Research update
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Could textured insoles help with MS walking problems? People with MS often have poor sensation on the soles of their feet. Could wearing special insoles in your shoes help increase the sensory feedback from the foot and lead to improvements in balance and walking? Authors Alfuth M Title Textured and stimulating insoles for balance and gait impairments in patients with multiple sclerosis and Parkinson’s disease: A systematic review and meta-analysis Journal Gait Posture. 2017; 51:132-141 > Read the summary tinyurl.com/ms-insoles
The study Several studies have investigated the effect of wearing textured insoles in people with MS. This study was a meta-analysis which pooled results from previous studies. To be included in the review the studies needed to be randomised clinical trials which compared textured or stimulating insoles with smooth insoles by measuring walking rhythm (cadence), walking speed (gait velocity), step length, and balance. Six studies were included in the final analysis - three of these were studies of people with MS. Of these three, one measured the effect when wearing textured insoles for the first time, while two measured the first time effect as well as after wearing the insoles for two or four weeks (total of 85 participants with MS).
The results At the first time of wearing textured insoles, there was no evidence of an effect compared with smooth insoles on walking rhythm, walking
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speed or step length. One of the studies found a small increase in forward/backward sway when wearing textured insoles for the first time. After wearing textured insoles for two or four weeks, there was no evidence of an effect compared to smooth insoles on walking rhythm, speed or balance. In one study, after two weeks of wear, there was some evidence of increased step length and stride, suggesting a more confident walking style.
What does it mean? Overall, this review concludes that textured insoles have no effect on balance or walking. Sensory feedback from muscles and joints in the lower leg and feedback from other senses such as vision, touch or the semicircular canals of the inner ear may be more important in maintaining balance and walking style. However, just three small studies were included in this meta-analysis; further studies with more participants and longer treatment periods will give more
evidence. Researchers in Australia are currently recruiting 176 participants for a three month trial of textured insoles.
More about MS and walking problems
In MS, many problems associated with walking are initially caused by the slowed or altered nerve conduction, which results in muscle weakness, spasm or spasticity (muscle stiffness) and sensory changes. However, other MS symptoms can have a large impact on walking, such as difficulties with balance, pain, tremor, dizziness and visual problems. For example, vision that is double, blurred or has altered depth perception can make it difficult to place your feet or judge steps and kerbs. The best way forward depends on what is causing the walking difficulties. A health professional, such as a GP, MS nurse or physiotherapist can advise. Treatment may To find out more involve physiotherapy about dealing with or drug treatments walking problems for to alleviate people with MS visit specific underlying mstrust.org.uk/ symptoms such as spasticity. walking-difficulties
Open Door February 2018 Office number: 01462 476700 mstrust.org.uk info@mstrust.org.uk