Gait Changes with Balance‐Based Torso‐Weighting in People with Multiple Sclerosis

Abstract

Background and Purpose People with multiple sclerosis (PwMS) commonly have mobility impairments that may lead to falls and limitations in activities. Physiotherapy interventions that might improve mobility typically take several weeks. Balance-based torso-weighting (BBTW), a system of strategically placing light weights to improve response to balance perturbations, has resulted in immediate small improvements in clinical measures in PwMS, but changes in spatio-temporal gait parameters are unknown. The purpose was to investigate the effects of BBTW on gait parameters in PwMS and healthy controls. Methods Design: non-randomized controlled experiment Participants 20 PwMS and 20 matched healthy controls Procedures PwMS walked on an instrumented mat at their fastest speed for three trials each in two conditions: without BBTW then with BBTW. Healthy controls walked in both conditions at two speeds: their fastest speed, and at velocities equivalent to their matched PwMS. Results Averaged gait trials showed that, with BBTW, PwMS had significantly increased velocity (p=.002), cadence (p=.007), and time spent in single-limb support (p=.014), with decreased time in double-limb support (p=.004). Healthy controls increased velocity (p=.012) and cadence (p=.015) and decreased support base (p=.014) in fast trials with BBTW; at matched velocities, step length (p=.028) and support base (p=.006) were significantly different from PwMS. All gait variables in healthy controls at fast speeds were significantly different from PwMS walking at their fastest speeds. Discussion All participants showed increases in gait velocity and cadence during fast walk with BBTW. Improvements in time spent in single- and double-limb support by PwMS with BBTW may reflect greater stability in gait. Future research might ascertain if these immediate improvements could enhance effectiveness of longer-term physiotherapy on functional mobility in PwMS.

Standing Data Disproves Biomechanical Mechanism for Balance-Based Torso-Weighting

“…Our findings indicate that a mechanism other than a pure biomechanical shift appears to underlie BBTW. Gait data from these participants revealed that weighting increased gait velocity (p=0.002) compared to gait without weight, 14 indicating that BBTW did have an effect. Any proposed alternative mechanism must account for the apparent integration of sensory stimuli provided by these strategically placed light weights and consequent adjustment of postural sway, improvements in stability with perturbations and rotational forces, and increases in gait velocity.…”

“…This investigation was part of a larger study that involved motion analysis of gait in unweighted and weighted conditions. 14 …”

Postural Sway and Motor Control in Trans-Tibial Amputees as Assessed by Electroencephalography during Eight Balance Training Tasks

“…Balance is an important part of rehabilitation [ 37 ] because falls are a major predisposing factor for fractures and death in the elderly [ 38 , 39 ]. It is well known that the loss of a foot or leg can reduce balance and impair gait [ 18 , 40 ].…”

Valoración del uso de las nuevas tecnologías en personas con esclerosis múltiple

“…En nuestro estudio, en la figura 5 se aprecia como el sujeto que ha obtenido más mejoras en la prueba del equilibrio estático lateral (tarea que más se identifica con el test que se ha pasado), la cual trata de cambiar el peso corporal de lado, aspecto cuya importancia fue medida en el estudio de Gorgas (2015), resultando tener una transferencia directa a la mejora y estabilidad de la marcha, ha sido el participante número 1, siendo este el único hombre, con la consiguiente contradicción de la afirmación de García-Pedroza ( 2003) respecto a que ser del género masculino es un factor negativo en la EM, pero hay que añadir que se trata del sujeto que lleva menos número de años con la enfermedad, no siendo este un factor relevante, puesto que el único participante que no experimenta mejoras en dicha tarea es el número 4 el cual, después del an-terior, es el que lleva menos tiempo con la enfermedad, pudiendo comprobar que en cuanto a la progresión de la EM no existen dos pacientes iguales (Arroyo, 2017) aunque en la actualidad ambos convivan con el mismo tipo de EM, siendo esta del tipo EMRR. Todos los demás, en mayor o menor medida, han alcanzado progresos en los valores obtenidos en dicha prueba al final del entrenamiento con respecto al comienzo del mismo.…”