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Quantifying Gait Impairment Using an Instrumented Treadmill in People with Multiple Sclerosis

DOI: 10.1155/2013/867575

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Abstract:

Background and Objective. Treadmill gait analysis has been proposed as an attractive alternative for overground walking measuring systems. The purpose of this study was twofold: first to determine spatiotemporal parameters of treadmill gait in patients with multiple sclerosis (MS) and second to examine whether these parameters are associated with specific functional impairments in this cohort. Method. Eighty-seven relapsing-remitting patients diagnosed with MS, 50 women and 37 men, aged 40.9 ± 11.9 with an expanded disability status scale (EDSS) score of 2.7 ± 1.6, participated in this study. Twenty-five apparently healthy subjects, 14 women and 11 men, aged 38.5 ± 9.4, served as controls. Spatiotemporal gait parameters were obtained using the Zebris FDM-T Treadmill (Zebris Medical GmbH, Germany). People with MS demonstrated significantly shorter steps, extended stride time, wider base of support, longer step time, reduced single support phase, and a prolonged double support phase compared to the healthy controls. The EDSS score was significantly correlated with all spatiotemporal gait parameters. Conclusion. The instrumented treadmill may be an effective tool in assessing ambulation capabilities of people with MS. 1. Introduction Multiple sclerosis (MS) is a neurologic disease affecting an estimated 2.5 million adults worldwide and is the most common disabling neurological disease in young adults. MS is diagnosed between ages 20 and 50 [1], is 2 to 3 times more common in women than in men [2], and results in demyelination and axonal loss in the central nervous system (CNS) [3]. Such CNS damage may result in ambulatory limitations which are key components of disability in patients with MS [4]. Approximately 75% of these patients experience clinically significant walking and balance disturbances [5] which may present even in the early stages of the disease and in individuals diagnosed with clinically isolated syndrome [6]. Gait impairments are associated with the severity of deficiency in various functional neurological systems, that is, muscle power loss, level of spasticity, degree of instability due to impaired coordination, and degree of sensory impairment. Impairment in one functional system alone or in combination contributes to the patient’s gait impairment, resulting in a specific gait pattern [7]. Variations may also be seen in the same patient over a period of time [8]. Therefore, increasing awareness of walking and balance limitations in this patient group requires continuous evaluation. Assessment is essential in order to monitor disease

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