Leah England
MSc Physiotherapy Dissertation Project
My project aims to shed light on a relatively new and little understood gait parameter in the assessment and treatment of MS...
Step Width Variability
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Read on for more information about how this can be crucial for patients and also practitioners.
Mulitple Sclerosis and Physiotherapy
Public Health England estimate that in the UK there are approximately 130,000 people living with MS, with 6,700 people diagnosed each year (MS Trust, 2020).
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Currently, there is no cure for MS and subsequently treatment must focus on the management of symptoms, which includes prescribed analgesics and therapy interventions, such as physiotherapy, occupational therapy and cognitive behavioural therapy (Multiple Sclerosis Trust, 2017; NHS, 2018).
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This means that effective treatment and management of patients from health care professionals is vital. Within this team, physiotherapy plays a key role. There is strong evidence to suggest physiotherapy interventions such as exercise based therapy have been shown to increase gait quality and speed, as well as balance and lower leg muscle strength in people with MS (Dalgas et al., 2009; Gutierrez et al., 2005).
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In addition, patients with MS have been shown to have increased variability in their gait patterns (Socie, Boes, Motl, & Sosnoff, 2011). This more specifically includes step width variability (Socie et al., 2013).
Step Width Variability
Step width variability is used to describe the changeable foot placement in the mediolateral plane (side-to-side) when walking. It can have a negative effect on a patient's gait in both the initial and later progression of the disease in MS and similar neurological diseases.
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Research has shown associations between walking function and step width variability across a variety of populations including stroke survivors (Stimpson et al., 2019), the elderly (Skiadopoulos et al., 2020), patients with cerebellar ataxias (Buckley et al., 2018), Parkinson's Disease (Rennie et al., 2018) and MS (Comber, Galvin & Coote, 2017). With more specific conclusions from Socie et al. (2013) who reported a greater step width variability in patients with MS compared to patients without MS and stated that the increased step width variability undoubtedly impacted upon a patient’s gait mechanics.
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However this research has been focused at a patient level, and so little is known about the clinical reasoning and perceptions of physiotherapists regarding gait or step width variability treating patient with MS.
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Therefore, through this study, we want to explore how physiotherapists clinically reason their assessment and treatment choices, and to understand the personal perceptions of these experiences. By doing this, we hope to add to the current body research by providing a more detailed representation of clinical experience and methodology employed throughout clinical practice.
If you have experience in treating MS or other similar neurological conditions, I would love to talk with you!
I am hosting a series of online focus groups across July and August with other experienced physiotherapists. Here we will be able to discuss your experiences working with patients with Multiple Sclerosis, in particular with gait variability.
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If this sounds intersting to you, please take a look at the Information Sheet, and use the contact me button below to register your interest!
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Or send this a link to a colleague who might be interested in my research!
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Thank you!!
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Contact Me
Thanks for your interest. Get in touch with any questions regarding participating in my research. I’d love to hear from you.
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