Joint Kinematics and Gait Pattern in Multiple Sclerosis: A 3D Analysis Comparative Approach

This cross-sectional study analyzed the lower limb (LL) behavior in terms of gait asymmetry and joints' kinematic parameters, comparing people with multiple sclerosis (pwMS) and unaffected individuals.

Data from 15 patients, EDSS ≤ 4.5, and 15 healthy control volunteers were gathered. The VICON Motion Capture System (14 infrared cameras), NEXUS software, Plug-in-Gait skeleton model and reflective markers were used to collect data for each subject during five gait cycles on a plane surface. Biomechanical analysis included evaluation of LL joints' range of motion (ROM) bilaterally, as well as movement symmetry.

Comparative biomechanical analysis revealed a hierarchy of vulnerability between the groups: the ankle is the most affected joint in pwMS (p = 0.008-0.014), the knee is moderately affected (p = 0.015 in swing phase), and the hip is the least affected (p > 0.05 in all phases). The swing phase showed the most significant left-right asymmetry impairment, as reflected by root mean square error (RMSE) values: swing-phase RMSE = 9.306 ± 4.635 (higher and more variable) versus stance-phase RMSE = 6.363 ± 2.306 (lower and more consistent).

MS does not affect the joints structurally; rather, it eliminates the ability to differentiate the fine-tuning control between them. The absence of significant left-right joint asymmetry differences during complete gait cycle indicates dysfunction in the global motor control.