Michael Psarakis1, David Greene2, Mark Moresi3, Michael Baker4, Peter Stubbs5, Matthew Brodie6, Stephen Lord7, Phu Hoang8. 1. Faculty of Health Sciences, Australian Catholic University, Locked bag 2002, Strathfield, NSW, Australia. Electronic address: michael.psarakis@acu.edu.au. 2. Faculty of Health Sciences, Australian Catholic University, Locked bag 2002, Strathfield, NSW, Australia. Electronic address: david.greene@acu.edu.au. 3. Faculty of Health Sciences, Australian Catholic University, Locked bag 2002, Strathfield, NSW, Australia. Electronic address: mark.moresi@acu.edu.au. 4. Faculty of Health Sciences, Australian Catholic University, Locked bag 2002, Strathfield, NSW, Australia. Electronic address: michael.baker@acu.edu.au. 5. Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia. Electronic address: p.stubbs@neura.edu.au. 6. Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia. Electronic address: m.brodie@neura.edu.au. 7. Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia. Electronic address: s.lord@neura.edu.au. 8. Faculty of Health Sciences, Australian Catholic University, Locked bag 2002, Strathfield, NSW, Australia; Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia. Electronic address: Phu.Hoang@acu.edu.au.
Abstract
BACKGROUND: Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis. METHODS: Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait. FINDINGS: Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion. INTERPRETATION: Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gait impairments that were not detectable using standard spatiotemporal gait parameters.
BACKGROUND:Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis. METHODS: Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait. FINDINGS: Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion. INTERPRETATION: Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gait impairments that were not detectable using standard spatiotemporal gait parameters.
Authors: Vanessa Ade; Dale Schalkwijk; Michael Psarakis; Michael D Laporte; Timothy J Faras; Remi Sandoval; Fadi Najjar; Peter W Stubbs Journal: PLoS One Date: 2018-07-12 Impact factor: 3.240