Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Examining Predictors of Gait Performance in MS

Physical Therapy; 2018 Jul; Mañago, Hebert, et al

For the major muscles in the lower extremity and trunk, hip abduction, ankle plantar flexion, trunk flexion, and knee flexion were the strongest predictors of gait performance in patients with multiple sclerosis (MS), a recent study found. Participants (n=72) were people with MS who had a mean Expanded Disability Status Scale (EDSS) score of 3.5. 11 lower extremity and trunk muscles were assessed. Gait performance was assessed with the Timed 25-Foot (7.62 m) Walk (T25FW) and 6-Minute Walk Test (6MWT). Researchers found:

  • Adjusted for age and sex, the multivariate model including hip abduction, ankle plantar flexion, trunk flexion, and knee flexion explained 57% of the adjusted variance in the T25FW; hip abduction, ankle plantar flexion, and trunk flexion explained 61% of the adjusted variance in the 6MWT.
  • The strongest predictors were ankle plantar flexion endurance for the T25FW and hip abduction strength for the 6MWT: a 1-SD increase in ankle plantar flexion (15.2 heel-raise repetitions) was associated with a 0.33-second reduction in the T25WT; a 1-SD increase in normalized hip abduction strength (0.14 kg/BMI) was associated with a

54.4-m increase in the 6MWT.


Mañago MM, Hebert JR, Kittelson J, Schenkman M. Contributions of ankle, knee, hip, and trunk muscle function to gait performance in people with multiple sclerosis: A cross-sectional analysis. Physical Therapy. 2018;98(7):595-604. doi:10.1093/ptj/pzy048.

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