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Objective. To evaluate the effect of wearing a Dorsiflexion Assist Orthosis (DAO) on walking distance, physiological cost, fatigue, strength and balance measures following a modified six-minute walk test (6MWT) in people with Multiple Sclerosis (MS).

Design. Randomized cross-over trial. Setting. Hospital Movement Laboratory. Participants. 34 people (26 female) with moderate MS, Expanded Disability Status Scale score (mean±SD) of 3.7±0.7.

Interventions. Modified 6MWT with and without a DAO worn on the weaker leg. Main Outcome Measures. Distance walked, perceived fatigue and the physiological cost of walking were compared between walking conditions. Pre-and post-walk changes in knee extensor and ankle dorsiflexor isometric strength and standing postural sway with eyes open and closed, were compared between walking conditions.

Results. There were no differences in distance walked or perceived fatigue between the two walking conditions. However, there was a reduced physiological cost of walking (p< 0.05), a smaller reduction in knee extensor strength (p< 0.05) and a smaller increase in standing postural sway with eyes open (p< 0.01) after walking while wearing the DAO, compared with no DAO. Conclusions. Despite not increasing walking distance or reducing perceived fatigue, the DAO reduced the physiological cost of walking and maintained knee strength and standing balance, which may have important implications for physical rehabilitation in people with MS. Further trials are required to determine if the beneficial effects of wearing a DAO found here are maintained for longer periods.