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Background: Public health responses to Coronavirus Disease 2019 (COVID-19) including lockdowns may negatively impact physical and mental functioning in clinical populations. People living with multiple sclerosis (MS) may be more susceptible to physical function deterioration while practicing social distancing. Recent reports have suggested that about 50% of people with MS (pwMS) decreased their leisure physical activity during COVID-19, and upwards of 30% reported decreased physical fitness levels. However, the impact of social distancing on adverse health-related outcomes such as falls has not received much scrutiny. Therefore, we explored the frequency and characteristics of falls experienced by people living with and without MS during the COVID-19 pandemic., Methods: Two-hundred and thirty-nine individuals, including 106 pwMS (median age: 59 years) and 133 people living without MS (median age: 66 years) were recruited for this cross-sectional study. A snowball sampling strategy was used for online recruitment. Participants completed a customized falls questionnaire and the number of falls experienced (if any) during COVID-19 was recorded. Fall-related characteristics such as the timing, locations, activities undertaken before falling and consequences, as well as self-reported physical activity were also recorded., Results: Overall, participants reported 232 falls (1.67 falls/person in pwMS and 0.41 falls/person in non-MS participants). People living with MS (pwMS) had a significantly higher frequency of falls (58.5% vs 21.8%; p< 0.001) and recurrent falls (45.3% vs 9.8%; p< 0.001) compared to non-MS participants. Additionally, pwMS reported a significantly higher proportion of in-home falls (83.9% vs 54.2%; p = 0.004), as well as a higher proportion of overall injuries (44.3% vs 12.5%, p< 0.001), fractures (5.7% vs 0.8%, p = 0.048), and healthcare utilization (9.4% vs 1.6%, p = 0.007) compared to non-MS participants. A similar proportion of pwMS (49.1%) and non-MS participants (52.2%) reported lower physical activity levels during COVID-19., Conclusion: This cross-sectional study revealed that pwMS remain at high risk of falls and fall-related outcomes during COVID-19. The high number of falls experienced by pwMS is of clinical concern considering the current strain on the healthcare system. Findings from this study highlight the importance of monitoring falls and the potential for telerehabilitation in persons with MS during COVID-19., (Copyright © 2021. Published by Elsevier B.V.)

Purpose of Review: Walking impairments are highly prevalent in persons with multiple sclerosis (PwMS) and are associated with reduced quality of life. Walking is traditionally quantified with various measures, including patient self-reports, clinical rating scales, performance measures, and advanced lab-based movement analysis techniques. Yet, the majority of these measures do not fully characterize walking (i.e., gait quality) nor adequately reflect walking in the real world (i.e., community ambulation) and have limited timescale (only measure walking at a single point in time). We discuss the potential of wearable sensors to provide sensitive, objective, and easy-to-use assessment of community ambulation in PwMS., Recent Findings: Wearable technology has the ability to measure all aspects of gait in PwMS yet is under-studied in comparison with other populations (e.g., older adults). Within the studies focusing on PwMS, half that measure pace collected free-living data, while only one study explored gait variability in free-living conditions. No studies explore gait asymmetry or complexity in free-living conditions. Wearable technology has the ability to provide objective, comprehensive, and sensitive measures of gait in PwMS. Future research should investigate this technology's ability to accurately assess free-living measures of gait quality, specifically gait asymmetry and complexity.