Prognosis of walking function in multiple sclerosis supported by gait pattern analysis

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Science

Background:

• Walking impairment is a significant and disabling symptom for people with MS (PwMS).
• Objective tracking and prognosis of ambulatory deterioration in PwMS are currently limited.
• This study aimed to identify prognostic markers for walking decline in PwMS.

Purpose of the Study:

• To objectively track the progression of clinical walking performance and kinematic gait patterns in PwMS over a 4-year period.
• To identify potential prognostic markers for the deterioration of ambulatory function in PwMS.
• To analyze gait progression based on MS type and pathological gait signatures.

Main Methods:

• Recruited 22 PwMS with gait impairments for a 4-year longitudinal study.
• Utilized standardized clinical walking tests (T25FW, 6MWT, MSWS-12) and 3D kinematic gait analysis.
• Assessed walking decline in the overall cohort and in subgroups based on MS type (RRMS, PMS) and gait pathology clusters.

Main Results:

• The overall cohort showed significant worsening in the 6-minute walk test (6MWT) over 4 years.
• Subjects with progressive MS (PMS) exhibited worsening Expanded Disability Status Scale (EDSS) scores, unlike those with relapsing-remitting MS (RRMS).
• PwMS with spastic-paretic gait (cluster 1) showed marked deterioration in T25FW and 6MWT, with cluster 1 gait impairments predicting 6MWT decline with 90.9% accuracy.

Conclusions:

• Quantitative functional outcomes and gait pattern analysis are valuable for tracking MS disease progression.
• Gait analysis provides insights into the pathomechanisms of gait deterioration in PwMS.
• This approach may serve as a complementary prognostic tool for assessing walking function in PwMS.