Jacob Callesen1, Ulrik Dalgas2, John Brincks3, Davide Cattaneo4. 1. VIA University College, Faculty of Health Science, Department of Rehabilitation and Health Promotion Research, Hedeager 2, 8200 Aarhus N, Denmark; Aarhus University, Department of Public Health, Section of Sport Science, Dalgas Avenue 4, 8000 Aarhus, Denmark. Electronic address: jlcl@ph.au.dk. 2. Aarhus University, Department of Public Health, Section of Sport Science, Dalgas Avenue 4, 8000 Aarhus, Denmark. 3. VIA University College, Faculty of Health Science, Department of Rehabilitation and Health Promotion Research, Hedeager 2, 8200 Aarhus N, Denmark. 4. IRCSS Fondazione Don Carlo Gnocchi, Via Capecelato 66, 20138 Milano Italy.
Abstract
INTRODUCTION: Despite the multitude of rehabilitation interventions targeting gait impairments in persons with multiple sclerosis (PwMS), only little is known about the relative association of muscle strength and balance on different gait outcomes. AIM: To determine the relative association of balance and muscle strength to three gait performance outcomes in PwMS. METHOD:90 PwMS were enrolled in this cross-sectional study (72% women; mean age=49.8 ± 10.5 years; mean EDSS=3.7 ± 1.3. Spearman correlation and multivariate linear regression analysis were used to determine associations between three (dependent) gait outcomes (six-minute walk test (6MW), Timed 25-Foot Walk (T25FW), and Six Spot Step Test (SSST)). Explanatory variables were maximal muscle strength of the knee extensors, kneeflexors, plantarflexors and dorsiflexors, static balance (postural sway), functional balance (Mini-BESTest) and age and gender. RESULTS:Static balance (r = 0.30 to 0.53; p<.05) and muscle strength of the knee extensors, knee flexors, plantarflexors and dorsiflexors (r = 0.28 to 0.47; p<.05) were weakly related to all gait performance outcomes, while functional balance showed strong relationships (r = 0.70 to 0.83; p<.05). Multivariate regression models including postural sway, muscle strength, and age and gender accounted for 32-39% of the variability in the 6MW, T25FW, and SSST. In 6MW and T25FW, with standardized beta coefficients for postural sway and muscle strength ranging from -0.34 to -0.37 (SE=0.09) and 0.18 to 0.35 (SE=0.10 to 0.12), respectively. For SSST, significant associations were only observed for balance. CONCLUSIONS:Balance and muscle strength are significantly associated with gait performance during fast walking, whereas only balance was associated with more complex walking tasks.
RCT Entities:
INTRODUCTION: Despite the multitude of rehabilitation interventions targeting gait impairments in persons with multiple sclerosis (PwMS), only little is known about the relative association of muscle strength and balance on different gait outcomes. AIM: To determine the relative association of balance and muscle strength to three gait performance outcomes in PwMS. METHOD: 90 PwMS were enrolled in this cross-sectional study (72% women; mean age=49.8 ± 10.5 years; mean EDSS=3.7 ± 1.3. Spearman correlation and multivariate linear regression analysis were used to determine associations between three (dependent) gait outcomes (six-minute walk test (6MW), Timed 25-Foot Walk (T25FW), and Six Spot Step Test (SSST)). Explanatory variables were maximal muscle strength of the knee extensors, kneeflexors, plantarflexors and dorsiflexors, static balance (postural sway), functional balance (Mini-BESTest) and age and gender. RESULTS: Static balance (r = 0.30 to 0.53; p<.05) and muscle strength of the knee extensors, knee flexors, plantarflexors and dorsiflexors (r = 0.28 to 0.47; p<.05) were weakly related to all gait performance outcomes, while functional balance showed strong relationships (r = 0.70 to 0.83; p<.05). Multivariate regression models including postural sway, muscle strength, and age and gender accounted for 32-39% of the variability in the 6MW, T25FW, and SSST. In 6MW and T25FW, with standardized beta coefficients for postural sway and muscle strength ranging from -0.34 to -0.37 (SE=0.09) and 0.18 to 0.35 (SE=0.10 to 0.12), respectively. For SSST, significant associations were only observed for balance. CONCLUSIONS: Balance and muscle strength are significantly associated with gait performance during fast walking, whereas only balance was associated with more complex walking tasks.
Authors: Pedro Moreno-Navarro; Ramón Gomez-Illán; Carmen Carpena-Juan; Ángel P Sempere; Francisco J Vera-Garcia; David Barbado Journal: J Clin Med Date: 2020-05-08 Impact factor: 4.241