The DOI matches its Crossref record; 119 of the 119 references it cites were found in a registry or an index.
Balance, gait, and falls in multiple sclerosis
Abstract
Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) and the most widespread nontraumatic cause of disability in young adults around the world. MS occurs in people of all ages, races, and ethnicities. MS is characterized by clinical symptoms resulting from lesions in the brain, spinal cord, or optic nerves that can affect balance, gait, and fall risk. Lesions accumulate over time and occur in different areas of the CNS causing symptoms that include weakness, spasticity, and fatigue, as well as changes in sensation, coordination, vision, cognition, and bladder function. Thus, it is not surprising that imbalance, gait dysfunction, and falls are common in people with MS. The overwhelming majority have abnormalities of postural control and gait even early in the disease course. In all, 50-80% have balance and gait dysfunction and over 50% fall at least once each year. Balance dysfunction in MS is conceptualized as three interrelated problems: decreased ability to maintain position, limited and slowed movement towards limits of stability, and delayed responses to postural displacements and perturbations. In addition, functional balance performance may be affected by impaired dual-task integration. Walking changes in MS include reduced gait speed, impaired walking balance, and reduced walking-related physical activity. Falls in people with MS are associated with injuries, reduced participation, and increased fear of falling. A wide and growing range of rehabilitation and medical interventions are available to address the changes in balance, gait, and fall risk associated with MS.
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Cites
Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)
Kurtzke, J. F. (1983) · Neurology · doi:10.1212/wnl.33.11.1444 · Cited by 15,011
Fischer, J. S., Rudick, R. A., Cutter, G., & Reingold, S. C. (1999) · Multiple Sclerosis Journal · doi:10.1177/135245859900500409 · Cited by 997
Measuring the impact of MS on walking ability
Hobart, J. C., Riazi, A., Lamping, D. L., Fitzpatrick, R. M., & Thompson, A. J. (2003) · Neurology · doi:10.1212/wnl.60.1.31 · Cited by 826
Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls
Goldman, M. D., Marrie, R. A., & Cohen, J. A. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507082607 · Cited by 675
Goodman, A. D., Brown, T. R., Krupp, L., Schapiro, R. T., Schwid, S. R., Cohen, R., Marinucci, L. N., & Blight, A. R. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60442-6 · Cited by 552
Gait and balance impairment in early multiple sclerosis in the absence of clinical disability
Martin, C. L., Phillips, B. A., Kilpatrick, T. J., Butzkueven, H., Tubridy, N. J., McDonald, E. A., & Galea, M. P. (2006) · Multiple Sclerosis Journal · doi:10.1177/1352458506070658 · Cited by 543
Effect of Exercise Training on Walking Mobility in Multiple Sclerosis: A Meta-Analysis
Snook, E. M., & Motl, R. W. (2008) · Neurorehabilitation and neural repair · doi:10.1177/1545968308320641 · Cited by 375
Predicting accidental falls in people with multiple sclerosis — a longitudinal study
Nilsagård, Y. E., Lundholm, C., Denison, E., & Gunnarsson, L. (2009) · Clinical Rehabilitation · doi:10.1177/0269215508095087 · Cited by 349
Self-citationRisk Factors for Falling Among People Aged 45 to 90 Years With Multiple Sclerosis
Finlayson, M. L., Peterson, E. W., & Cho, C. C. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2006.06.002 · Cited by 332
Givon, U., Zeilig, G., & Achiron, A. (2008) · Gait & Posture · doi:10.1016/j.gaitpost.2008.07.011 · Cited by 316
Cited by
Sorted by citations
Items 201–272 of 272
Özdoğar, A. T., Daştan, S., Ertekin, Ö., Baba, C., & Özakbaş, S. (2021) · Journal of Multiple Sclerosis Research · doi:10.4274/jmsr.galenos.2021.6-3
Mendes, B. R. D. F., da Silva, V. P., & Guimarães, M. V. C. (2021) · International Journal of Health Science · doi:10.22533/at.ed.15921151010
Association Between Lower Limb Spasticity and Falls in Persons with Multiple Sclerosis
Abasıyanık, Z., Baba, C., Kahraman, T., et al. (2021) · Journal of Multiple Sclerosis Research · doi:10.4274/jmsr.galenos.2021.2021.8-4
Yüksel, H., & Mungan, S. (2022) · Turkish Journal of Clinics and Laboratory · doi:10.18663/tjcl.1069550
Frechette, M. L., Abou, L., Rice, L. A., & Sosnoff, J. J. (2022) · Topics in Spinal Cord Injury Rehabilitation · doi:10.46292/sci21-00026
Internationale Studienergebnisse
(2022) · physiopraxis · doi:10.1055/a-1767-1407
Avaliação do equilíbrio em indivíduos com Esclerose Múltipla: estudo transversal
Bernardes, L. V. D. S., dos Santos, M. R., Oliveira, L. S., et al. (2022) · Revista Neurociências · doi:10.34024/rnc.2022.v30.13131
Raynaud, F., & Viadere, A. (2023) · Soins · doi:10.1016/j.soin.2023.02.010
Stagger along the Corpus Callosum – A Rare form of Adult Metachromatic Leukodystrophy
Amba, P., Wilson, V., & Hosur, B. (2023) · Neurology India · doi:10.4103/0028-3886.383822
Chen, V. L., Hildebrand, A. D., Mañago, M. M., et al. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.105101
Self-citationde Andrade, P. H. S., Fonseca, B. H. D. S., Osawa, C. R., da Silva, A. E., de Souza, L. A. P. S., & Luvizutto, G. J. (2024) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2023.2299726
“Changes in the cerebellar system can lead to balance problems that can cause instability during standing and walking (Cameron and Nilsagard, 2018; Chee et al., 2021).”
Ghaffari, R., Rajabi, R., Shahrbanian, S., et al. (2024) · Sport Sciences for Health · doi:10.1007/s11332-023-01143-y
“Given that maintaining balance in a standing position is one of the obvious problems of MS patients, and on the other hand, these patients urgently need to balance to perform daily tasks, it is necessary to improve balance with basic and principled plans [30].”
Sharma, A., Kumari, S., Sharma, P., et al. (2024) · Physical & Occupational Therapy In Geriatrics · doi:10.1080/02703181.2024.2302089
Reduced White Matter Fiber Density in Patients with Multiple Sclerosis
Gharaylou, Z., Shahbodaghy, F., Kolivand, P., Kolivand, M., Azizzadeh, F., & Rostampour, M. (2024) · Brain Connectivity · doi:10.1089/brain.2023.0068
“Then we applied a whole-brain and regional tract-based spatial Introduction M ultiple sclerosis (MS) stands as the most prevalent nontraumatic impairment in young and middle-aged individuals (Cameron and Nilsagard, 2018).”
Ali, E. A., Afefy, H. M. E., & Abdallah, Z. A. (2022) · Egyptian Journal of Health Care · doi:10.21608/ejhc.2022.342704
“The HBM represents a great challenge for children with MS disease that promote their level of functioning, improve their QOL for long time and coping patterns toward stress that caused by the disease process (Cameron, & Nilsagard, 2018, Hashem, 2020 and Salime, et al., 2022) .”
BackgroundPawlak, A., Marciniec, K., & Szczypińska, Z. (2023) · The Journal of Neurological and Neurosurgical Nursing · doi:10.15225/pnn.2023.12.4.5
“Many people with multiple sclerosis report feeling really tired, even if they have slept well [29] .”
BackgroundDoce, A. V., Delgado, L. G., Gómez, M. J. A., Rubio, M. P. S., Meca‐Lallana, V., Muñoz, B. D. R., Bosch-Martín, M. A., Doce, O. V., García, P. O., & Tapiador, N. (2024) · Neurorehabilitation · doi:10.3233/nre-240038 · Cited by 1
“A marked association has been reported between spasticity and fatigue (Cameron et al., 2018).”
A esclerose múltipla e os benefícios do exercício
Rosas, R. R., Perdigão, G. N., & Martini, C. S. D. S. (2024) · Cuerpo Cultura y Movimiento · doi:10.15332/2422474x.9881
Pekmez, H., Altiparmak, A., Inceoğlu, F., Akçiçek, M., Bolayır, A., Ozbay, Z., Aydın, M., & Arpacı, M. (2024) · Turkish Journal of Medical Sciences · doi:10.55730/1300-0144.5839
“Multiple sclerosis (MS) is a chronic illness characterized by inflammation in the central nervous system (CNS) [1,2].”
BackgroundGrosserová, B., Janatová, M., Horáková, D., et al. (2024) · Studia sportiva · doi:10.5817/sts2024-2-8
“…sensory impairment, fatigue, sphincter impairment etc.) Gait and balance disorders in particular, as one of the most common symptoms of MS, are present in up to 50–80 % of people with MS and it is reported that more than 50 % of patients fall at least once a year (Cameron & Nilsagard, 2018).”
BackgroundHippotherapy Used in Medical Recovery
Condurache, I., Duduca, I., Gheorghiță, A., Nechita, A., Mucileanu, C., & Rotariu, M. (2024) · Balneo and PRM Research Journal · doi:10.12680/balneo.2024.741
“This aspect is particularly significant, as falls are associated with injuries, decreased participation in activities, and an increased fear of falling among patients [19].”
Meyer, B. M., Agarwal, N., Gamboa, K. M., O’Learly, A., Solomon, A. J., McGinnis, R. S., & Ceruolo, M. (2024) · medRxiv · doi:10.1101/2024.11.05.24316692
“Among the estimated 2.8 million PwMS worldwide, 50-80% report issues with gait and balance, with over half experiencing a fall each year (1,3,4).”
BackgroundInfluentialLi, J. B., Farrell, J. W., & Valles, D. (2024) · IEEE International Conference on Bioinformatics and Biomedicine (BIBM) · doi:10.1109/bibm62325.2024.10822219
“The loss of balance and muscle control contribute to the gait patterns of PwMS, such that more than 50% of people with MS have balance and walking difficulties [7].”
Mental Practice for Gait Improvement
Piemonte, M. E. P., & Honda, K. Y. T. (2024) · Springer eBooks · doi:10.1007/978-3-031-74123-4_34
The principles of balance assessment and rehabilitation
Pavlou, M., & Whitney, S. L. (2025) · Oxford University Press eBooks · doi:10.1093/med/9780198834380.003.0016
Kumari, R., Walia, S., Khanna, S., & Wadhwa, G. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106451
Risk Factors for Falls Among the Elderly in China: A Cross-Sectional StudyPreprint
Zhang, N., & Li, D. (2025) · Research Square · doi:10.21203/rs.3.rs-6612142/v1
Power production during the five times sit to stand test in people with multiple sclerosis
Patrick, C. M., Bast, I. E., Scarsbrook, M. W., Swanson, C. W., Fling, B. W., & Johnson, K. A. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106582
Brown, D., & Yang, F. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106587
Giesler, P. J., Kipp, M., & Hawlitschka, A. (2025) · Cells · doi:10.3390/cells14130969
“Gait abnormalities often arise early and progress with disease duration [12–14]; approximately 50% of patients require walking aids within 15 years of diagnosis, and around 10% become wheelchair-dependent [13,15–17].”
Cardini, R., Bertoni, R., Carpinella, I., Pegorini, C., Tacchino, A., Grange, E., Guidotti, V., Brichetto, G., Solaro, C. M., Budassi, T., et al. (2025) · Digital Health · doi:10.1177/20552076251346694
“4,5 Managing fatigue and improving mobility have become a primary goal in rehabilitation.”
InfluentialArashloopour, H. T., Khajavi, D., & Faraji, F. (2025) · مجله دانشگاه علوم پزشکی اراک · doi:10.61882/jams.28.2.91
DelMastro, H. M., Simaitis, L. B., Constantine, A., Glazer, E., Ranuro, K., Tuorto, J., & Gromisch, E. S. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106677
A study of the responsiveness of the Six-Spot Step Test in people with multiple sclerosis
Køhler, E., Callsen, J., & Brincks, J. (2025) · Acta Neurologica Belgica · doi:10.1007/s13760-025-02887-9
“As a result, it is not surprising that MS negatively affects balance, gait function, and the risk of falling [2].”
Multiple sclerosis and dental care
Cloney, N., & Dickens, T. (2025) · Dental Update · doi:10.12968/denu.2025.52.8.556
Tract-based Quantitative MRI for Resolving the Clinico-Radiological Paradox in Multiple SclerosisPreprint
Abdullah, O., Wen, P., Abdelrazeq, A., et al. (2025) · medRxiv · doi:10.1101/2025.09.17.25335756
Kinematics, singularity, and workspace analysis of a balance rehabilitation parallel manipulator
Chien, K.-H., Chen, Z., & Ren, X. (2025) · Robotica · doi:10.1017/s026357472510252x
“Besides stroke, other CNS disorders, such as Parkinson’s disease (PD) and multiple sclerosis (MS), have been shown to cause impairments in balance and gait function [6, 7].”
DelMastro, H. M., Turner, A. P., Gomes, K. E., Neto, L. O., Dhari, Z., & Gromisch, E. S. (2025) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2025.09.014
Does foot morphology influences postural control in people with multiple sclerosis?
Casu, G., Porta, M., Arippa, F., Leban, B., Frau, J., Coghe, G., Cocco, E. E., & Pau, M. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106793
Ganesan, M., Kanekar, N., Mehendale, K., et al. (2025) · Motor Control · doi:10.1123/mc.2025-0024
Approaches to sensory–motor symptoms in neurological diseases
Özden, F., Özkeskin, M., & Başer, M. (2025) · Somatosensory & Motor Research · doi:10.1080/08990220.2025.2585799
“The most common disabling consequences of motor dysfunction in MS are difficulty in walking, impaired posture, and frequent falls (Cameron & Nilsagard, 2018; Prosperini & Castelli, 2018).”
Development and Usability of MSafe: A Fall Risk Application for Older Adults with Multiple Sclerosis
Hsieh, K. L., Backus, D. A., Willingham, T. B., & Sanford, J. A. (2025) · Sensors · doi:10.3390/s25227075
“Across all ages, one in two people with MS experience a fall every 6-month period [7–9].”
Zanotto, T., Kumar, D. P., Tabatabaei, A., LYNCH, S. G., He, J., Herda, T. J., Devos, H., Thiyagarajan, R., Chaves, L. D., Seldeen, K. L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26709680
Nombela-Cabrera, R., Pérez‐Nombela, S., Avendaño‐Coy, J., Comino‐Suárez, N., Arroyo-Fernández, R., Gómez-Soriano, J., & Serrano‐Muñoz, D. (2023) · Figshare · doi:10.6084/m9.figshare.24431951
Nombela-Cabrera, R., Pérez‐Nombela, S., Avendaño‐Coy, J., Comino‐Suárez, N., Arroyo-Fernández, R., Gómez‐Soriano, J., & Serrano‐Muñoz, D. (2024) · Figshare · doi:10.6084/m9.figshare.24432076
Hinchliffe, C. H. L., Rehman, R. Z. U., Pinaud, C., Branco, D., Jackson, D., Ahmaniemi, T., Guerreiro, T., Chatterjee, M., Manyakov, N. V., Pandis, I., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26729860
Zanotto, T., Kumar, D. P., Tabatabaei, A., LYNCH, S. G., He, J., Herda, T. J., Devos, H., Thiyagarajan, R., Chaves, L. D., Seldeen, K. L., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26709683
ЕФЕКТИВНІСТЬ ФІЗИЧНОЇ ТЕРАПІЇ В РЕАБІЛІТАЦІЇ ПОРУШЕНЬ РІВНОВАГИ У ПАЦІЄНТІВ ІЗ РОЗСІЯНИМ СКЛЕРОЗОМ
Гриб, В. А., & Фабрика, І.-Р. М. (2025) · Art of Medicine · doi:10.21802/artm.2025.4.36.12
Cardini, R., Gervasoni, E., Germanotta, M., Aprile, I. G., Cecchi, F., Pedrini, C., Gobbo, M., Pollet, J., Pullara, R., Amato, M. P., et al. (2026) · PLoS ONE · doi:10.1371/journal.pone.0337440
“Gait and balance impairments are highly prevalent in People with Multiple Sclerosis (PwMS), affecting up to 80% over the course of the disease [1].”
Elmoazen, D. M., Talaat, M., Elfatatry, A., et al. (2026) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-025-00981-6
“Deficits in postural control in MS are likely multifaceted, stemming from impairments in cognitive, visual, vestibular, motor, sensory, and coordination functions, with varying contributions from each factor among individuals [4].”
Ateş, Y., Özkan, T., Erkoç, A., Hangün, S. F., Vural, G., & Ünlüer, N. Ö. (2026) · Neurological Sciences · doi:10.1007/s10072-026-08811-0
Evanchick, C., Lopez, N., Gromisch, E. S., Campo, M. A., & DelMastro, H. M. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107067
Usta, S., Serin, E. K., & Doğru, B. V. (2026) · Research Square · doi:10.21203/rs.3.rs-8768612/v1
Risk factors for falls among older adults in China: a cross-sectional study
Lei, T., & Li, D. (2026) · BMC Public Health · doi:10.1186/s12889-026-26784-9
“Recurrent symptoms associated with chronic diseases can negatively affect balance function [49].”
Elshazly, E., El-Seidy, E. A. S., Kotit, M., Al-Malt, A. M., & Bahnasy, W. S. (2026) · The Egyptian Journal of Otolaryngology · doi:10.1186/s43163-026-01076-6
Mosharaf, M., Saberi, S., Hillier, S. L., & Sadeghi-Demneh, E. (2026) · Disability and Rehabilitation · doi:10.1080/09638288.2026.2665035
Uzun, M., Polat, H., Horata, E. T., & Erel, S. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107226
Ahmed, G. U., Abbas, H., Komal, F., Muskan, F., Tharwani, A., Khiani, R. K., Ramani, S., Raza, A. A., Shaikh, J. G., Sanaullah, O., et al. (2026) · BMC Neurology · doi:10.1186/s12883-026-04961-y · Cited by 2
“Impaired gait and poor hand coordination directly interfere with daily activities [7].”
Abakay, H., Yetkin, M. F., Çopuroğlu, Ö. B., et al. (2026) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-026-04463-3
Santamaría, G., Jiménez-Callejo, E., López, N. R., Cacharro, L. M., Gutiérrez‐Abejón, E., Sánchez-Valdeón, L., & Fernández‐Lázaro, D. (2026) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk11020219
Stadio, A. D., Francavilla, B., Ralli, M., et al. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107316
Baroni, A., Fregna, G., Azzolina, D., Severini, G., & Straudi, S. (2026) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.26.09188-4
yousefvand, M., & Ziyar, Z. (2025) · مجله علمی دانشگاه علوم پزشکی رفسنجان · doi:10.66224/jrums.24.8.709
Vienažindytė, I., Klėgėris, T., Ulozienė, I., et al. (2026) · Medicina · doi:10.3390/medicina62061158
“Balance dysfunction and impaired spatial orientation are common in MS and may partly reflect altered perception of gravitational verticality [17–23].”
Grosserová, B., Janatová, M., Horáková, D., & Novotná, K. (2026) · Acta Neurologica Scandinavica · doi:10.1155/ane/3369935
The mediating role of falls efficacy in fall risk among older adults: A secondary analysis
Ou, J., Sun, L., & Wang, Z. (2026) · Geriatric Nursing · doi:10.1016/j.gerinurse.2026.104187
Lagravinese, G., Manippa, V., Farella, A., Natale, A., Todisco, R., Aresta, S., Guglielmo, M., Trane, S. D., Fiore, P., Scaramuzzi, G. F., et al. (2026) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2026.107882
Farmanesh, A., Ordieres-Meré, J. B., Sanchis, R. G., & Aladro-Benito, Y. (2026) · Digital Health · doi:10.1177/20552076261488885
Zúnica‐García, S., Pastor-Vidal, B., Gracia‐Sánchez, A., Jiménez‐Trujillo, I., Chicharro‐Luna, E., & Sempere, Á. P. (2026) · Foot & Ankle Specialist · doi:10.1177/19386400261484267
Feasibility of a Mixed Reality Framework for Balance Assessment in Multiple Sclerosis
Finti, A., Franzò, M., Pasini, G., Fioretti, M., Vizzaccaro, G., Covelli, E., Marinozzi, F., & Bini, F. (2026) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-032-37736-4_41
Balancing participation and fall risk in people with multiple sclerosis – a qualitative study
Forsberg, A., Carling, A., & Nilsagård, Y. E. (2026) · Clinical Rehabilitation · doi:10.1177/02692155261498393
Self-citation
Metadata
- Authors
- Cameron, M. H., & Nilsagård, Y. E.
- Affiliations
- Oregon Health & Science University (US)
- Corresponding author
- Michelle H. Cameron
- Venue
- Handbook of Clinical Neurology
- Publisher
- Elsevier
- Published
- 2018
- Volume
- 159
- Pages
- 237-250
- ISSN
- 0072-9752 (ISSN-L)
- OpenAlex
- W2901140528
- Semantic Scholar
- 2dd80ce699e3ddccf18361ebf85fe2d3b33b605a
- Cited by
- 271
- References
- 115
- Citations by year
- 2026: 28 · 2025: 46 · 2024: 68 · 2023: 40 · 2022: 37 · 2021: 34 · 2020: 16 · 2019: 2
- FWCI
- 68.29
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Handbook of clinical neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- multiple sclerosis, balance disorders, gait disturbance, falls, postural control, dual-task performance, fear of falling, spasticity, fatigue, rehabilitation therapy
- MeSH terms
- Accidental Falls, Postural Balance, Humans, Multiple Sclerosis, Sensation Disorders, Gait Disorders, Neurologic
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