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The present multicenter study on early\u2010stage PwMS aims at analyzing which aspects are associated with patient\u2010reported walking limitations measured with the 12\u2010item Multiple Sclerosis Walking Scale (MSWS\u201012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010two PwMS (EDSS\u00a0\u2264\u00a02.5) were assessed using the Fullerton Advanced Balance Scale\u2014short (FAB\u2010s), the Fatigue Severity Scale (FSS) and the 6\u2010min Walk Test (6MWT), the latter administered also to 21 healthy subjects. Participants performed the 6MWT wearing three inertial sensors on ankles and trunk. Instrumented metrics describing gait velocity (stride length and frequency) and quality (regularity, symmetry, instability) were computed from sensor data. Fatigue (FSS), balance (FAB\u2010s), walking endurance (6MWT) and instrumented metrics were entered in a multiple regression model with MSWS\u201012 as dependent variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gait symmetry, gait instability, fatigue and balance were significantly associated with self\u2010rated walking ability, whilst walking endurance and velocity were not. Fatigue, balance, gait symmetry and instability were more impaired in participants reporting mild\u2010to\u2010moderate (MS<jats:sub>MM\u2010PWL<\/jats:sub>, 25\u00a0\u2264\u00a0MSWS\u201012\u00a0&lt;\u00a075) compared to those reporting none\u2010to\u2010minimal (MS<jats:sub>nm\u2010PWL<\/jats:sub>, 0 \u2264 MSWS\u201012 \u2264 25) perceived walking limitations. Compared to healthy subjects, gait symmetry and stability were reduced in MS<jats:sub>nm\u2010PWL<\/jats:sub> and MS<jats:sub>MM\u2010PWL<\/jats:sub>, even in those participants with EDSS\u00a0\u2264\u00a01.5.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Instrumentally assessed gait quality aspects (symmetry and instability) are associated with patient\u2010reported walking ability in early\u2010stage PwMS and seem sensitive biomarkers to detect subtle impairments even in the earliest stages of the disease (EDSS\u00a0\u2264\u00a01.5). Future studies should assess their ability to follow walking change due to MS progression or pharmacological\/rehabilitation interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14866","type":"journal-article","created":{"date-parts":[[2021,4,17]],"date-time":"2021-04-17T09:11:15Z","timestamp":1618650675000},"page":"2259-2268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Instrumentally assessed gait quality is more relevant than gait endurance and velocity to explain patient\u2010reported walking ability in early\u2010stage multiple sclerosis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7486-0706","authenticated-orcid":false,"given":"Ilaria","family":"Carpinella","sequence":"first","affiliation":[{"name":"IRCSS Fondazione Don Carlo Gnocchi Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gervasoni","sequence":"additional","affiliation":[{"name":"IRCSS Fondazione Don Carlo Gnocchi Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Anastasi","sequence":"additional","affiliation":[{"name":"IRCSS Fondazione Don Carlo Gnocchi Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachele","family":"Di Giovanni","sequence":"additional","affiliation":[{"name":"CRRF Mons. 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