Abstract
Ambulation is frequently affected by multiple sclerosis (MS), and is one of the most valued neurological functions among individuals with MS. While walking speed and walking distance have been used for decades as indicators of disease progression, other aspects of gait disturbance are not routinely assessed, and the impact of walking limitations on the daily activities and quality of life of patients is not fully understood. Recently, rehabilitation techniques, devices, and medications that aim directly at improving walking performance have been tested in individuals with MS. At the same time, clinician-rated and patient-reported measures of ambulation are being validated in this patient population. As a consequence of these advances, clinicians can draw from a growing body of evidence to enhance decision-making and outcome measurement when trying to help MS patients fight one of the most visible consequences of their disease.

Keywords
Ambulation, multiple sclerosis, rehabilitation, symptom management, outcome measurement

Disclosure: Francois Bethoux, MD, has received research support as well as consulting and speaking honoraria from and been an advisory board member member for Medtronic Inc.; received speaking honoraria from and been an advisory board member for Allergan; received research support from and been an advisory board member for Acorda
Therapeutics; received speaking honoraria from Biogen Idec; and received consulting honoraria from IMPAX Laboratories.
Received: June 8, 2009 Accepted: September 3, 2009
Correspondence: Francois Bethoux, MD, The Mellen Center for MS, 9500 Euclid Avenue/U10, Cleveland, OH 44195. E: bethouf@ccf.org