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

Multiple sclerosis induces locomotor impairments. The objective was to characterize the effects of Multiple Sclerosis on whole-body angular momentum control during gait initiation.

Fifteen patients with Multiple Sclerosis with Expanded Disability status scale of 2.5 and 16 healthy participants were instructed to perform gait initiation. Spatiotemporal parameters, whole-body angular momentum, net external moment about the body's center of mass and its components were calculated by using a 3D motion capture system and two force plates.

Patients with Multiple Sclerosis had a significantly smaller whole-body angular momentum range during the double support phase of gait initiation in the transversal plane (p = 0.011), and smaller net external moment at the transition between the initial double support phase and the execution phase in the sagittal plane (p = 0.013). In the transversal plane, patients with Multiple Sclerosis had a smaller net external moment during the double support phase (p = 0.024) and between the double support phase and the execution phase (p < 0.001).

Despite preserved spatiotemporal parameters during gait initiation, patients with Multiple Sclerosis with low disability had reduced net external moments in the transversal and sagittal planes during the critical transitional period of this functional task, which appeared as a compensatory modality to preserve global postural stability. This finding highlights the cautious rotational behaviors in these planes to prevent the risk of falling and preserve dynamic stability. Whole-body angular momentum and net external moment are relevant parameters for functional and disease progression follow-up of the disease.