A Multifactorial Model of Multiple Sclerosis Gait and Its Changes Across Different Disability Levels

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Science

Background:

• Mobility assessment is crucial for managing Multiple Sclerosis (MS).
• Instrumented gait analysis offers detailed metrics but lacks a specific model for MS-related gait deterioration.
• A validated gait model is needed to understand and quantify gait impairments in people with MS (pwMS).

Purpose of the Study:

• To develop and validate a gait model for discriminating underlying features of gait deterioration in pwMS.
• To characterize gait impairment across different disability levels in pwMS using the developed model.

Main Methods:

• Gait data collected from 114 pwMS (mild, moderate, severe disability) and 24 healthy controls using inertial sensors.
• Exploratory and confirmatory factor analysis applied to 36 gait metrics derived from 6-minute walk tests.
• Model validation through characterization of gait impairment across disability groups.

Main Results:

• A five-domain gait model was developed: rhythm/variability, pace, asymmetry, forward dynamic balance, and lateral dynamic balance.
• Significant gait alterations in rhythm/variability, asymmetry, and pace were observed even in the mild disability group.
• Dynamic balance deterioration was evident in moderate and severe disability groups.

Conclusions:

• A conceptual gait model for disease-specific mobility assessment in pwMS was successfully developed and validated.
• The model effectively highlights clinically relevant gait changes across all disability levels, including those with subclinical impairment.
• This model shows potential as a monitoring biomarker for pwMS.