Patient Reported Outcome Measures for Gait Assessment in Multiple Sclerosis: a Systematic Review of Psychometric Properties

Abstract

Multiple Sclerosis (MS) assessments often rely on clinician-rated measures and neuroimaging, which do not fully capture the so-called "invisible symptoms" like fatigue, pain, and gait disturbances. Patient Reported Outcome Measures (PROMs) address this gap, but variability in their psychometric properties complicates their use in research and clinical practice. The aim of this study was to critically appraise and compare gait-related PROMs in MS, evaluating their psychometric properties using the COSMIN framework. A systematic review was conducted following PRISMA guidelines, with searches in MEDLINE and EMBASE. Eleven gait-related PROMs for MS were identified, with 40 studies included in the review. The 12-Item Multiple Sclerosis Walking Scale (MSWS-12) was the most studied. While gait-related PROMs offer valuable insights into patient-reported functional status and disease progression, variability in study quality and psychometric evaluation highlights the need for caution when using these tools.