Planned gait termination in ambulatory people with multiple sclerosis: A cross-sectional comparison with healthy controls.

INTRODUCTION: Gait termination (GT), the transition from steady-state walking to stable standing, requires precise deceleration and postural control. Because multiple sclerosis (MS) is associated with heterogeneous motor, sensory and balance impairments, planned GT may reveal mobility alterations beyond those observed during steady-state walking. METHODS: This cross-sectional study included 25 ambulatory people with MS (pwMS; Expanded Disability Status Scale [EDSS] score ≤4.5) and 25 healthy controls (HC). Planned GT was assessed over six trials using the GAITRite® electronic walkway, with three trials terminating with each limb. Final termination-step width was designated as the primary outcome; other planned-GT outcomes were secondary, steady-state gait outcomes were supportive, and EDSS associations were exploratory. RESULTS: Final termination-step width was greater in pwMS than in HC (Hodges-Lehmann estimate, 5.65 cm; 95% confidence interval, 4.34-7.33; p < 0.001). pwMS also showed wider penultimate termination-step width, lower GT velocity, greater velocity reduction, shorter final step length, and longer double-support time (all Holm-adjusted p < 0.001). During steady-state walking, maximum step velocity was lower and step width was greater (both Holm-adjusted p = 0.015). In velocity-adjusted sensitivity analyses, differences in both termination-step widths, GT velocity, final step length, and double-support time remained significant (primary-outcome p < 0.001; secondary Holm-adjusted p ≤ 0.020). Higher EDSS scores were associated with wider penultimate (Kendall's tau-b=0.384, Holm-adjusted p = 0.010) and final (tau-b=0.488, Holm-adjusted p = 0.002) termination-step widths. CONCLUSION: Planned GT was characterised by greater velocity reduction, shorter final step length, wider terminal foot placement, and prolonged double-support time in pwMS. Planned GT may provide complementary information to steady-state gait assessment.