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

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation Science

Background:

• Gait dysfunction is a prevalent and significant symptom in multiple sclerosis (MS).
• Understanding the specific gait pathologies in MS is crucial for effective management and treatment.
• Comprehensive gait analysis provides objective data on motor impairments.

Purpose of the Study:

• To profile gait pathology in individuals with MS using 3D gait analysis and clinical tests.
• To identify distinct gait patterns associated with MS.
• To evaluate the potential of gait profiling for patient stratification and monitoring disease progression.

Main Methods:

• Thirty-seven MS patients and 20 healthy controls underwent comprehensive 3D gait analysis.
• Gait analysis included treadmill walking at individual speeds and clinical walking tests.
• Hierarchical cluster and principal component analysis were used to identify gait patterns.

Main Results:

• MS patients showed restricted knee/ankle motion, increased gait variability, asymmetry, and impaired dynamic stability.
• Reduced knee range of motion was the most accurate differentiator between MS patients and controls (83.3%).
• Three principal pathological gait patterns were identified: spastic-paretic, ataxia-like, and unstable.

Conclusions:

• Impaired knee and ankle control is a common characteristic of gait dysfunction in MS.
• Personalized gait profiles and clustering algorithms show promise for stratifying MS patients.
• Objective gait measures are vital for monitoring disease progression and treatment efficacy in MS clinical trials.