How Does Multiple Sclerosis Contribute to Difficulty Walking Down Stairs?

Reviewed by Tomas Diaz, MD

Emergency Medicine

Multiple sclerosis can weaken leg muscles and affect balance, making it harder for people to walk down stairs safely.

Explanation

In multiple sclerosis, the immune system attacks the protective covering of nerves, disrupting signals that control balance and muscle strength. As a result, people with MS often experience leg weakness and poor coordination. Research shows that balance problems and altered walking patterns are common in people with MS, making stair descent especially difficult. Going down stairs is more challenging than walking on flat ground because it requires more precise control, which increases the risk of missteps and falls. People with MS often develop different strategies to stay upright. These compensatory movements may include using other muscle groups more heavily or changing how they distribute their body weight in order to avoid falls.

(References)

Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol. 2018;159:237-250. doi: 10.1016/B978-0-444-63916-5.00015-X. PMID: 30482317.
Kline PW, Christiansen CL, Hager ER, Alvarez E, Mañago MM. Movement compensations during a step ascent task are associated with stair climbing performance in people with multiple sclerosis. Gait Posture. 2021 Jun;87:27-32. doi: 10.1016/j.gaitpost.2021.04.022. Epub 2021 Apr 15. PMID: 33878510; PMCID: PMC8441993.
Sieljacks PS, Søberg CA, Michelsen AS, Dalgas U, Hvid LG. Lower extremity muscle strength across the adult lifespan in multiple sclerosis: Implications for walking and stair climbing capacity. Exp Gerontol. 2020 Oct 1;139:111025. doi: 10.1016/j.exger.2020.111025. Epub 2020 Jul 24. PMID: 32712158.

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