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Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis
1Service de Rééducation Neuro-Orthopédique, Inserm U 483, Hôpital Rothschild, 33 boulevard de Picpus, F-75012 Paris, France. philippe.thoumie@rth.ap-hop-paris.fr
Objective:
To evaluate the correlation between gait speed and strength in multiple sclerosis (MS) with particular regard to patients presenting with proprioceptive loss.
Methods:
Gait evaluation and isokinetic testing of muscular function were performed in 20 patients with unaided gait (expanded disability status scale < 6). Patients were separated into two groups in relation to the occurrence of somatosensory involvement: pyramidal group (8 patients) and sensory-pyramidal group (12 patients). Ten healthy subjects of similar age, sex, and height constituted a control group to evaluate gait parameters.
Results:
In the whole patient group, gait speed was reduced and strongly related to hamstring peak torque but not with quadriceps peak torque. The gait speed and peak torques of quadriceps and hamstrings were similar in both groups of patients. However, in the patients with proprioceptive loss there was both a strong correlation between gait speed and hamstring torque and a significant correlation with quadriceps torque. In the pyramidal group there was poor or no correlation.
Conclusion:
In patients with undifferentiated MS there is some correlation between gait speed and muscle strength. In the case of sensory loss, a higher contribution of both flexor and extensors of the lower limbs was observed, suggesting that muscular compensation occurred in this situation to maintain gait speed. These results are relevant to assess rehabilitation modalities in MS.