Walking aids to improve gait in hereditary spastic paraplegia - effects and predictive parameters in a short-term sensor-based evaluation.

INTRODUCTION: Symptomatic management of hereditary spastic paraplegia (HSP) often involves assistive devices, yet neither the timing nor the choice of device is standardized, and their immediate impact on mobility in HSP remains poorly characterized. We aimed to quantify the immediate effects of classical walking aids in HSP, and to identify individualized responses. METHODS: HSP patients and healthy controls performed a standardized 4 × 10 meters walking test under three conditions: unaided, with bilateral walking sticks, and with a four-wheel walker. Mobile gait parameters were recorded for each condition, and participants rated their perceived walking adaptations. RESULTS: In the patient cohort (n = 46), assistive devices significantly improved step length, while other gait parameters were unchanged or worsened. Subgroup analyses indicated that patients with less clinical impairment, but greater fear of falling, older age, and higher body weight derived particular benefit from the use of walking aids. Subjective ratings were generally positive, with most patients assessing the devices as more helpful than baseline. Perceived improvements largely aligned with objective gait changes. CONCLUSIONS: Classical assistive devices may yield measurable, immediate benefits in gait performance in HSP reflecting patient perceptions. Future studies should investigate longer familiarization periods to evaluate sustained functional adaptations and optimize device recommendations.