Reality Running Title: Visual Cues and Gait in MS

Objective: To study the effects of visual cues, provided through a portable visual-feedback virtual reality (VR) apparatus, on the walking abilities of patients with Multiple Sclerosis (MS). Methods: On-line (display-on) and residual short-term therapeutic effects on walking speed and stride length were measured in sixteen randomly selected patients with gait disturbances predominantly due to cerebellar ataxia. Results: Patients whose baseline walking speed (BWS) was below the median showed an average on-line improvement of 13.46 % in their walking speed, while patients whose BWS was above the median improved their speed by 1.47%. The average short-term residual therapeutic improvement in walking speed was 24.49 % in patients with BWS below the median, and 9.09 % in patients with BWS above the median. Similar results were obtained for improvements in stride length. These results of improved functions in patients are particularly noteworthy when compared with the lack of change in healthy control subjects. Conclusions: Patients with MS showed improvement in walking abilities using VR visual-feedback cues.