Objectives The primary aim of this study was to investigate the immediate effects of textured insoles on balance and gait in people with MS. The secondary aim was to explore any effects after two weeks of wear. Study Design Within-session repeated-measures design with an exploratory follow up period. Setting Hospital gait laboratory Participants Forty-six participants with MS (34 female), age mean (SD) 49 years, who could walk 100m unassisted or using one stick/crutch. Intervention Participants were tested wearing three types of insole in a randomised order: control (smooth insole), texture (Algeos UK Ltd) or texture 2 (CrocsTM 11 ). Participants were then randomly allocated to wear one of the textured insoles for two weeks, after which they were retested. main outcome measures Standing balance (centre of pressure excursions and velocity) was measured with eyes open and closed on a Kistler force platform. Spatio-temporal parameters of gait were measured using a GAITRite system. Results The textured insoles had no significant immediate effects on balance or gait, apart from an increase in anterior-posterior sway range with eyes open in texture 2 (mean difference 4.5 mm, p<0.05). After two weeks, balance was not significantly different, but both textured insoles showed statistically significant effects (p<0.05) on spatio-temporal parameters of gait, with mean stride length increases of 3.5 cm (texture 1) and 5.3 cm (texture 2) when wearing the insoles. Conclusions After two weeks of wear there were improvements to spatio-temporal parameters of gait. However, whether this was a placebo or learning effect is unclear.