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

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Multiple sclerosis (MS) patients exhibit significant gait pathology, including restricted knee and ankle movement. Identifying distinct gait patterns can help tailor treatments and monitor disease progression.

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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.