Walking while talking--difficulties incurred during the initial stages of multiple sclerosis disease process

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Multiple sclerosis (MS) commonly causes gait and cognitive deficits, even early in the disease.
• Assessing gait under cognitive load is crucial due to the simultaneous nature of these functions in daily activities.

Purpose of the Study:

• To evaluate gait and gait variability in patients with clinically isolated syndrome (CIS) suggestive of MS while performing a cognitive task.
• To identify early pathological changes in gait associated with the initial stages of MS.

Main Methods:

• Fifty-two CIS patients and 28 healthy controls participated.
• Gait parameters were measured using an electronic walkway (GAITRite system).
• Participants walked under normal, fast, and dual-task conditions (walking with word list generation test).

Main Results:

• CIS patients exhibited slower, asymmetrical gait with a wider base of support compared to controls.
• Dual-tasking significantly increased double support time and reduced velocity in CIS patients, but not controls.
• These gait alterations suggest ongoing pathological processes in the early phase of MS.

Conclusions:

• Gait impairment and cognitive deficits are present in the early stages of MS (CIS).
• Dual-tasking challenges reveal subtle gait abnormalities indicative of early disease progression.
• Physical rehabilitation should address gait-cognitive dual-tasking to mitigate fall risk in early MS patients.