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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]

The present study expands on current understanding of dual-task cognitive-motor interference, by including cortical activation measures to both traditional and ecologically valid dual-task paradigms. Fifteen individuals with multiple sclerosis and 14 control participants underwent mobility testing while wearing functional near-infrared spectroscopy. In the absence of increased prefrontal cortical activation, subjects with multiple sclerosis performed significantly worse on measures of cognition under both single- and dual-task conditions. These findings suggest that persons with multiple sclerosis may be unable to allocate additional cortical resources to cognition under dual-task conditions, leading to significant cognitive-motor interference and decrements in performance. This study is the first to investigate cortical activation across several commonly used and ecologically valid dual-task assessments. [ABSTRACT FROM AUTHOR]

Slowed somatosensory conduction contributes to heightened postural instability and reduced proprioception among persons with multiple sclerosis (PwMS). Despite these delays, previous studies have noted increased proprioceptive reliance for balance in PwMS. The combination of heightened proprioceptive reliance and slowed signal transduction poses challenges in maintaining balance for MS individuals that may contribute to increased fall risk. Our lab has shown backward walking (BW) is more sensitive to detecting falls than forward walking (FW). During BW, there is increased dependence on proprioception due to the elimination of visual cues. However, no study to date has objectively established a definitive relationship between proprioception and BW. Therefore, the objective of this study is to examine the contributions of proprioception to BW compared to FW. Thirty-five participants (average age:51.20±11.46, median PDDS:1) have completed the study. Participants completed BW and FW at both 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 two-alternative forced-choice procedure. Significant correlations were seen for vibration sensation and FW comfortable (r=0.59; p<0.01), FW fast (r=0.60; p<0.01), BW comfortable (r=0.67; p<0.01), and BW fast (r=0.65; p<0.01). 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=0.75; fast β=0.74) compared to FW (comfortable β=0.67; fast β=0.70). Given the marked decline in proprioception among individuals with MS and the evident differences in proprioception between fallers and non-fallers in prior studies, there is significant clinical relevance in conducting fall risk assessments and interventions that evaluate and enhance proprioception. Due to its heightened proprioceptive reliance, BW not only provides a more effective approach to assessing fall risk but may potentially represent a more efficacious exercise intervention modality. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThe study aimed to determine the test-retest reliability and concurrent validity of the Ratings of Perceived Stability (RPS) scale as a measure of balance exercise intensity in persons with multiple sclerosis (MS).Twenty participants with MS (mean age: 58.1 ± 15.29; 60% female) performed 14 balance tasks on two separate occasions wearing body-worn inertial sensors and rated their perceived stability for each task. Sensor data included sway velocity and angle, gait speed, turn velocity, and lean angle. Intraclass correlation coefficients (ICC) and Spearman rank correlations (rs) were employed to assess reliability and validity, respectively.The RPS showed good to excellent test-retest reliability (ICC> 0.75) on 12 out of the 14 tasks. The stability ratings revealed moderate relationships with postural sway outcomes in static balance tasks (rs: 0.49 to 0.77) and weak to moderate associations with gait speed (rs: −0.69 to −0.14). Ratings of stability were also strongly related to turn velocity (rs= −0.77) and moderately related to lean angle (rs= 0.58).The RPS scale offers a promising clinical tool to measure balance exercise intensity for persons with MS. This standardized scale allows for tailored balance training with a novel means for exercise monitoring and progression in this population.The Ratings of Perceived Stability (RPS) scale is a reliable and valid measure for determining balance exercise intensity in persons with multiple sclerosis.The RPS scale can contribute to clear evaluation, description, and replication of balance training intensity in future balance interventions.The Ratings of Perceived Stability (RPS) scale is a reliable and valid measure for determining balance exercise intensity in persons with multiple sclerosis.The RPS scale can contribute to clear evaluation, description, and replication of balance training intensity in future balance interventions. [ABSTRACT FROM AUTHOR]