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Handbook of Human Motion pp 1–13Cite as

Gait and Multiple Sclerosis

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Abstract

Gait analysis technology has led to an increased understanding of the changes in mobility that contribute to increasing disability in people with multiple sclerosis (MS). At all levels of the disease spectrum, changes in joint angles, moments, and muscle activation have been identified, which has lead to the investigation of key impairments that limit functional mobility in people with MS. Comprehensive three-dimensional gait analysis has characterized gait changes that worsen with increasing disability and deteriorate with walking-induced fatigue. This important ability to measure movement performance is resulting in a greater appreciation of the link between movement impairment during gait and its impact on daily functions. This knowledge will hopefully increase our ability to target specific aspects of gait with individualized physical therapy strategies.

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References

  • Amato MP et al (2001) Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Mult Scler 7:340–344

    Article  Google Scholar 

  • Bakshi R (2003) Fatigue associated with multiple sclerosis: diagnosis, impact and management. Mult Scler 9:219–227

    Article  MathSciNet  Google Scholar 

  • Barr C et al (2014) Walking for six minutes increases both simple reaction time and stepping reaction time in moderately disabled people with Multiple Sclerosis. Mult Scler Relat Disord 3(4):457–462

    Google Scholar 

  • Barr CJ et al (2016) Orthotic and therapeutic effect of functional electrical stimulation on fatigue induced gait patterns in people with multiple sclerosis. Disabil Rehabil 0(0):1–13

    Google Scholar 

  • Benedetti MG et al (1999) Gait abnormalities in minimally impaired multiple sclerosis patients. Mult Scler 5:363–368

    Article  Google Scholar 

  • Burschka JM et al (2012) An exploration of impaired walking dynamics and fatigue in multiple sclerosis. BMC Neurol 12:161

    Article  Google Scholar 

  • Cameron MH et al (2008) Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction. Somatosens Mot Res 25:113–122

    Article  Google Scholar 

  • Cattaneo D, Jonsdottir J (2009) Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult Scler 15:59–67

    Article  Google Scholar 

  • Cattaneo D et al (2002) Do static or dynamic AFOs improve balance? Clin Rehabil 16:894–899

    Article  Google Scholar 

  • Citaker S et al (2011) Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture 34:275–278

    Article  Google Scholar 

  • Crenshaw SJ et al (2006) Gait variability in people with multiple sclerosis. Mult Scler 12:613–619

    Article  Google Scholar 

  • Dalgas U et al (2014) Aerobic intensity and pacing pattern during the six-minute walk test in patients with multiple sclerosis. J Rehabil Med 46:59–66

    Article  Google Scholar 

  • Davies BL et al (2015) Neurorehabilitation strategies focusing on ankle control improve mobility and posture in persons with multiple sclerosis. J Neurol Phys Ther 39(4):225–232

    Article  Google Scholar 

  • Dixon J et al (2014) Effect of textured insoles on balance and gait in people with multiple sclerosis: an exploratory trial. Physiotherapy 100(2):142–149

    Article  Google Scholar 

  • Dobkin BH (2008) Fatigue versus activity-dependent fatigability in patients with central or peripheral motor impairments. Neurorehabil Neural Repair 22:105–110

    Article  Google Scholar 

  • Everaert DG et al (2010) Does functional electrical stimulation for foot drop strengthen corticospinal connections? Neurorehabil Neural Repair 24:168–177

    Article  Google Scholar 

  • Feys P et al (2013) Spatio-temporal gait parameters change differently according to speed instructions and walking history in MS patients with different ambulatory dysfunction. Mult Scler Relat Disord 2(3):238–246. doi: 10.1016/j.msard.2013.01.004

    Google Scholar 

  • Fisk JD et al (1994) Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clinical Infect Dis 18(Suppl 1):S79–S83

    Article  MathSciNet  Google Scholar 

  • For Clinical Practice Guidelines, M.S.C. & Others (1998) Fatigue and multiple sclerosis: evidence-based management strategies for fatigue in multiple sclerosis: clinical practice guidelines. The Council. The Consortium of Multiple Sclerosis Centers, in conjunction with the Paralyzed Veterans of America (PVA). http://www.mscare.org/?page=practice_guidelines

  • Gijbels D, Eijnde B, Feys P (2011) Comparison of the 2- and 6-minute walk test in multiple sclerosis. Mult Scler 17:1269–1272

    Article  Google Scholar 

  • Givon U, Zeilig G, Achiron A (2009) Gait analysis in multiple sclerosis: characterization of temporal-spatial parameters using GAITRite functional ambulation system. Gait Posture 29:138–142

    Article  Google Scholar 

  • Goldman MD, Marrie RA, Cohen JA (2008) Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls. Mult Scler 14:383–390

    Article  Google Scholar 

  • Güner S et al (2015) Knee muscle strength in multiple sclerosis: relationship with gait characteristics. J Phys Ther Sci 27(3):809–813

    Article  Google Scholar 

  • Hadjimichael O, Vollmer T, Oleen-Burkey M (2008) Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes 6:100

    Article  Google Scholar 

  • Heesen C et al (2008) Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Mult Scler 14:988–991

    Article  Google Scholar 

  • Hemmett L et al (2004) What drives quality of life in multiple sclerosis? QJM 97:671–676

    Article  Google Scholar 

  • Huisinga JM et al (2011) Is there a relationship between fatigue questionnaires and gait mechanics in persons with multiple sclerosis? Arch Phys Med Rehabil 92:1594–1601

    Article  Google Scholar 

  • Huisinga JM et al (2012) Gait mechanics are different between healthy controls and patients with multiple. J Appl Biomech 2012 Human Kinetics, p 2

    Google Scholar 

  • Hutchinson B et al (2009) Toward a consensus on rehabilitation outcomes in MS: gait and fatigue. Int J MS Care 11:67–78

    Article  MathSciNet  Google Scholar 

  • Kalron A, Givon U (2016) Gait characteristics according to pyramidal, sensory and cerebellar EDSS subcategories in people with multiple sclerosis. J Neurol. Available at: http://dx.doi.org/10.1007/s00415-016-8200-6

  • Karpatkin H, Rzetelny A (2012) Effect of a single bout of intermittent versus continuous walking on perceptions of fatigue in people with multiple sclerosis. Int J Care 14:124–131

    Article  Google Scholar 

  • Kasser SL et al (2011) A prospective evaluation of balance, gait, and strength to predict falling in women with multiple sclerosis. Arch Phys Med Rehabil. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21840497

  • Kehoe M et al (2014) Predictors of the physical impact of multiple sclerosis following community-based, exercise trial. Multiple Scler 10:1352458514549395

    Google Scholar 

  • Kelleher KJ, Spence W et al (2010a) The characterisation of gait patterns of people with multiple sclerosis. Disabil Rehabil 32:1242–1250

    Article  Google Scholar 

  • Kelleher KJ, Spence WD et al (2010b) The effect of textured insoles on gait patterns of people with multiple sclerosis. Gait Posture 32:67–71

    Article  Google Scholar 

  • Kieseier BC, Pozzilli C (2012) Assessing walking disability in multiple sclerosis. Mult Scler J 18:914–924

    Article  Google Scholar 

  • Kuo AD, Donelan JM, Ruina A (2005) Energetic consequences of walking like an inverted pendulum: step-to-step transitions. Exerc Sport Sci Rev 33:88–97

    Article  Google Scholar 

  • Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452

    Article  Google Scholar 

  • Kutzelnigg A et al (2007) Widespread demyelination in the cerebellar cortex in multiple sclerosis. Brain Pathol 17:38–44

    Article  Google Scholar 

  • LaRocca NG (2011) Impact of walking impairment in multiple sclerosis. Patient 4:189–201

    Article  Google Scholar 

  • Lizama LEC et al (2016) The use of laboratory gait analysis for understanding gait deterioration in people with multiple sclerosis. Mult Scler J 22(14):1768–1776

    Google Scholar 

  • Lizrova Preiningerova J et al (2015) Spatial and temporal characteristics of gait as outcome measures in multiple sclerosis (EDSS 0 to 6.5). J Neuroeng Rehabil 12(1):1–7

    Article  Google Scholar 

  • Martin CL et al (2006) Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler 12:620–628

    Article  Google Scholar 

  • Matsuda PN et al (2011) Falls in multiple sclerosis. PM & R J Inj funct Rehabil 3:624–632, quiz 632

    Google Scholar 

  • McGibbon CA (2003) Toward a better understanding of gait changes with age and disablement: neuromuscular adaptation. Exerc Sport Sci Rev 31(2):102–108

    Article  Google Scholar 

  • McLoughlin JV et al (2014) Dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with multiple sclerosis. Archives of physical medicine and rehabilitation. Available at: http://www.sciencedirect.com/science/article/pii/S0003999314010703

  • McLoughlin JV et al (2014b) Six minutes of walking leads to reduced lower limb strength and increased postural sway in people with multiple sclerosis. NeuroRehabilitation 35(3):503–508

    Google Scholar 

  • McLoughlin J et al (2015) Association of postural sway with disability status and cerebellar dysfunction in people with multiple sclerosis: a preliminary study. Int J MS Care 17(3):146–151

    Article  Google Scholar 

  • McLoughlin JV et al (2016) Fatigue induced changes to kinematic and kinetic gait parameters following six minutes of walking in people with multiple sclerosis. Disabil Rehabil 38(6):535–543

    Article  Google Scholar 

  • Morgante F et al (2011) Is central fatigue in multiple sclerosis a disorder of movement preparation? J Neurol 258:263–272

    Article  Google Scholar 

  • Morris ME et al (2002) Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis. J Neurol Neurosurg Psychiatry 72:361–365

    Article  Google Scholar 

  • Motl RW et al (2010) Multiple sclerosis walking Scale-12 and oxygen cost of walking. Gait Posture 31:506–510

    Article  Google Scholar 

  • Motl RW, Sandroff BM et al (2012a) Energy cost of walking and its association with gait parameters, daily activity, and fatigue in persons with mild multiple sclerosis. Neurorehabil Neural Repair 26:1015–1021

    Article  Google Scholar 

  • Motl RW, Suh Y et al (2012b) Evidence for the different physiological significance of the 6-and 2-minute walk tests in multiple sclerosis. BMC Neurol 12:6

    Article  Google Scholar 

  • Ng AV et al (2004) Functional relationships of central and peripheral muscle alterations in multiple sclerosis. Muscle Nerve 29:843–852

    Article  Google Scholar 

  • Pau M et al (2015) Effect of spasticity on kinematics of gait and muscular activation in people with multiple sclerosis. J Neurol Sci 358(1–2):339–344

    Article  Google Scholar 

  • Paul L et al (2008) The effect of functional electrical stimulation on the physiological cost of gait in people with multiple sclerosis. Mult Scler 14:954–961

    Article  Google Scholar 

  • Phan-Ba R et al (2012) Motor fatigue measurement by distance-induced slow down of walking speed in multiple sclerosis. PloS One 7:e34744

    Article  Google Scholar 

  • Pike J et al (2012) Social and economic burden of walking and mobility problems in multiple sclerosis. BMC Neurol 12:94

    Article  Google Scholar 

  • Pilutti LA et al (2012) Further validation of multiple sclerosis walking scale-12 scores based on spatiotemporal gait parameters. Arch Phys Med Rehabil

    Google Scholar 

  • Prosperini L et al (2011) The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. J Neurol Sci 304:55–60

    Article  Google Scholar 

  • Prosperini L, Petsas N et al (2013a) Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis. Mult Scler J 20(1):81–90. doi: 10.1177/1352458513490546

    Google Scholar 

  • Prosperini L, Sbardella E et al (2013a) Multiple sclerosis: white and gray matter damage associated with balance deficit detected at static posturography. Radiology 268:181–189

    Article  Google Scholar 

  • Ramdharry GM et al (2006) De-stabilizing and training effects of foot orthoses in multiple sclerosis. Mult Scler 12:219–226

    Article  Google Scholar 

  • Ramstrand N, Ramstrand S (2010) AAOP state-of-the-science evidence report: the effect of ankle-foot orthoses on balance—a systematic review. J Prosthet Orthot 22:P4–P23

    Article  Google Scholar 

  • Remelius JG et al (2012) Gait impairments in persons with multiple sclerosis across preferred and fixed walking speeds. Arch Phys Med Rehabil 93(9):1637–1642. doi: 10.1016/j.apmr.2012.02.019

    Google Scholar 

  • Rougier P et al (2007) What compensatory motor strategies do patients with multiple sclerosis develop for balance control? Rev Neurol 163:1054–1064

    Article  Google Scholar 

  • Sandroff BM et al (2014) Comparing two conditions of administering the six-minute walk test in people with multiple sclerosis. Int J MS Care 16:48–54

    Article  Google Scholar 

  • Sandroff BM, Pilutti LA, Motl RW (2015) Does the six-minute walk test measure walking performance or physical fitness in persons with multiple sclerosis? NeuroRehabilitation 37(1):149–155

    Article  Google Scholar 

  • Savci S et al (2005) Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis. Disabil Rehabil 27:1365–1371

    Article  Google Scholar 

  • Schubert M et al (1998) Walking and fatigue in multiple sclerosis: the role of the corticospinal system. Muscle Nerve 21:1068–1070

    Article  Google Scholar 

  • Scott SM et al (2013) Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation. J Rehabil Med 45:364–369

    Article  Google Scholar 

  • Sehle A et al (2014) Objective assessment of motor fatigue in multiple sclerosis: the Fatigue index Kliniken Schmieder (FKS). J Neurol 261(9):1752–1762

    Article  Google Scholar 

  • Sheffler LR et al (2008) Functional effect of an ankle foot orthosis on gait in multiple sclerosis: a pilot study. Am J Phys Med Rehabil 87:26

    Article  Google Scholar 

  • Sheffler LR et al (2009) Neuroprosthetic effect of peroneal nerve stimulation in multiple sclerosis: a preliminary study. Arch Phys Med Rehabil 90:362–365

    Article  Google Scholar 

  • Smith MM, Arnett PA (2005) Factors related to employment status changes in individuals with multiple sclerosis. Mult Scler 11:602–609

    Article  Google Scholar 

  • Sosnoff JJ, Shin S, Motl RW (2010) Multiple sclerosis and postural control: the role of spasticity. Arch Phys Med Rehabil 91:93–99

    Article  Google Scholar 

  • Sosnoff JJ et al (2011a) Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther 35:129–132

    Article  Google Scholar 

  • Sosnoff JJ et al (2011b) Mobility, balance and falls in persons with multiple sclerosis. PloS One 6:e28021

    Article  Google Scholar 

  • Sosnoff JJ, Sandroff BM, Motl RW (2012) Quantifying gait abnormalities in persons with multiple sclerosis with minimal disability. Gait Posture 36(1):154–156. doi: 10.1016/j.gaitpost.2011.11.027

    Google Scholar 

  • Taylor PN et al (1999) Clinical use of the Odstock dropped foot stimulator: its effect on the speed and effort of walking. Arch Phys Med Rehabil 80:1577–1583

    Article  Google Scholar 

  • Thickbroom GW et al (2006) Central motor drive and perception of effort during fatigue in multiple sclerosis. J Neurol 253:1048–1053

    Article  Google Scholar 

  • Thickbroom GW et al (2008) Enhanced corticomotor excitability with dynamic fatiguing exercise of the lower limb in multiple sclerosis. J Neurol 255:1001–1005

    Article  Google Scholar 

  • Thoumie P, Mevellec E (2002) Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. J Neurol Neurosurg Psychiatry 73:313–315

    Article  Google Scholar 

  • Thoumie P et al (2005) Motor determinants of gait in 100 ambulatory patients with multiple sclerosis. Mult Scler 11:485–491

    Article  Google Scholar 

  • Trisolini M et al (2010) Global economic impact of multiple sclerosis. Multiple Sclerosis International Federation London, United Kingdom [Online]

    Google Scholar 

  • van der Linden ML et al (2014) Habitual functional electrical stimulation therapy improves gait kinematics and walking performance, but not patient-reported functional outcomes, of people with multiple sclerosis who present with foot-drop. PloS One 9:e103368

    Article  Google Scholar 

  • Wagner JM et al (2014) Plantarflexor weakness negatively impacts walking in persons with multiple sclerosis more than plantarflexor spasticity. Arch Phys Med Rehabil 95(7):1358–1365. doi: 10.1016/j.apmr.2014.01.030

    Google Scholar 

  • Yahia A et al (2011) Relationship between muscular strength, gait and postural parameters in multiple sclerosis. Ann Phys Rehabil Med 54:144–155

    Article  Google Scholar 

  • Zackowski KM et al (2009) Sensorimotor dysfunction in multiple sclerosis and column-specific magnetization transfer-imaging abnormalities in the spinal cord. Brain J Neurol 132:1200–1209

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Flinders University, Adelaide, Australia

    James McLoughlin

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  1. James McLoughlin
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Correspondence to James McLoughlin .

Editor information

Editors and Affiliations

  1. Motion & More, Barcelona, Spain

    Bertram Müller

  2. Klinik für Orthopädie und Unfallchirurgi, Universitätsklinikum Heidelberg, Heidelberg, Germany

    Sebastian I. Wolf

  3. Institut for Biomechanics und Orthopedic, German Sport University Cologne, Cologne, Germany

    Gert-Peter Brueggemann

  4. Houston, Texas, USA

    Zhigang Deng

  5. ACRISP, FedUniversity, Cremorne, New South Wales, Australia

    Andrew McIntosh

  6. Wilmington, Delaware, USA

    Freeman Miller

  7. Research, C-Motion, Inc., Germantown, Maryland, USA

    William Scott Selbie

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McLoughlin, J. (2016). Gait and Multiple Sclerosis. In: Müller, B., et al. Handbook of Human Motion. Springer, Cham. https://doi.org/10.1007/978-3-319-30808-1_65-1

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  • DOI: https://doi.org/10.1007/978-3-319-30808-1_65-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-30808-1

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