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Objective: The purpose of the study was to understand how people with multiple sclerosis experience dual-tasking situations in their everyday lives. Methods: Focus groups involving a total of 11 individuals with multiple sclerosis (eight females and three males) participated in this qualitative inquiry. Participants were asked open-ended questions focused on the nature of and consequences around dual tasking when standing or walking. Reflexive thematic analysis was employed to examine the data. Results: Three themes were generated from the data: (a) Life Is a Dual Task, (b) The Social Divide, and (c) Sacrifices for Stability. Conclusions: This study highlights the significance and impact of dual tasking on the lived experience of adults with multiple sclerosis, furthering the need to more fully examine this phenomenon and potentially improve fall-prevention interventions and facilitate community participation. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study was to identify differences in community mobility in adults with multiple sclerosis (MS) at various ambulation levels. METHODS: Seventy-one adults with MS completed a survey about their mobility impairment and avoidance of challenging mobility tasks. Individuals were categorized as having mild, moderate, or severe gait impairment. RESULTS: Participants across the different functional groups significantly differed in perceived ambulation disability, fatigue impact, falls efficacy, quality of life, challenges with dual-tasking, and self-efficacy for community mobility. There were no significant differences between the mild and moderate gait impairment groups in crossing a busy street or going out in different ambient conditions. Significant differences were found between those with mild impairment and those with severe impairment in avoidance of various terrain elements, heavy manual doors, postural transitions, attentional situations, and crowded places. The only environmental dimension that significantly differed across all 3 groups was carrying 2 or more items, in which avoidance increased as ambulation worsened. CONCLUSIONS: Avoidance behavior for particular environmental features can begin relatively early in the disease process. This underscores the need to further study mobility differences, community ambulation, and participation restrictions in adults with MS. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]