{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:18:17Z","timestamp":1792113497011,"version":"4.4.0"},"reference-count":88,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Multiple Sclerosis (MS) is associated with impaired gait and a growing number of clinical trials have investigated efficacy of various interventions. Choice of outcome measures is crucial in determining efficiency of interventions. However, it remains unclear whether there is consensus on which outcome measures to use in gait intervention studies in MS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>We aimed to identify the commonly selected outcome measures in randomized controlled trials (RCTs) on gait rehabilitation interventions in people with MS. Additional aims were to identify which of the domains of the International Classification of Functioning, Disability and Health (ICF) are the most studied and to characterize how outcome measures are combined and adapted to MS severity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Pubmed, Cochrane Central, Embase and Scopus databases were searched for RCT studies on gait interventions in people living with MS according to PRISMA guidelines.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>In 46 RCTs, we identified 69 different outcome measures. The most used outcome measures were 6-minute walking test and the Timed Up and Go test, used in 37% of the analyzed studies. They were followed by gait spatiotemporal parameters (35%) most often used to inform on gait speed, cadence, and step length. Fatigue was measured in 39% of studies. Participation was assessed in 50% of studies, albeit with a wide variety of scales. Only 39% of studies included measures covering all ICF levels, and Participation measures were rarely combined with gait spatiotemporal parameters (only two studies).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Selection of outcome measures remains heterogenous in RCTs on gait rehabilitation interventions in MS. However, there is a growing consensus on the need for quantitative gait spatiotemporal parameter measures combined with clinical assessments of gait, balance, and mobility in RCTs on gait interventions in MS. Future RCTs should incorporate measures of fatigue and measures from Participation domain of ICF to provide comprehensive evaluation of trial efficacy across all levels of functioning.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257809","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T19:39:33Z","timestamp":1633030773000},"page":"e0257809","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Outcome measures used in trials on gait rehabilitation in multiple sclerosis: A systematic literature review"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7049-7655","authenticated-orcid":true,"given":"L.","family":"Santisteban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Teremetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Irazusta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. G.","family":"Lindberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0923-0788","authenticated-orcid":true,"given":"A.","family":"Rodriguez-Larrad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"issue":"8","key":"pone.0257809.ref001","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S1474-4422(14)70101-2","article-title":"Pathogenesis of multiple sclerosis: insights from molecular and metabolic imaging","volume":"13","author":"O Ciccarelli","year":"2014","journal-title":"Lancet Neurol"},{"issue":"2","key":"pone.0257809.ref002","first-page":"54","article-title":"Influence of Cognitive and Motor Abilities on the Level of Current Functioning in People with Multiple Sclerosis","volume":"58","author":"S Slavkovic","year":"2019","journal-title":"Zdr Varst"},{"key":"pone.0257809.ref003","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.gaitpost.2016.09.026","article-title":"Gait deficits in people with multiple sclerosis: A systematic review and meta-analysis","volume":"51","author":"L Comber","year":"2017","journal-title":"Gait Posture"},{"issue":"7","key":"pone.0257809.ref004","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1177\/1352458508088916","article-title":"Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable","volume":"14","author":"C Heesen","year":"2008","journal-title":"Mult Scler"},{"key":"pone.0257809.ref005","doi-asserted-by":"crossref","first-page":"481574","DOI":"10.1155\/2015\/481574","article-title":"Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis","volume":"2015","author":"L Prosperini","year":"2015","journal-title":"Neural Plast"},{"issue":"4","key":"pone.0257809.ref006","doi-asserted-by":"crossref","first-page":"e169","DOI":"10.1016\/j.lpm.2014.10.019","article-title":"Update on rehabilitation in multiple sclerosis","volume":"44","author":"C Donze","year":"2015","journal-title":"Presse Med"},{"issue":"2","key":"pone.0257809.ref007","doi-asserted-by":"crossref","first-page":"104066","DOI":"10.1016\/j.lpm.2021.104066","article-title":"Rehabilitation in multiple sclerosis in 2021","volume":"50","author":"C Donz\u00e9","year":"2021","journal-title":"Presse Med"},{"key":"pone.0257809.ref008","first-page":"CD012732","article-title":"Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews","volume":"1","author":"B Amatya","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0257809.ref009","doi-asserted-by":"crossref","first-page":"708","DOI":"10.3389\/fneur.2017.00708","article-title":"Technologies for Advanced Gait and Balance Assessments in People with Multiple Sclerosis","volume":"8","author":"CJ Shanahan","year":"2018","journal-title":"Front Neurol"},{"issue":"5","key":"pone.0257809.ref010","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S1474-4422(12)70059-5","article-title":"International Advisory Committee on Clinical Trials in Multiple Sclerosis. 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