s role in BW compared to forward walking (FW) in MS and to compare differences in proprioception between MS fallers and non-fallers. Methods: Fifty participants (average age: 50.34 ± 11.84, median Patient Determined Disease Steps [PDDS]: 2) completed the study. Participants completed BW and FW at comfortable and fast speeds. We have previously established vibration sensation as a proxy measure for proprioception. Vibration thresholds were quantified at the great toe bilaterally using a 2-alternative forced-choice procedure. Results: Significant correlations were seen for vibration sensation and FW comfortable (ρ = 0.35), FW fast (ρ = 0.34), BW comfortable (ρ = 0.46), and BW fast (ρ = 0.46). After controlling for age, sex, and PDDS, vibration sensation significantly predicted performance during all walking tasks, with larger beta coefficients seen during BW (comfortable β = 0.57; fast β = 0.58) compared to FW (comfortable β = 0.41; fast β = 0.45). Fallers performed significantly worse than non-fallers for vibration sensation (P = 0.04). Discussion and Conclusions: Considering the notable decrease in proprioception in participants with MS and the clear distinction between fallers and non-fallers, it is crucial to conduct fall risk assessments and interventions focusing on proprioception. With its heightened reliance on proprioception, BW offers a promising method for assessing fall risk and could be an effective exercise intervention. Video Abstract available for more insights from the authors (see the Supplemental Digital Content available at: http://links.lww.com/JNPT/A490).

Neural circuit mechanisms underlying context-specific halting in Drosophila

Walking is a complex motor programme involving coordinated and distributed activity across the brain and the spinal cord. Halting appropriately at the correct time is a critical component of walking control. Despite progress in identifying neurons driving halting1–6, the underlying neural circuit mechanisms responsible for overruling the competing walking state remain unclear. Here, using connectome-informed models7–9 and functional studies, we explain two fundamental mechanisms by which Drosophila implement context-appropriate halting. The first mechanism (‘walk-OFF’) relies on GABAergic neurons that inhibit specific descending walking commands in the brain, whereas the second mechanism (‘brake’) relies on excitatory cholinergic neurons in the nerve cord that lead to an active arrest of stepping movements. We show that two neurons that deploy the walk-OFF mechanism inhibit distinct populations of walking-promotion neurons, leading to differential halting of forward walking or turning. The brake neurons, by constrast, override all walking commands by simultaneously inhibiting descending walking-promotion neurons and increasing the resistance at the leg joints. We characterized two behavioural contexts in which the distinct halting mechanisms were used by the animal in a mutually exclusive manner: the walk-OFF mechanism was engaged for halting during feeding and the brake mechanism was engaged for halting and stability during grooming.

Effect of Backward Walking Versus Forward Walking Training on Balance Among Children with Cerebral Palsy

Background: Cerebral palsy is characterized by long-term impairments in movement and posture that limit an individual’s ability to perform daily activities. Effective rehabilitation methods, such as forward and backward walking training, can improve balance and functional mobility in children with cerebral palsy.Objective: To compare the effects of backward walking training versus forward walking training on balance in children with cerebral palsy.Methods: A randomized clinical trial was conducted with 20 children aged 7-14 years, recruited from Children’s Hospital and Jinnah Hospital, Lahore. Participants were randomly divided into two groups: Group A (Forward Walking Training) and Group B (Backward Walking Training). Each group underwent training three times per week for 40 minutes over four weeks. Balance and mobility were assessed using the Time-Up-and-Go (TUG) test, Pediatric Balance Scale (PBS), and Figure-8 Walk Test (FW8T). Statistical analysis was performed using SPSS version 25, with Mann-Whitney U test used for between-group comparisons.Results: The backward walking group showed significant improvements in TUG (p = 0.03), PBS (p = 0.01), and FW8T (p = 0.01) compared to the forward walking group.Conclusion: Backward walking training showed superior improvements in balance and functional mobility compared to forward walking training in children with cerebral palsy.

Decentralized control law for load-adaptive gaits of multi-legged robots inspired by millipedes

ABSTRACT Millipedes increase the duty ratio and wavelength of their gait to enhance thrust force against resistive load. However, the underlying control mechanisms responsible for generating such adaptive gaits remain elusive. In this study, we proposed a decentralized control law based on the concept of ‘discrepancy function’. Our proposed walking controller successfully reproduced the load-adaptive gaits of millipedes on the inclined ground. Furthermore, we evaluated the adaptability of our controller to horizontal resistive forces that hinder forward walking. Our simulation results suggest that the millipede-inspired controller could be beneficial for multi-legged robots equipped with leg actuators operating under limited motor outputs.

Analysis of electroencephalography characteristics during walking in stroke patients under different conditions: a cross-sectional study.

Aims/Background Backward walking is gaining traction in rehabilitation therapy, showing promise as an intervention for stroke patients with walking difficulties. However, the brain activity patterns (neurophysiological mechanisms) underlying backward walking in these patients remain unclear. This study investigated the neurophysiological mechanism in stroke patients within 1 year of their stroke. Methods Twenty-four subjects walked forward and backward for 5 min on an 8-m track while their electroencephalographic signals were collected. The power values of each frequency band were compared during forward and backward walking, and the delta to alpha power ratio (DAR) was calculated. Results The results showed a significant increase in α-band activity within the frontal cortex during backward walking (p < 0.05). This increase correlated positively with scores on the Fugl-Meyer lower extremity motor function assessment scale. Similarly, α-band activity showed significant enhancement within the right parietal cortex during backward walking (p < 0.05). There were no significant differences between forward and backward walking states in δ, θ, and β wavebands across the entire brain region (p > 0.05). Additionally, the DAR was significantly lower during backward walking than during forward walking (p < 0.05). Conclusion This study suggests that backward walking may more effectively activate neural activity in the prefrontal and right posterior parietal cortices. This finding supports the potential of backward walking to enhance motor execution and walking function in stroke patients, thereby supporting its application as a rehabilitation method.

Trunk kinematics and limb movement of horses walking backwards and forwards in hand and lifting a single limb

Equine physiotherapy commonly includes basic exercises such as walking backward (BW) and voluntary lifting of single limbs (SLL), but trunk movements during these have not been studied. In order to compare the trunk kinematics during BW and SLL with forward walking (FW), nine horses were measured in FW, BW and during SLL triggered by tactile cue. Kinematics were obtained from skin markers captured by ten high-speed video cameras. Trunk angles were calculated in sagittal and horizontal planes from withers, dorsal to spinous processes of the 16th thoracic vertebra (T16), 2nd and 4th sacral vertebrae (S2, S4), WT16S2 and T16S2S4 respectively. From the hooves, maximum hoof height during swing phase and horizontal distance between hoof and median body plane during swing and stance phases were determined.Dorsoventral range of motion (ROM) and maximum flexion of WT16S2 was significantly larger in BW than in FW, while laterolateral ROM was significantly smaller during hindlimb swing phase in BW and SLL than in FW. In contrast, dorsoventral ROM of T16S2S4 was significantly smaller during stance and swing phases of hindlimbs in BW compared to FW, and throughout the movement. During forelimb swing phase, T16S2S4 ROM was significantly larger in BW than SLL. Hindhoof height in SLL was significantly higher than in FW. Distance between median body plane and hooves was significantly larger in BW than in FW, and significantly larger in BW than in SLL for hindlimb swing phase. In BW, increased lumbosacral stabilisation and the larger area of support created by fore- and hindlimbs may represent a strategy to enhance body stabilisation, as BW entails some insecurity.

Sleep benefits perceptual but not movement-based learning of locomotor sequences

Practicing complex locomotor skills, such as those involving a step sequence engages distinct perceptual and motor mechanisms that support the recall of learning under new conditions (i.e., skill transfer). While sleep has been shown to enhance learning of sequences of fine movements (i.e., sleep-dependent consolidation), here we examined whether this benefit extends to learning of a locomotor pattern. Specifically, we tested the perceptual and motor learning of a locomotor sequence following sleep compared to wake. We hypothesized that post-practice sleep would increase locomotor sequence learning in the perceptual, but not in the motor domain. In this study, healthy young adult participants (n = 48; 18–33 years) practiced a step length sequence on a treadmill cued by visual stimuli displayed on a screen during training. Participants were then tested in a perceptual condition (backward walking with the same visual stimuli), or a motor condition (forward walking but with an inverted screen). Skill was assessed immediately, and again after a 12-h delay following overnight sleep or daytime wake (n = 12 for each interval/condition). Off-line learning improved following sleep compared to wake, but only for the perceptual condition. Our results suggest that perceptual and motor sequence learning are processed separately after locomotor training, and further points to a benefit of sleep that is rooted in the perceptual as opposed to the motor aspects of motor learning.

Study protocol of a randomized controlled trial comparing backward walking to forward walking training on balance in multiple sclerosis: The TRAIN-MS trial

Balance impairment and accidental falls are a pervasive challenge faced by persons with multiple sclerosis (PwMS), significantly impacting their quality of life. While exercise has proven to be an effective intervention for improving mobility and functioning in PwMS, current exercise approaches predominantly emphasize forward walking (FW) and balance training, with variable improvements in balance and fall rates. Backward walking (BW) has emerged as a promising intervention modality for enhancing mobility and strength outcomes; however, significant gaps remain. Specifically, there is limited knowledge about the efficacy of BW interventions on outcomes such as static, anticipatory, and reactive balance, balance confidence, falls, and cognition. This randomized controlled trial aims to determine the feasibility, acceptability, and impact of 8-weeks of backward walking training (TRAIN-BW) as compared to forward walking training (TRAIN-FW). Ninety individuals with MS with self-reported walking dysfunction or ≥ 2 falls in the past 6 months will be randomized in blocks, stratified by sex and disease severity to either the TRAIN-BW or TRAIN-FW intervention groups. Adherence and retention rates will be used to determine feasibility and the Client Satisfaction Questionnaire will be used to assess acceptability. The primary outcomes will be static, anticipatory, and reactive balance. Secondary outcomes include walking velocity, balance confidence, concern about falling, cognition, physical activity, and fall rates measured prospectively for 6 months after post-testing. Additionally, the extent to which cognitive functioning influences response to intervention will be examined. Backward walking training may be an innovative intervention to address balance impairments and falls in persons with MS.

Effectiveness of forward and retro walking in subjects with osteoarthritis of knee: A comparative study

Effectiveness of forward and retro walking in subjects with osteoarthritis of knee: A comparative study

A leg model based on anatomical landmarks to study 3D joint kinematics of walking in Drosophila melanogaster.

Walking is the most common form of how animals move on land. The model organism Drosophila melanogaster has become increasingly popular for studying how the nervous system controls behavior in general and walking in particular. Despite recent advances in tracking and modeling leg movements of walking Drosophila in 3D, there are still gaps in knowledge about the biomechanics of leg joints due to the tiny size of fruit flies. For instance, the natural alignment of joint rotational axes was largely neglected in previous kinematic analyses. In this study, we therefore present a detailed kinematic leg model in which not only the segment lengths but also the main rotational axes of the joints were derived from anatomical landmarks, namely, the joint condyles. Our model with natural oblique joint axes is able to adapt to the 3D leg postures of straight and forward walking fruit flies with high accuracy. When we compared our model to an orthogonalized version, we observed that our model showed a smaller error as well as differences in the used range of motion (ROM), highlighting the advantages of modeling natural rotational axes alignment for the study of joint kinematics. We further found that the kinematic profiles of front, middle, and hind legs differed in the number of required degrees of freedom as well as their contributions to stepping, time courses of joint angles, and ROM. Our findings provide deeper insights into the joint kinematics of walking in Drosophila, and, additionally, will help to develop dynamical, musculoskeletal, and neuromechanical simulations.

EMG-based prediction of step direction for a better control of lower limb wearable devices

Background and objectivesLower-limb wearable devices can significantly improve the quality of life of subjects suffering from debilitating conditions, such as amputations, neurodegenerative disorders, and stroke-related impairments. Current control approaches, limited to forward walking, fall short of replicating the complexity of human locomotion in complex environments, such as uneven terrains or crowded places. Here we propose a high-level controller based on two Support Vector Machines exploiting four surface electromyography (EMG) signals of the thigh muscles to detect the onset (Toe-off intention decoder) and the direction (Directional EMG decoder) of the upcoming step. Methods and materialsWe validated a preliminary version of the approach by acquiring EMG signals from ten healthy subjects, performing steps in four directions (forward, backward, right, and left), in three different settings (ground-level walking, stairs, and ramps), and in both steady-state and static conditions. Both the Toe-off intention and Directional EMG decoders have been tested with a 5-fold cross-validation repeated five times, using linear and radial-basis-function kernels, and by changing the classification output timing, from 200 ms before to 50 ms after the toe-off. ResultsThe Toe-off intention decoder reached a median accuracy of 83.34 % (interquartile range (IQR): 6.48) and specificity of 92.72 % (IQR: 3.62) in its radial-basis-function version, while the Directional EMG decoder's median accuracy ranged between 73.92 % (IQR: 5.8), 200 ms before the toe-off, to 92.91 % (IQR: 4.11), 50 ms after the toe-off, with the radial-basis-function kernel implementation. For both the Toe-off intention and Directional EMG decoders the radial-basis-function version achieved better performances than the linear one (Wilcoxon signed rank test, p < 0.05). Conclusions and significanceThe combination of the two decoders proved to be a promising solution to detect the step initiation and classify its direction, paving the way for wearable devices with a broader range of movements and more degrees of freedom, ultimately promoting usability in uncontrolled settings and better reactions to external perturbations. Additionally, the encumbrance of the setup is limited to the thigh of the leg of interest, which simplifies the implementation in compact devices, concurrently limiting the sensors worn by the subject.

Effects Of Forward &amp; Backward Walking on Gait Parameters of Patients with Chronic Stroke: A Preliminary Trial

Background: Gait training after stroke is of paramount importance for independent living and quality of life. Objectives: The purpose of this study was to examine the effects of forward and backward walking over a firm level and a sandy surface on gait parameters among stroke patients. Methods: A total of 20 subjects randomly assigned to four groups were evaluated on various gait parameters while walking on a firm level surface and on sand. Baseline evaluation of temporal and spatial parameters of gait was conducted through stride analysis and final measurement after 3 weeks of intervention. Results: Backward walking on sand showed a statistically significant improvement in walking velocity, cadence, step/stride length, and gait symmetry among chronic stroke patients. Conclusion: The results of this study support the use of backward walking on sand as a new tool to improve functional walking among stroke patients. Such enhanced improvement can be attributed to the fact that backward walking on sand is more challenging than forward walking.

A Confounding-Domain Randomized Approach for Providing Source Location Privacy Preservation for Wireless Sensor Networks

Wireless sensor networks (WSNs) have advanced technologically, allowing for a wide range of Internet of Things (IoT) applications. The Internet of Things (IoT) provides a platform for connecting items to achieve a specific goal with minimal human intervention. Various practical sectors, such as environmental monitoring and defense, demand IoT support with maximum object connectivity, and low human participation, yet face security concerns from strong unauthorized entities. As location privacy is one of these major vulnerabilities, continual monitoring of contextual information may lead the attacker to the asset's position. The location privacy of the source node that detects and reports the presence of an event is critical. In this study, we provide a source location privacy (SLP) preservation technique based on confounding domain angular routing (SLP-CDAR) that attempts to improve security while increasing network lifespan. To avoid traffic analysis attacks, packets first undergo a random walk, followed by a perplexing time domain routing that creates additional diversionary pathways. The packets are then routed via angle routing, followed by a random path, and finally delivered to the base station using the forward random walk technique. The experimental results prove that the proposed scheme enhances the location privacy strength while providing an improved network lifetime, and a swift increase in the entropy.

A Performance Efficient Quadrant-Based Scheme for Multiple Assets Location Preservation in Wireless Sensor Networks

The usefulness of wireless sensor networks has grown throughout numerous areas, many of which demand constant monitoring of the event of interest by the sensor nodes. The wireless transfer of information and the connection of the sensors, however, present the network with a number of security risks. A real-world concern is a danger to source location privacy for networks when several events of interest are monitored. In this research, we present the quadrant-based boundary routing (QBR) method for multiple source location privacy protection. In the first phase, the packet is routed arbitrarily away from the source nodes by random routing, and then quadrant routing begins. Before being sent to the base station using a forward random walk, the packet is transmitted to either side of the network border. We present a theoretical analysis of the maximum delay for the proposed technique. Extensive simulations are carried out and results demonstrate that in contrast to Shortest Path Routing, QBR elevates security by 880.95%, entropy by 623.28%, and capture rate by 71.42% for multiple assets, whereas contemporary PRLPRW increases the corresponding metrics by 692%, 390%, and 49.28%, respectively.

Possibilities of backward walking application in the rehabilitation of patients with gonarthrosis: review

INTRODUCTION. Osteoarthritis of the knee joint or gonarthrosis (GA) is one of the most common joint pathologies. The medical and social significance of GA is associated with its high prevalence and a significant percentage of premature disability and a significant deterioration in the quality of life due to persistent pain syndrome. Modern treatment of patients with GA includes a combination of pharmacological and non-pharmacological methods; physical therapy is the leading method of non-drug therapy. By now, a number of studies have been conducted to research the effectiveness of backward walking (BW) in people with GA. AIM. Analysis of scientific data on the possibilities of using BW in the rehabilitation of patients with GA. MATERIALS AND METHODS. A systematic search of literary sources by keywords was carried out: “backward walking”, “gonarthrosis”, “knee osteoarthritis”, “knee joint”, “rehabilitation”, “physical therapy”. DISCUSSION. Recently, backward locomotion is increasingly used in medicine. Kinetic and kinematic analysis during BW showed a number of advantages over the usual method of movement, which can be successfully used for rehabilitation of patients with GA. BW is associated with less overload on knee joints. It is also one of the few natural ways of strengthening the quadriceps. It prevents excessive stretching of the anterior cruciate ligament and improves the stability of the knee joint. BW leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity. CONCLUSION. There is evidence that adding BW to conventional physiotherapy treatment may further reduce pain, functional disability and improve the strength of the quadriceps muscles.

Aktivitas Berjalan Di Atas Papan Titian Terhadap Perkembangan Motorik Kasar Anak Usia 5-6 Tahun

Gross motor skills are the ability to move the body using large muscles, most or all of the body's gross motor skills are needed by children to sit, kick, run, go up and down stairs. The aim of this research is to determine the effect of walking on a boardwalk on gross motor development in children aged 5-6 years. The method used in this research is quasi-experiment. The design of this research is pretest and posttest (the one group pretest posttest design). This research was conducted at the Asfiyah Lidah Wetan Islamic Kindergarten, Lakarsantri District, Surabaya, East Java. The practice time in the field is 7 weeks with a training duration of 2 times per week. The population in this study were all students at Asfiyah Islamic Kindergarten who were active in walking on the boardwalk with a total of 45 students. The sampling technique in this research is total sampling, namely a sampling technique with the number of samples equal to the population. The research instruments that I carried out were using tests of walking forward with arms outstretched, walking sideways with arms outstretched, walking forward with hands on the waist, walking forward with hands folded in front of the chest, and standing on one leg in an airplane stance. The collection technique in this study used Wilcoxon. The conclusion in this study shows that there is a significant Sig (2-tailed) influence of the activity of walking on the boardwalk on the gross motor development of children aged 5-6 years at the Asfiyah Lidah Wetan Islamic Kindergarten using the outstretched hands forward walking test, walking sidewaysarms outstretched, walking forward with hands on your waist, walking forward with your hands folded in front of your chest, and standing on one leg in an airplane stance. It is proven that the Sig value. (2-tailed) of the five indicators &lt; 0.05.

Measurement Properties of Backward Walking and Its Sensitivity and Feasibility in Predicting Falls in People With Multiple Sclerosis.

People with multiple sclerosis (MS) experience mobility impairments that elevate fall risk, increasing the need to identify clinical measures that accurately predict falls. Backward walking (BW) better differentiates fallers from nonfallers in MS. However, no studies have reported the measurement properties of the backward walking Timed 25-Foot Walk (B-T25-FW) and BW metrics, like BW velocity. Additionally, it is unknown whether BW can predict future falls in MS or its link to activity levels. This study assessed the reliability and responsiveness of B-T25-FW and BW metrics, including BW velocity. It also examined whether BW could predict falls at 3 and 6 months and its association with activity levels. During 2 separate visits, 23 people with MS completed the forward walking Timed 25-Foot Walk (F-T25-FW) and B-T25-FW, as well as forward walking and BW assessments in which spatiotemporal measures were recorded. Test-retest reliability was determined with intraclass correlation coefficients, and minimum detectable changes were calculated. Correlation analyses explored the relationship between BW velocity, B-T25-FW, prospective falls, and activity levels. B-T25-FW and BW velocity exhibited excellent test-retest reliability. Large effect sizes to interpret clinically meaningful change in the B-T25-FW and BW velocity were also found. Both metrics demonstrated modest negative correlations with falls at 3 and 6 months and correlated strongly with very active minutes at 3- and 6-months post study. The B-T25-FW and BW velocity are effective and reliable in clinical use for evaluating functional mobility in people with MS, are sensitive enough to detect subtle changes, and may be a meaningful marker for tracking disease progression and treatment efficacy.

Function of flow wakes for queuing trilobites: Positioning rather than drag reduction – Criteria for drag force assessment in palaeontological CFD simulations

Trilobites are one of the most important invertebrate clades in the Palaeozoic, with significant disparity in morphology and behaviour, the latter including intriguing instances of queueing. Previous studies employed Computational Fluid Dynamics (CFD) to investigate queuing behaviour in the Devonian trilobite Trimerocephalus chopini and found drag reduction effects. Novel calculations that define a ratio between drag force and Apparent Gravity (W), along with the Submerged Froude Number (Frsub), however, reveal that the obtained drag force was practically negligible in terms of the underwater mobility of trilobites. A trilobite would start to experience difficulty in forward walking only when the relative flow speed was over 42 cm/s, which is inconsistent with the interpreted palaeoenvironment or the predicted moving speed of trilobites. Nevertheless, according to the proposed cantilever model, a trilobite had the ability to sense very minute change in fluid velocity (>7.16 μm/s). High-sensitivity mechanical sensors distributed along the body, either on the exoskeleton or limbs, empowered queuing individuals to discern the fixed self-similar pattern of the wake generated by their predecessors in the queue. In general, if a trilobite were out of the wake, the asymmetrical velocity and pressure field would aid in repositioning itself, facilitating the maintenance of migratory queues. This permitted blind trilobites to securely sense their companions, compensating for lack of long-range visual capability. This paradigm of force assessment is suitable to Computational Fluid Dynamic analyses in other extinct animal-environment interactions, offering a framework to evaluate whether drags and wakes impact more on organism's mobility (W≫0.1,Frsub≫1) or their mechanical sensors, and provides a unique cross-scale insight into animals' adaptation to palaeohydrodynamic variation.

Backwards walking speed reserve in persons with multiple sclerosis

BackgroundDecreased gait speed is common in persons with Multiple Sclerosis (PwMS) and has been associated with elevated fall risk. The walking speed reserve (WSR) indicates the ability to increase gait speed on demand and has previously been examined in PwMS. Backward walking is a sensitive measure of fall risk in PwMS; however, no studies have reported on the utility of backward walking speed reserve (BW-WSR) as a clinical assessment tool of functional mobility or fall risk in PwMS, nor have they associated this measure with cognition. Methods23 PwMS completed walking trials at their preferred walking speed (PWS) and maximal walking speed (MWS). Participants performed these walking trials in both the forward (FW) and backward direction (BW). The forward walking speed reserve (FW-WSR) was calculated as the difference between MWS and PWS in the forward direction, while the backward walking speed reserve (BW-WSR) was calculated as the difference between MWS and PWS in the back backward direction. Correlation analyses examined the relationship between the FW- and BW-WSR with clinical assessments of functional mobility (the timed up-and-go) as well as cognitive functioning (the Symbol Digit Modalities Test, the Brief Visuospatial Memory Test-Revised, the California Verbal Learning Test, and the Trail Making Test A and B). Correlations also examined the relationship between FW- and BW-WSR with prospective falls. ResultsA lower BW-WSR was associated with disease severity and poorer performance on clinical walking and balance assessment, as well as with decreased information processing speed and attentional performance. Interestingly, FW-WSR showed similar relations. Neither FW- or BW-WSR were associated with prospective risk in this small sample of PwMS. ConclusionThe BW-WSR did not offer a distinct advantage over other measures, such as the FW-WSR, PWS, or MWS, in the forward or backward direction. The selection of the most sensitive clinical measures of functional mobility and fall risk is crucial; our study holds valuable clinical implications for PwMS by providing novel insights into functional mobility assessments in PwMS.

On the Move: Correlation of Impaired Mobility with Spatial Navigation Ability in Persons with Multiple Sclerosis.

Spatial navigation ability is essential for independent living, and it relies on complex cognitive and motor processes that are vulnerable to decline in persons with multiple sclerosis (pwMS). The role of mobility in the physical act of navigation has been well documented; however, its association with cognitive processing that supports efficient navigation and recall of the environment is unknown. This study examined the relation between clinical mobility function and spatial navigation ability in pwMS. In a clinical sample of 43 individuals with relapsing-remitting MS (MPDDS = 2; age 25-67 years), we assessed spatial navigation ability in a virtual Morris water maze that allowed for active search by controlling a joystick while seated at a computer, and subsequent free recall of environment details. Individuals with worse mobility (measured by slower forward and backward walking) traveled less efficient virtual navigation routes to the goal location and recalled fewer accurate details of the environment. A stratified analysis by disability revealed moderate-strong correlations for those with a low level of disability, and effects were attenuated in individuals with a high level of disability. Given that the virtual navigation task was performed while seated, evidence of any correlation with mobility suggests differences in navigation ability that cannot be ascribed to general walking impairment, and instead suggests a role for mobility impairment to modify cognitive processing supporting navigation in pwMS.