Quantitative assessment of the effects of 6 months of adapted physical activity on gait in people with multiple sclerosis: a randomized controlled trial

Corona, Federica; Coghe, Giancarlo; Marongiu, Elisabetta; Loi, Andrea; Crisafulli, Antonio; Concu, Alberto; Galli, Manuela; Marrosu, Maria Giovanna; Cocco, Eleonora

doi:10.1080/09638288.2016.1244291

Cited by 24 publications

(48 citation statements)

References 42 publications

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“…This is in line with previous studies reporting that impaired knee flexion is an important MS-associated gait characteristic and a valid predictor of walking function/gait speed in these patients 41 , 42 . Intriguingly, improved knee flexion as induced by pharmacological agents (fampridine 40 , baclofen 43 ), or with functional electrical stimulation 44 or physical exercise 43 , 45 have previously been associated with enhanced walking function in PwMS. Restoring knee excursion thus seems to be a promising approach for future treatment options aiming at improving walking function in PwMS 46 .…”

Section: Discussionmentioning

confidence: 99%

Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time

Filli

Sutter

Easthope

et al. 2018

Sci Rep

104

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Gait dysfunction is a common and relevant symptom in multiple sclerosis (MS). This study aimed to profile gait pathology in gait-impaired patients with MS using comprehensive 3D gait analysis and clinical walking tests. Thirty-seven patients with MS walked on the treadmill at their individual, sustainable speed while 20 healthy control subjects walked at all the different patient’s paces, allowing for comparisons independent of walking velocity. Kinematic analysis revealed pronounced restrictions in knee and ankle joint excursion, increased gait variability and asymmetry along with impaired dynamic stability in patients. The most discriminative single gait parameter, differentiating patients from controls with an accuracy of 83.3% (χ2 test; p = 0.0001), was reduced knee range of motion. Based on hierarchical cluster and principal component analysis, three principal pathological gait patterns were identified: a spastic-paretic, an ataxia-like, and an unstable gait. Follow-up assessments after 1 year indicated deterioration of walking function, particularly in patients with spastic-paretic gait patterns. Our findings suggest that impaired knee/ankle control is common in patients with MS. Personalised gait profiles and clustering algorithms may be promising tools for stratifying patients and to inform patient-tailored exercise programs. Responsive, objective outcome measures are important for monitoring disease progression and treatment effects in MS trials.

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Section: Discussionmentioning

confidence: 99%

Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time

Filli

Sutter

Easthope

et al. 2018

Sci Rep

104

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“…Stride length was the only gait parameter that was found significantly correlated with all levels of PA intensity as well as step count and VM count. Reduced stride length, which is one of the typical features of the gait pattern in pwMS and is due to weakness, spasticity, reduced proprioception and changes in motor integration, has been proven sensitive to physical rehabilitation and exercise [46][47] and it was also found associated with the risk of falling and fatigue [48][49]. Thus it is reasonable to hypothesize that pwMS characterized by higher values of step length are in some way more inclined to be engaged in PA, even of moderate and vigorous intensity.…”

Section: Discussionmentioning

confidence: 99%

What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?

Porta

Pilloni

Coghe

et al. 2020

Preprint

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Background: Although the mutual relationship between ambulation and Physical Activity (PA) in people with Multiple Sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Methods: Thirty-one pwMS (17F, 14M, mean age 52.5, mean Expanded Disability Status Scale score 3.1) were requested to wear a tri-axial accelerometer 24h/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e. gait speed, stride length, cadence and duration of stance, swing and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman’s rank correlation coefficient rho.Results: Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, p<0.001), percentage of sedentary activity (rho = -0.44, p<0.001) and percentage of moderate-to-vigorous activity (rho = 0.48, p<0.001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.Conclusions: The data obtained suggest that the most relevant determinants associated with higher and more intense levels of physical activity in free-living conditions are gait speed and stride length.The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.

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“…Since its introduction in 2009, the Gait Profile Score has been used in clinical practice world-wide, particularly in children with cerebral palsy to improve understanding of their complex gait patterns [19], evaluate the use of Botulinum toxin [20] and evaluate surgical outcomes [21]. In addition to cerebral palsy, there is published research using GPS in other populations such as Charcot-Marie Tooth [22], Hereditary Spastic Paraplegia [23], Multiple Sclerosis [24], Parkinson's Disease [25] , and amputees [26]. The GPS has also been used to create or validate other outcome measures [27,28].…”

Section: Concurrent Validitymentioning

confidence: 99%

Validation of the foot profile score

et al. 2019

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BACKGROUND There are numerous static measures of foot posture but there is no published score of dynamic foot motion. Three-dimensional gait analysis can include a multi-segment foot model like the Oxford Foot Model (OFM) to comprehensively quantify foot kinematic deviations across the gait cycle but it lacks an overall score, like the Gait Profile score (GPS), used to summarize the quality of lower extremity motion. RESEARCH QUESTION This paper introduces the Foot Profile Score (FPS), a single number, analogous to the GPS but based on kinematic data of the OFM. The aim of this study is to validate the FPS by studying its properties and design, and analyse it against a clinical assessment of foot deformity. METHODS Concurrent validity was established for the FPS analysing the relationship with Clinical Foot Deformity Score (CFDS) in 60 subjects with a condition affecting the lower limbs globally Content validity was established for the six Foot Variable Scores (FVS) that make up the FPS using a multiple regression of the CFDS on the 6 FVS in the 60 subjects. Predictive validity was established analysing the relationship of the FPS and GPS comparing 60 global involvement subjects with 60 subjects with isolated foot deformity. RESULTS Pearson correlation between the FPS and CFDS was significant at 0.62 (p<0.001). Each element of FVS contributes positively to predicting the CFDS with R2 = 0.456 (p<0.001). FPS contributed independently to the prediction of CFDS (t=3.9, p<0.001). The correlation between the GPS and FPS in the global involvement group was significant at r = 0.64 (p<0.001), while there was no correlation found with r = 0.08 (p=0.54) in the foot deformity group. SIGNIFICANCE The FPS is the first validated score of dynamic foot motion.

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Quantitative assessment of the effects of 6 months of adapted physical activity on gait in people with multiple sclerosis: a randomized controlled trial

Cited by 24 publications

References 42 publications

Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time

Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time

What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?

Validation of the foot profile score

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