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

Björn Zörner1, Pascal Hostettler2, Christian Meyer1

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Multiple Sclerosis and Related Disorders
|April 29, 2022
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Summary

Gait pattern analysis accurately predicts walking decline in people with MS (PwMS). Specific spastic-paretic gait impairments worsen over time, impacting mobility and serving as a key prognostic marker for MS-related walking deterioration.

Keywords:
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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.