Patients with multiple sclerosis and low disability display cautious rotational behavior during gait initiation

Area of Science:

• Neuroscience
• Biomechanics
• Rehabilitation Science

Background:

• Multiple sclerosis (MS) commonly causes locomotor impairments.
• Understanding gait initiation challenges in MS is crucial for managing mobility.
• Gait initiation involves complex control of whole-body angular momentum.

Purpose of the Study:

• To investigate the effects of Multiple Sclerosis on whole-body angular momentum control during gait initiation.
• To quantify differences in angular momentum and net external moments between MS patients and healthy individuals.

Main Methods:

• Utilized 3D motion capture and force plates to analyze gait initiation in 15 MS patients (EDSS 2.5) and 16 healthy controls.
• Calculated spatiotemporal parameters, whole-body angular momentum, and net external moments about the center of mass.
• Focused on the double support and transition phases of gait initiation.

Main Results:

• MS patients showed significantly reduced whole-body angular momentum in the transversal plane during double support (p=0.011).
• Reduced net external moments were observed in MS patients in the sagittal plane (p=0.013) and transversal plane (p=0.024) during critical gait initiation phases.
• Significant reductions in transversal plane net external moments persisted between gait phases (p<0.001) in MS patients.

Conclusions:

• Despite preserved spatiotemporal parameters, early MS is associated with reduced net external moments in critical gait initiation phases.
• These reductions represent cautious rotational behaviors to preserve dynamic stability and prevent falls.
• Whole-body angular momentum and net external moment are valuable biomarkers for assessing functional status and disease progression in MS.