Abstract
Purpose
Conduct a systematic review aimed to identify and synthesise evidence describing how walking impairment impacts the way persons with multiple sclerosis (MS) participate in activities within their homes and communities. Further, we assessed the sensitivity of the International Classification of Functioning, Disability and Health (ICF) framework to the lived walking experience for persons with MS.
Methods
Seven electronic databases were searched for peer-reviewed articles on the walking experience of persons with MS. Qualitative articles were included if they included quotes from persons with MS regarding community walking. Qualitative data were synthesised using a hybrid inductive and deductive thematic analysis, guided by the ICF framework and quality was appraised using the CASP tool.
Results
We included 90 eligible studies (214 quotes, 1813 participants). Study quality was high in 54% of studies. Four themes were identified: (1) adapting to physical barriers; (2) navigating society; (3) emotion and mindset; and (4) personal relationships.
Conclusions
The impact of walking impairment on community participation is perceived by persons with MS as negative and the cause of disconnect from those around them. Barriers are largely perceived as extrinsic to the self. Caution should be exercised when conceptualising walking experiences with MS using the ICF framework alone.
Implications for rehabilitation
This study reinforces the understanding of walking with multiple sclerosis (MS) as dynamic and multifaceted, shaped by physical, societal, relational, and psychological factors.
There is a need for enhanced advocacy efforts that extend beyond infrastructure, targeting the immediate social networks and broader communities of individuals with MS.
Consumer and community co-designed research is pivotal in recognising emotion and mindset as central, not peripheral, to the walking experience for persons with MS.
When conducting a walking-related needs analysis for persons with MS, we recommend that clinicians integrate psychological and physical outcomes.
