Impaired speed-dependent modulation of the gait pattern in multiple sclerosis
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ORIGINAL COMMUNICATION
Impaired speed‑dependent modulation of the gait pattern in multiple sclerosis David Weller1 · Linard Filli2 · Christian Meyer2 · Lilla Lörincz1 · Michael Linnebank3 · Michael Weller1 · Armin Curt2 · Björn Zörner2 Received: 7 May 2020 / Revised: 28 May 2020 / Accepted: 30 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Walking dysfunction is common in people with multiple sclerosis (MS). Besides walking speed or endurance, one crucial feature of ambulatory function is the ability to adjust the gait pattern according to walking speed which relies on the integrity of spinal motor centres, their reciprocal connections to supraspinal networks and peripheral sensory input. Objective To investigate the capacity of people with MS to modify their gait pattern in response to changes in walking speed. Methods 3D gait analysis during free treadmill walking was performed in 35 people with MS and 20 healthy controls. Twelve kinematic parameters ranging from basic spatiotemporal measures to complex indicators of intralimb coordination were assessed at different absolute and relative walking speeds. Results Cadence, double-limb support time, trunk movements and especially measures of intralimb coordination demonstrated significantly less speed-dependent modifications in MS than in controls. These limitations were more prominent in subjects with stronger MS-related impairment (worse outcome in clinical walking tests, higher Expanded Disability Status Scale). Conclusion The incapacity to modify specific elements of the walking pattern according to walking speed contributes to gait dysfunction in people with MS limiting activities of daily living. Gait modulation may serve as sensitive marker of walking function in MS. Trial registration Clinicaltrials.gov, NCT01576354; first posted April 12, 2012. Keywords Multiple sclerosis · Walking · Gait · Velocity · Coordination
Introduction
David Weller and Linard Filli contributed equally to the study.
Bipedal walking is a distinctive feature of human beings and crucial for many activities of everyday life. Different functional aspects of gait can be distinguished such as
* Björn Zörner [email protected]
Michael Weller [email protected]
David Weller [email protected]
Armin Curt [email protected]
Linard Filli [email protected]
1
Christian Meyer [email protected]
Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland
2
Lilla Lörincz [email protected]
Spinal Cord Injury Center, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland
3
Department of Neurology, University Witten/Herdecke and Evangelische Kliniken Gelsenkirchen, Munckelstraße 32, 45879 Gelsenkirchen, Germany
Michael Linnebank linnebank@evk‑ge.de
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walking speed, endurance, balance, the control of direction or the ability to avoid obstacles. Also, adjusting the gait pattern acc
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