title: Foot placement patterns of female rollator users with multiple sclerosis in the community.
abstract: OBJECTIVE
  The objective of this study was to investigate the relationship between medio-lateral foot placement characteristics and environmental context when individuals with Multiple Sclerosis (MS) walk with a rollator (four-wheeled walker).
  
  
  METHODS
  Ten women diagnosed with MS, who used rollators regularly, participated in this study. First, a rollator-based technique of calculating step width (SW) was validated in this patient population by comparing the output of an instrumented rollator (iWalker) to a laboratory-based Vicon Motion Capture System. Secondly, the iWalker-based technique was used to calculate the participants' SW and SW variability as they used the iWalker in four common outdoor community environments.
  
  
  RESULTS
  There was a strong level of agreement between the iWalker and Vicon SW calculations, with an intra-class correlation coefficient of 0.993 and a root-mean-square difference of 0.71 cm. Furthermore, SW variability (P = 0.002), but not SW (P = 0.288), was influenced by the walking environment (i.e. between the in-lab vs. up-ramp and up-ramp vs. down-ramp conditions).
  
  
  CONCLUSIONS
  Foot placement variability appears to be influenced by the walking environment of MS patients. Therefore, an enhanced understanding of walker-user interactions in relation to the environment must be established in order to improve mobility.
authors.affiliation: Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada. justin.chee@utoronto.ca
authors.forename: Justin N
authors.initials: JN
authors.lastname: Chee
authors.forename: William H
authors.initials: WH
authors.lastname: Gage
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
authors.forename: Karl F
authors.initials: KF
authors.lastname: Zabjek
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D003430:Cross-Sectional Studies; D051341:Dependent Ambulation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D051346:Mobility Limitation; D009048:Motor Skills; D009103:Multiple Sclerosis / Q000503:physiopathology*; D019370:Observation; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011446:Prospective Studies; D012656:Self-Help Devices; D014853:Walkers / Q000706:statistics & numerical data*; D016138:Walking / Q000502:physiology*