Six-Minute Walk Test Performance in Persons With Multiple Sclerosis While Using Passive or Powered Ankle-Foot...

Area of Science:

• Neurology
• Rehabilitation Engineering
• Biomechanics

Background:

• Gait impairment is a common challenge for individuals with multiple sclerosis (MS).
• Ankle-foot orthoses (AFOs) are used to assist with mobility, but powered versions are less explored for MS.
• Understanding the impact of powered AFOs on walking endurance is crucial for improving quality of life.

Purpose of the Study:

• To evaluate if a powered ankle-foot orthosis (AFO) enhances walking endurance in people with MS.
• To compare the effects of a portable powered AFO (PPAFO) against passive AFO and no AFO on walking performance.

Main Methods:

• A short-term intervention study was conducted in a university research laboratory.
• Sixteen participants with MS and existing AFO use underwent three 6-minute walk tests (6MWTs).
• Tests were performed with shoes only, a prescribed passive AFO, and a PPAFO, with assistive devices on the impaired limb.

Main Results:

• The PPAFO resulted in a shorter 6MWT distance compared to both the passive AFO and shoe-only conditions.
• No significant differences in metabolic cost of transport were found across the three footwear conditions.
• Current PPAFO design did not enhance endurance walking performance in this MS sample.

Conclusions:

• The tested PPAFO did not improve walking endurance in individuals with MS-related gait impairment.
• Further investigation into modified PPAFO designs or expanded training protocols is warranted.
• Optimizing powered orthotics may be key to improving endurance for MS patients with gait challenges.