This observational study aims to investigate the relationship between walking fatigability, changes in spatiotemporal gait parameters, and risk of falling in individuals with multiple sclerosis (MS). Participants will be divided into two groups: those with walking fatigability and those without.

Each participant will undergo functional tests to detect deterioration in patiotemoral gait parameters and risk of falling .

The results of this study will help understand how walking fatigability affects gait and fall risk in MS, providing insights for rehabilitation strategies.

Multiple sclerosis (MS) is a chronic neurological disease that often affects mobility, balance, and endurance. Walking fatigability, defined as a decline in walking performance over time, is a common problem in individuals with MS and may increase the risk of falls. Understanding how walking fatigability influences gait patterns and fall risk is essential for designing targeted rehabilitation strategies.

This observational study aims to investigate the relationship between walking fatigability, spatiotemporal gait parameters, and fall risk in individuals with MS. Participants will be recruited from Alexandria University Hospital and will be divided into two groups based on the presence or absence of walking fatigability. Inclusion criteria include confirmed MS diagnosis, ability to walk independently, and willingness to provide informed consent. Exclusion criteria include acute MS relapse, comorbid conditions affecting gait, or cognitive impairment that prevents safe participation.

Participants will undergo 6-Minute Walk Test to assess walking performance, and gait parameters such as step length and double time support.and gait speed will be recorded. Fall risk will be evaluated using a Timed Up and Go (TUG) test and The Falls Efficacy Scale-International (FES-I).

Data will be analyzed to compare gait changes and fall risk between the two groups. Correlations between walking fatigability and specific gait parameters will be explored to identify patterns associated with higher fall risk. The findings of this study are expected to inform clinical decision-making and rehabilitation approaches, contributing to safer and more effective mobility management for individuals with MS.

Inclusion Criteria:

• Sixty-two RRMS patients from both sexes.
• Aged from 20 to 40 years with a confirmed diagnosis of multiple sclerosis (based on McDonald criteria).
• Ambulatory for at least 6 minutes, without the use of assistive devices.
• EDSS score between 2.0 and 5.0.
• no relapse within 1 month prior to participation

Exclusion Criteria:

• The presence of other neurological or orthopaedic conditions that could affect gait or balance.
• Severe cognitive impairment (as determined by clinical history or physician report).
• Active MS relapses or corticosteroid treatment within the last 30 days.
• Visual or vestibular impairments that significantly interfere with gait or postural control.
• Diabetic patients will be excluded as this will interfere with balance.

Sixty-two RRMS will be recruited in this study from multiple sclerosis specialized clinic in the Neurology department, Faculty of Medicine, Alexandria University. The patients will be diagnosed and referred to by a neurologist participants aged from 20 to 40 years with a confirmed diagnosis of multiple sclerosis (based on McDonald criteria). Ambulatory for at least 6 minutes, without the use of assistive devices.EDSS score between 2.0 and 5.0.no relapse within 1 month prior to participation