Spatio-temporal gait parameters change differently according to speed instructions and walking history in MS patients with different ambulatory dysfunction

Mult Scler Relat Disord. 2013 Jul;2(3):238-46. doi: 10.1016/j.msard.2013.01.004. Epub 2013 Feb 22.

Abstract

Background: Different walking capacity test formats are applied, but their impact on the gait pattern in persons with MS (pwMS) has not yet been investigated according to baseline velocity performance.

Objective: To assess, in pwMS with different ambulation dysfunction, the impact of speed instructions and previous walking tests (2 and 6min walking test; 2MWT and 6MWT) on spatiotemporal gait parameters.

Methods: 27 participants, divided in three groups based on usual gait speed (Most Limited Community Walkers; MLCW<0.82m/s, CW>1.14m/s, LCW show intermediate values), completed the 2MWT and 6MWT. Before and after each test, they walked on the GAITRite walkway system at both usual and fastest speed. Spatio-temporal gait parameters were measured and analyzed with ANOVA.

Results: All gait parameters in the MLCW were significantly different from other groups. In contrast to the MLCW, the LCW and CW subgroups showed greater velocity in the fastest compared to usual speed condition, associated with a significant increase in cadence and step length. After the 6MWT, small changes in cadence at usual speed and step time at fastest speed were observed in the MLCW subgroup only. No impact of the 2MWT on gait parameters was found in any group.

Conclusions: The ability to accelerate was dependent on the severity of ambulatory dysfunction. Prolonged walking during the 6MWT has, in contrast to the 2MWT, some impact on gait parameters in the most disabled group only.

Keywords: 2MWT; 6MWT; Gait pattern; Motor fatigue; Multiple sclerosis; Usual and fastest speed.