Multiple Sclerosis Mobility Aids: How to Choose the Right Support

Living with multiple sclerosis, or MS, is an exercise in patience. Because your body may not respond the way it used to in certain scenarios—and sometimes, because it responds in a way that is totally unplanned—you’ve learned to expect the unexpected.

That’s especially true when it comes to walking. MS-related weakness, spasticity, balance problems, and foot drop can make getting from point A to B a real challenge. Mobility aids are designed to support people with multiple sclerosis, but each device works differently, and some may be better suited to certain situations than others. We talked with leading MS mobility experts to find out how to choose the right mobility aid when you have multiple sclerosis, along with tips for getting the most support from your device.

Why Does Multiple Sclerosis Affect Mobility?

Multiple sclerosis is a chronic condition that damages the protective covering of nerves in the central nervous system. In turn, this disrupts communication between the brain, spinal cord, and the rest of the body.

When signals involving movement are disrupted, walking becomes less coordinated and people with MS may experience symptoms that make mobility difficult, including:

• Fatigue. Research shows that fatigue is directly correlated with walking speed and mobility in MS.
• Foot drop. This common MS symptom affects the ability to lift the foot with each step, contributing to falls.
• Leg weakness. A recent study in the Journal of Neurology found muscle weakness and spasticity to be among the most common symptoms of MS.
• Loss of coordination. When muscles are weak and nerve signals are not firing the way that they should, it’s easy to lose coordination when you walk.
• Muscle stiffness. In a recent survey of 1,177 people living with MS, 62% said they felt muscle stiffness (sometimes also referred to as spasticity).
• Numbness. Nerve damage in multiple sclerosis can lead to a numb or tingling sensation in your legs and feet, making it hard to feel the ground as you walk.
• Poor balance. Between loss of sensation and lack of strength, it’s no surprise that balance becomes an issue, leading to greater mobility challenges.
• Spasticity. This symptom often occurs in tandem with muscle stiffness and weakness, according to research in the Journal of Neurology.

Signs It May Be Time for a Mobility Aid

Every person with multiple sclerosis experiences the disease a little differently, but there are universal indications that someone may need mobility support, including difficulty with balance and weakness, says Shauna Buchmoyer, an occupational therapist with United Disabilities Services in Lancaster, PA.

“It’s not a one size fits all formula,” Buchmoyer says. “As a therapist, I’ll ask questions: Have you had a fall in the home? Are you off-balance walking from point A to point B? Do you reach for objects at home to steady yourself on?” If you are living with MS, it can be hard to see the changes in your mobility when they happen gradually. These are a few indicators that it could be time to consider a mobility aid:

• You are experiencing stumbles, falls, or near falls several times a week.
• You steady yourself by leaning on the walls or furniture when you walk.
• One foot is dragging when you step.
• It takes a conscious effort to lift your foot when you walk.
• You are unsteady when you turn.
• You limit the length of outings because of fatigue.
• You avoid social gatherings due to fatigue or fear of falling.

“If you are afraid of falling, you won’t do things that challenge your balance, which in turn makes you weak from lack of movement,” Buchmoyer says. “In those cases, a mobility aid can give you the confidence to keep doing the things you love.”

Best Mobility Aids for Multiple Sclerosis

Which mobility device is right for you depends on multiple variables. “I look at medical history, do a standardized mobility assessment, and evaluate cognitive status,” says Buchmoyer. “I’m trying to determine: What are the tools they need to manage their situation?”

These are a few of the mobility aids for MS that you and your doctor or physical therapist might discuss, and what to consider before buying.

Braces and Devices for MS Foot Drop

Foot drop is one of the most common symptoms of multiple sclerosis. Along with physical therapy, there are two devices that can help improve the ability to walk safely with foot drop.

Ankle-foot orthosis (AFO). An AFO is a brace that supports your foot and ankle, helping position the foot for walking. Designs differ in rigidity, materials, and how they work with your shoe. Which one is right for you depends on your gait, ankle control, and other symptoms. Recent research suggests that AFOs are best for improving balance and gait while walking but provide less support when standing in place.

Functional electrical stimulation (FES). Functional electrical stimulation is one of the leading therapies to treat foot drop. An FES device uses mild electrical pulses to stimulate the nerve that tells the muscles to lift the front of your foot. The stimulation is timed to your steps and the device is often used in conjunction with an AFO.

In both cases, a specialist will work with you to fit an AFO or FES. These options can improve your foot clearance, but they won’t address issues like loss of balance that can occur with MS. Your therapist can assess whether you also need a walking aid.

Canes for Multiple Sclerosis

Research has found that people with multiple sclerosis who receive instruction for and use walking aids like canes experience fewer falls and greater overall mobility than those who do not use walking support.

Canes are typically either single-point or quad canes. As the names imply, a single-point cane features one rubber tip that contacts the ground for support, while the base of a quad cane has four small points for greater stability. Which one you choose will depend on how much of an issue balance is for you—but not in the way you might think, says Buchmoyer. “With a single point cane, if you let go it falls to the ground. With four points, the cane stays upright if you let go of it, which means you don’t have to lean over and pick it up.”

Since bending forward increases the risk of falling, those with balance issues might do better with a quad cane, she notes. “On the other hand, if someone just wants to feel secure as they move, a single point might be appropriate.”

The hand grip on your cane is also an important consideration. The Mayo Clinic notes that hand grips made from foam or featuring ergonomically correct holds for your fingers may be more comfortable. In addition, if you struggle with hand weakness, a larger grip is likely a better choice.

Cane height matters. “You want to have about 45 degrees of bend in elbow when you rest the cane in order to have a little give and take in arm extension when walking,” Buchmoyer says. (You’ll carry your cane on the side opposite your weaker side and use it to counterbalance each step.)

While canes are perhaps the least intrusive means of support with MS, they are also the least robust. If you need substantial help bearing weight or finding your balance, a walker or rollator may be a better option.

Walkers and Rollators Make Walking With MS Easier

With multiple sclerosis, sometimes a cane is no longer sufficient for support. If that’s the case, a walker or rollator can help. The primary difference between a walker vs. rollator is that traditional walkers have four legs with rubber feet, requiring you to lift and place the device with every step, while rollators have three or four legs and wheels, so that you push the device forward as you step. (There are also two-wheel walkers, which are a hybrid between the two devices.)

“When deciding between a walker and a rollator, take into account that any time you add mobility, you lose stability,” says Kimberly Fredsall, DPT, MSCS, a Level III Multiple Sclerosis Specialist and physical therapist at Gaylord Specialty Healthcare in Wallingford, CT. “A rollator with four wheels is going to be less sturdy than a walker with two wheels. If someone has really poor balance and cannot control the rollator, it is unsafe. However, if they have good control, a rollator can be a very useful device for fatigue with the built-in seat and for uneven terrain with the larger wheels.” Some versions are also designed to promote a more erect posture while walking.

Manual Wheelchairs

Propelling yourself manually can be a gateway to independence with multiple sclerosis, but it depends on the strength of your upper body and the quality of chair you are using. Per the Multiple Sclerosis Foundation, wheelchairs for people with MS should be “light, maneuverable, and collapsible.”

Other considerations for lightweight wheelchairs include backrest and seat support, especially if someone has a weak core or midsection, says Buchmoyer. “Fit matters,” she adds. “Measure the hip width of the seat, and your own hip width. You want two inches of space on either side of chair so you don’t slide around but have enough space to change position and get pressure relief.”

Power Wheelchairs

Electric wheelchairs, also called power chairs, can be a game changer if you are struggling to walk or propel yourself manually. With the press of a joystick, often controllable with one finger, you can make your power chair take you wherever you want to go.

Power chairs come in a range of sizes and styles. Most operate via a single or double battery, which has a stated mile range and is rechargeable either through the chair itself or by removing it and plugging it into an outlet. A controller attaches to one arm of the chair and through it you can direct the chair to move forward, backward, or turn.

Lightweight electric wheelchairs, which can weigh under 30 pounds, have the advantage of folding and fitting in the back of a car or small storage space at home. Larger power chairs may have more features and cushioning but can weigh over 100 pounds and require a lift device to get into a van for travel.

If you’re considering a power chair, work with your physical or occupational therapist to identify your greatest needs. “If someone is having progressive weakness, difficulty navigating their environment, or experiencing an increase in falls, that’s when I’d recommend it,” says Buchmoyer, adding that the choice is highly individualized. “If someone can walk a short distance and that’s all they want to do, it’s different than someone who is struggling to walk and frustrated because it limits their ability to get out and enjoy the community.”

If you foresee spending full days in the chair, talk with your care team about a manual or power wheelchair designed specifically around your needs. “Almost every component of a wheelchair can be customized which is important for skin integrity, range of motion, shoulder preservation, fatigue, and comfort,” says Fredsall, adding that if you go this route, “it is important to get fitted with a specialist.”

Mobility Scooters

Should you get a mobility scooter? Experts advise caution for people with multiple sclerosis. “The support is different than a wheelchair,” says Buchmoyer. “It may have a seatbelt, but not all scooters are designed to hold someone with a weak core in place.”

Some scooters are heavier than power chairs; some also may be faster or have a longer battery range. Always check the manufacturer's specifications. The devices can make quick work of sidewalks and store aisles, but many are not meant to go off-road or be used on uneven terrain. Along with evaluating your physical strength to ride one, consider where you plan to travel and whether a scooter is a practical means of getting you there.

Comparing Mobility Aids for MS

How to Choose the Right MS Mobility Aid

Two people with multiple sclerosis can have very different mobility needs, based on symptoms, lifestyle, and other health considerations. To figure out which assistive device is best for you, work with your physical or occupational therapist. These are some of the topics you may discuss.

What Is Your Biggest Mobility Problem?

Are you struggling with balance? MS muscle weakness? Foot drop? All of the above? Different symptoms benefit from different types of support, so the first step will be pinpointing which issues present the greatest challenges.

“Person A may have a high level of mobility with only minor strength deficits contributing to foot drop and may only need to use a single point cane and a low-profile dorsiflexion assist brace,” says Fredsall. “Person B may have a lower level of mobility, have significant leg weakness that may be more appropriate for a quad cane or walker and more constant use of an ankle foot orthosis (AFO) in order to ambulate safely.”

Identifying the mobility issue that is affecting you the most allows you and your care team to narrow down which supportive device will serve your needs best.

What Are Your Mobility Goals?

As part of self-care with multiple sclerosis, most people are looking for ways to make daily life easier and getting around more manageable. But some people have additional specific goals, like participating in a charity walk or accompanying a grown child down the aisle at their wedding.

Make a short list of activities you want to accomplish with MS, and review it with your care team, so that you are all working toward the goal together. For example:

• Achieve a fitness or athletic goal.
• Attend an important event independently.
• Continue to work in your professional career with less fatigue.
• Get to the bathroom safely at night.
• Improve your safety on trips to and from the car and your home.
• Join a family reunion or trip.
• Shop independently without worrying about fatigue.

What Is Your Current Lifestyle and Home Situation?

So much of choosing a mobility device is dependent on the environment you intend to use it in. If you live in a building with stairs up to the front door, a mobility scooter or power chair may not be the best fit since it requires lifting and carrying to bring it inside.

On the other hand, if you have a garage or single-story home and have plans to travel, a scooter or electric wheelchair could be a better option than a walker or cane.

Talk with your MS care team about how your home is set up, the area you live or work in, and where you plan to use your mobility device the most. Additionally, your team should consider posture, pressure management, and how you will move between the device and other surfaces. Tell your therapist if getting up from a chair is difficult or if you need help moving to a toilet, bed, or car seat. A transfer plan is important with any form of seated mobility support.

Can You Use a Mobility Aid and Still Stay Active?

Not only is it possible to use a mobility device for MS and stay active, it’s imperative. Research suggests a correlation between MS and higher risk of cardiovascular disease, making it essential that those with the chronic condition continue to perform activities that increase their heart rate and promote oxygen and blood flow, even when faced with mobility challenges.

“Physical activity is good for anyone with any level of mobility support needs,” maintains Buchmoyer. “Someone with a wheelchair needs just as much activity as someone with a cane. Any activity is good activity.”

Additionally, physical activities that improve strength and balance can help to counteract these symptoms of MS. Your exercise plan should reflect your abilities and symptoms. Options to discuss include supported walking, seated movement, resistance exercises, stretching, or arm cycling. Balance exercises may also be useful, but the setup and level of assistance should be individualized.

Many people with multiple sclerosis are heat-sensitive—if that’s the case for you, plan for cooling and rest breaks during your activity. Exercise-related warming can temporarily worsen existing symptoms; always discuss any changes with your care team.

Getting Fitted and Trained to Use a Mobility Aid

When you’re investing in a mobility aid that will become a regular part of your daily life, making sure it fits your body properly and learning how to use it correctly are critical components for success. The process usually involves three steps:

Mobility Assessment

Your physical or occupational therapist will do a full evaluation of your capabilities, including such things as your gait, walking pattern, balance, and endurance. “Various objective measures look at balance, fatigability, and function,” says Fredsall. “However, a score does not guarantee need. Need is about the patient’s function and what works best for them.”

Fitting the Device

Each mobility aid has different fit needs.

• Cane. A cane should be adjusted so that there is a 45-degree bend in your arm when you stand with your arm down and relaxed.
• Walker. A walker should be at a height such that you can bear down on it with your arms to support your weight as needed, but not so low that you must bend significantly at the waist for support.
• Rollator. An upright rollator should be adjusted so that your forearms can rest comfortably on the armrests for support while keeping your spine vertical as you walk.
• Wheelchair. Your wheelchair should be measured to ensure your hands can reach the top of the rims when your arms are bent. The seat should be wide enough to leave an inch or two on either side of your hips, but not so wide that you slide around when moving.
• Power chair. Adjust the power chair controller so that you can reach it comfortably with one arm relaxed on the armrest. Adjust the seat height if possible so that your knees are over your feet and your legs form a right angle.
• Mobility scooter. Raise or lower the seat height so that your feet rest flat on the footrest and you do not need to lean forward to reach the steering column.

Using Your Mobility Aid in Real Life

Once you’ve chosen your device and you’ve been fitted to make sure it’s comfortable and safe, you’ll work with your physical therapist to practice using it in everyday situations.

With mobility aids like canes and rollators, daily use is pretty straightforward. Learning how to collapse your walker or rollator so that it fits into a car or storage space is also important. The more comfortable you are assembling and disassembling, the more likely you’ll be to use it every day.

When it comes to power mobility chairs and scooters, you’ll want to get familiar with moving forward, backward, and turning in tight spaces. You should also practice going over small bumps, like the threshold or saddle between two rooms, and navigating pavement imperfections outdoors.

Does Insurance Cover Mobility Aids for MS?

Coverage depends on your plan, the device, and documentation of medical necessity. A multiple sclerosis diagnosis alone does not establish coverage for every mobility aid.

Medicare Part B covers medically necessary walkers, including rollators, when eligibility requirements are met and the device is prescribed for home use. Under Original Medicare, you generally pay 20% of the Medicare-approved amount after meeting the Part B deductible if the supplier accepts assignment. Medicare also covers eligible wheelchairs and scooters. Power mobility may require an in-person examination and a written prescription, and some power wheelchairs require prior authorization.

Medicare’s power mobility criteria focus on mobility-related daily activities in the home. Wanting a scooter only for shopping or recreation does not, by itself, meet those criteria. Your provider must document the need and why less supportive equipment is insufficient.

Before purchasing, ask your insurer and supplier:

• Is this specific device covered under my plan?
• What prescription, assessment, and authorization do I need?
• Do I have to use a particular supplier?
• What will I pay and which features are excluded?
• How are repairs and replacement parts handled?

Not all companies take insurance, either. Journey does not accept or process insurance claims, but products are eligible for reimbursement with an FSA or HSA.

If cost is a barrier, ask your rehabilitation team about local loan programs, rentals, or financial assistance resources.

Finding Mobility Support That Fits Your Life

Choosing a mobility aid for multiple sclerosis means thinking about the whole picture: You’ll want to address your biggest mobility challenges while also considering the logistics of your current living situation, your goals for using a mobility device, and other health issues that may affect your ability to use a mobility aid.

Share all these details with your care team. Together, you can find support that helps you move more comfortably and keep participating in the activities that bring you joy.