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Fatigue significantly worsens gait in moderate-to-severe multiple sclerosis (MS) patients after a 6-minute walk test (6MWT). This study identifies key gait alterations, aiding physiotherapists in setting targeted treatment goals for persons with MS.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease affecting gait and mobility.
  • Fatigue is a common and disabling symptom in persons with MS (PwMS).
  • The 6-minute walk test (6MWT) is a common measure of functional mobility.

Purpose of the Study:

  • To investigate the impact of induced fatigue on spatiotemporal gait parameters in PwMS.
  • To compare gait changes after the 6MWT across different severity levels of MS.

Main Methods:

  • A cross-sectional study involving 56 PwMS categorized by Expanded Disability Status Scale (EDSS) scores (mild, moderate, severe) and 25 healthy controls.
  • Spatiotemporal gait parameters were measured using the GAITRite electronic walkway before and after the 6MWT.
  • The Modified Fatigue Impact Scale (MFIS) was used to assess fatigue levels.

Main Results:

  • Fatigue levels were significantly higher in moderate and severe MS groups compared to the mild group.
  • Gait velocity, cadence, and step length decreased, while step time, stance, and double support time increased with higher EDSS scores.
  • Post-6MWT, moderate and severe MS groups showed significant worsening in gait velocity, step length, step time, double support time, and increased asymmetry in step and single support times.

Conclusions:

  • Walking-induced fatigue, as simulated by the 6MWT, exacerbates gait impairments in moderate-to-severe PwMS (EDSS ≥ 4.0).
  • Identifying specific gait alterations post-fatigue is crucial for developing targeted physiotherapy interventions.
  • These findings can inform clinical practice for managing gait dysfunction in MS.