Is There a Relationship Between Fatigue Questionnaires and Gait Mechanics in Persons With Multiple Sclerosis?

Fatigue induced changes to kinematic and kinetic gait parameters following six minutes of walking in people with multiple sclerosis

“…Previous work examining the energy cost of walking in people with mild MS during the 6MWT has not shown any association with self-reported fatigue [31] with cardiorespiratory demands or exertion dyspnoea [32]. However, associations between self-reported fatigue and reduced distance and velocity have been reported [33,34], which likely relate more directly to the motor impairments observed in gait [16].…”

“…In the less affected leg there was an increase in knee power absorption at loading response, which has been previously shown to correlate with fatigue impact using the modified fatigue impact scale [16]. The increased ankle power absorption on the less affected leg in stance phase may also indicate poor eccentric control in the ankle plantarflexors due to muscle fatigue.…”

“…Presently there has been limited research into the direct effects of muscle fatigue on daily activities such as walking in people with MS. Higher levels of fatigue are reported in the afternoon by people with MS, however previous work has reported no significant differences in spatiotemporal characteristics of gait 3 measured in the afternoon of a day compared to the morning [15]. A more detailed study of gait mechanics in people with MS found reduced ankle power at push-off, reduced knee power absorption and reduced peak knee extensor moments to be associated with increased levels of selfreported fatigue [16], suggesting that fatigue is associated with gait changes in people with MS.…”

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

“…The pattern of knee hyperextension was slightly greater when fatigued with the FES on which may have been done to further compensate for eccentric demands imposed on the knee extensors which are likely to have been weakened further after the fatiguing walk [21]. Poor knee control has been shown to correlate with fatigue [19] and has been shown to deteriorate with walking induced fatigue [18,40]. This avoidance pattern leads to slightly reduced power absorbed at the knee of the more affected limb.…”

“…Fatigue in people with MS typically exacerbates pre-existing deficits in gait, with fatigued individuals demonstrating slower walking speeds with associated shorter step lengths and prolonged periods of double support compared to non-fatigued individuals [17]. Moreover, signs of impaired neuromuscular control of gait mechanics have been associated with the severity of fatigue experienced by people with MS [18,19].…”