Effect of rehabilitation on gaitpatterns of patients with multiple sclerosis: review of the literature

Gait impairment is common in patients with multiple sclerosis (MS). Despite many available studies on improvement of gait pattern in patients with multiple sclerosis, rehabilitation treatment protocols are still controversial in the literature.The aim of this study was to evaluate gait pattern characteristics in MS patients with specific clinical symptoms and offer suitable treatment protocols considering previous studies. An electronic search was performed in PubMed, Embase, Google scholar and ISI Web of Sciences from 1990 to 2014 using some keywords include physical therapy, multiple sclerosis, walking pattern, gait and rehabilitation. Selected articles were divided into two categories namely, gait characteristics and patterns (n=27) and affective treatment protocols on gait (n=33). Then, modified downs and black tool was used for quality assessment.Among 27 papers in the first category, the score of 25 papers were lower than 19 and the score of 2 papers were equal to 19. From 33 papers in second category, the score of 21 papers were lower than 19 and the score of 12 papers were equal and higher than 19. Articles with the score of equal and higher than 19 have high methodological quality. Spastic and cerebellar ataxia gait pattern have been seen in patients with multiple sclerosis. Considering the clinical symptoms and the gait patterns in a properly designed rehabilitation program is needed. The reported results of this studysuggest the application ofStretch-based relaxationtrainingin rehabilitation program of spastic gait pattern among MS patients. Moreover, balance and strength training may necessary in training program of MS people with cerebellar ataxia gait pattern.