TY - JOUR
T1 - Plantarflexor weakness negatively impacts walking in persons with multiple sclerosis more than plantarflexor spasticity
AU - Wagner, Joanne M.
AU - Kremer, Theodore R.
AU - Van Dillen, Linda R.
AU - Naismith, Robert T.
N1 - Funding Information:
Supported by the National Institutes of Health (NIH) (grant no. K12 HD055931 , grant no. K23NS052430-01A1 , grant no. CO6 RR020092 , grant no. RR024992 , and grant no. 2R01 HD047709 ) and the National Center for Research Resources (NCRR) (grant no. UL1 RR024992 ), a component of the NIH and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NCRR or the NIH.
PY - 2014/7
Y1 - 2014/7
N2 - Objectives To determine whether plantarflexor (PF) spasticity or ankle strength best predicts variance in walking capacity or self-perceived limitations in walking in persons with multiple sclerosis (MS) and whether persons with MS with PF spasticity are weaker and have greater walking dysfunction than do persons with MS without PF spasticity. Design Cross-sectional study. Setting University research laboratory. Participants Forty-two adults with MS (mean age, 42.9±10.1y; Expanded Disability Status Scale score, median=3.0, range=0-6) and 14 adults without disability (mean age, 41.9±10.1y). Intervention Not applicable. Main Outcome Measures PF spasticity and dorsiflexion and PF maximum voluntary isometric torque were assessed using the modified Ashworth Scale and a computerized dynamometer, respectively. The Timed 25-Foot Walk Test was the primary outcome measure of walking capacity. Secondary measures included the 6-Minute Walk Test and the 12-item Multiple Sclerosis Walking Scale. Results PF strength was the most consistent predictor of variance in walking capacity (Timed 25-Foot Walk Test: R2 change=.23-.29, P≤ 6-Minute Walk Test: R;bsupesup& change=.12-.29, P≤.012), and self-perceived limitations of walking (12-item Multiple Sclerosis Walking Scale: R2 change=.04-.14, P<.18). There were no significant differences (P>.05) between persons with MS with PF spasticity and persons with MS without PF spasticity for any of the outcome measures. Conclusions Our study suggests a unique contribution of PF weakness to walking dysfunction in persons with MS, and highlights the importance of evaluating PF strength in this clinical population.
AB - Objectives To determine whether plantarflexor (PF) spasticity or ankle strength best predicts variance in walking capacity or self-perceived limitations in walking in persons with multiple sclerosis (MS) and whether persons with MS with PF spasticity are weaker and have greater walking dysfunction than do persons with MS without PF spasticity. Design Cross-sectional study. Setting University research laboratory. Participants Forty-two adults with MS (mean age, 42.9±10.1y; Expanded Disability Status Scale score, median=3.0, range=0-6) and 14 adults without disability (mean age, 41.9±10.1y). Intervention Not applicable. Main Outcome Measures PF spasticity and dorsiflexion and PF maximum voluntary isometric torque were assessed using the modified Ashworth Scale and a computerized dynamometer, respectively. The Timed 25-Foot Walk Test was the primary outcome measure of walking capacity. Secondary measures included the 6-Minute Walk Test and the 12-item Multiple Sclerosis Walking Scale. Results PF strength was the most consistent predictor of variance in walking capacity (Timed 25-Foot Walk Test: R2 change=.23-.29, P≤ 6-Minute Walk Test: R;bsupesup& change=.12-.29, P≤.012), and self-perceived limitations of walking (12-item Multiple Sclerosis Walking Scale: R2 change=.04-.14, P<.18). There were no significant differences (P>.05) between persons with MS with PF spasticity and persons with MS without PF spasticity for any of the outcome measures. Conclusions Our study suggests a unique contribution of PF weakness to walking dysfunction in persons with MS, and highlights the importance of evaluating PF strength in this clinical population.
KW - Ankle
KW - Multiple sclerosis
KW - Muscle spasticity
KW - Muscle strength dynamometer
KW - Rehabilitation
KW - Walking
UR - http://www.scopus.com/inward/record.url?scp=84903271768&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2014.01.030
DO - 10.1016/j.apmr.2014.01.030
M3 - Article
C2 - 24582617
AN - SCOPUS:84903271768
SN - 0003-9993
VL - 95
SP - 1358
EP - 1365
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 7
ER -