Gait Mechanics Are Different Between Healthy Controls and Patients With Multiple Sclerosis

Abstract

Multiple sclerosis (MS) causes severe gait problems in relatively young individuals, yet there have been limited studies to quantitatively identify the specific gait parameters that are affected. The purpose of this study was to define any differences in biomechanical gait parameters between patients with MS and healthy controls. A total of 31 MS patients and 31 healthy controls were evaluated: joint torques and joint powers were calculated at the ankle, knee, and hip during the stance phase of gait. The self-selected walking velocity was used as a covariate in the analysis to ensure that group differences were not due to differences in walking velocity between the MS and healthy control groups. Reduced angular range, less joint torque, and reduced joint power were seen in patients with MS. We also found significant correlations between biomechanical gait parameters and EDSS score, which provides a clinical rating of disease severity. Our findings provide a quantitative assessment of the gait mechanics employed in patients with MS. The altered lower extremity mechanics observed in patients with MS reflect both a neurological and strength deficit compared with healthy controls during walking.

Orthotic and therapeutic effect of functional electrical stimulation on fatigue induced gait patterns in people with multiple sclerosis

“…This may have been due to increases in knee flexion velocity as the corresponding knee extensor moment in early stance showed no real change. This suggests that compared to baseline there was a greater capacity for eccentric knee extensor activity leading to greater negative work [12] performed by the lower limb during the loading phase in early stance.…”

“…More importantly this significant increase in hip power generation late in stance, combined with (non-significant) increases in power generated at the ankle at the same time, were likely key factors responsible for the increases in walking speed. The significant increases in hip power generation and absorption earlier in stance likely represent improved neuromuscular control of the hip in transitioning from controlling flexion to initiating extension through eccentric and concentric muscle activity [12].…”

“…increased flexion) around late swing and foot contact likely contributing to decreases in step length and walking speed. Furthermore, reductions in joint kinetics, namely internal hip, knee and ankle moments and powers have also been reported [5,12], with the patterns of joint kinetics also revealing inefficiencies in the absorption and generation of power during gait which are likely related to neuromuscular factors [12], including deficits in strength of the knee extensor and ankle dorsiflexor muscles [13].…”

Gait characteristics according to pyramidal, sensory and cerebellar EDSS subcategories in people with multiple sclerosis

“…Numerous studies have examined gait characteristics in PwMS [3][4][5][6] confirming that PwMS walk slower with decreased stride lengths [3,4], reduced knee and ankle motion [5] and elevated variability [6] compared to healthy controls. Research studies have also established that gait parameters change throughout the disease process.…”

Quantification of Gait Abnormalities in Healthy-Looking Multiple Sclerosis Patients (with Expanded Disability Status Scale 0-1.5)

“…Another important aspect of gait in MS patients is the altered biomechanics of joint movement; kinematic studies in MS patients suggest that there are deficits in motor control that are not captured on clinical neurological examination [1][2][3]7] . These changes in movements of the lower limb joints may be caused by impaired motor control.…”