TY - JOUR
T1 - Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis
AU - Plotnik, Meir
AU - Wagner, Joanne M.
AU - Adusumilli, Gautam
AU - Gottlieb, Amihai
AU - Naismith, Robert T.
N1 - Funding Information:
We thank Ms. Natalie Karlibach and Ms. Tamar Azrad from the Center of Advanced Technologies in Rehabilitation at Sheba Medical Center for technical support. This research has been supported by NIH K12 HD055931 (Wagner, PI), and NMSS PP1940 (Wagner, PI). This publication was made possible by Grant Number UL1 RR024992 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. This research was also supported in part by NIH Grants CO6 RR020092 and RR024992 (Washington University Institute of Clinical and Translational Sciences—Brain, Behavioral, and Performance Unit). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Gait impairments in persons with multiple sclerosis (pwMS) leading to decreased ambulation and reduced walking endurance remain poorly understood. Our objective was to assess gait asymmetry (GA) and bilateral coordination of gait (BCG), among pwMS during the six-minute walk test (6MWT), and determine their association with disease severity. We recruited 92 pwMS (age: 46.6 ± 7.9; 83% females) with a range of clinical disability, who completed the 6MWT wearing gait analysis system. GA was assessed by comparing left and right swing times, and BCG was assessed by the phase coordination index (PCI). Several functional and subjective gait assessments were performed. Results show that gait is more asymmetric and less coordinated as the disease progresses (p < 0.0001). Participants with mild MS showed significantly better BCG as reflected by lower PCI values in comparison to the other two MS severity groups (severe: p = 0.001, moderate: p = 0.02). GA and PCI also deteriorated significantly each minute during the 6MWT (p < 0.0001). GA and PCI (i.e., BCG) show weaker associations with clinical MS status than associations observed between functional and subjective gait assessments and MS status. Similar to other neurological cohorts, GA and PCI may be important parameters to assess and target in interventions among pwMS.
AB - Gait impairments in persons with multiple sclerosis (pwMS) leading to decreased ambulation and reduced walking endurance remain poorly understood. Our objective was to assess gait asymmetry (GA) and bilateral coordination of gait (BCG), among pwMS during the six-minute walk test (6MWT), and determine their association with disease severity. We recruited 92 pwMS (age: 46.6 ± 7.9; 83% females) with a range of clinical disability, who completed the 6MWT wearing gait analysis system. GA was assessed by comparing left and right swing times, and BCG was assessed by the phase coordination index (PCI). Several functional and subjective gait assessments were performed. Results show that gait is more asymmetric and less coordinated as the disease progresses (p < 0.0001). Participants with mild MS showed significantly better BCG as reflected by lower PCI values in comparison to the other two MS severity groups (severe: p = 0.001, moderate: p = 0.02). GA and PCI also deteriorated significantly each minute during the 6MWT (p < 0.0001). GA and PCI (i.e., BCG) show weaker associations with clinical MS status than associations observed between functional and subjective gait assessments and MS status. Similar to other neurological cohorts, GA and PCI may be important parameters to assess and target in interventions among pwMS.
UR - http://www.scopus.com/inward/record.url?scp=85088497850&partnerID=8YFLogxK
U2 - 10.1038/s41598-020-68263-0
DO - 10.1038/s41598-020-68263-0
M3 - Article
C2 - 32709914
AN - SCOPUS:85088497850
SN - 2045-2322
VL - 10
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 12382
ER -