Morphofunctional aspects of lower limb in multiple sclerosis.

Gait, as an expression of the locomotive system, needs a complex biomechanical analysis, which allows the description of multiple sclerosis (MS) specific patterns, MS patients having a polymorphism of motion patterns. The studied group consisted of 13 MS patients with gait disorders, average age of the group was of 36 years. The evaluation of the subjects comprises: clinical evaluation (anamnesis, neurological examination), paraclinical evaluation (MRI), functional evaluation, neuro-physiologic evaluation and biomechanical evaluation. Biomechanical examination was completed using the force and pressure-measuring platform of plantar pressure distribution Footscan Scientific Version, RSscan. The studied parameters were: contact area, active contact area, heel rotation, foot balance, foot angle. The evaluated zones during a gait cycle were: the heel, medial foot, antefoot. Although the analysis of contact area in the lateral foot did not show any significant differences between the right and the left foot, it nonetheless underlined a major difference in the expression of maximum and minimum values, which meant that MS patients with clinically detectable gait disorders had a tendency to increase contact area to maintain balance. Examining the foot positions in relation to the movement direction and to the foot vertical axis, we noticed the existence of certain elements indicating an orientation tendency of the foot. This tendency had to be related to neutral position (corresponding to anatomical position) of the foot. We also noticed a foot deviation in abduction, associated with visible pronation and decrease of the contact area corresponding to medial plantar zone.