Background: This research aims to compare lower limb inter-segmental coordination, a higher order property of the human movement system, during walking between healthy controls and people with multiple sclerosis (PwMS) with and without fall history.
Methods: Fifty PwMS (25 patients with fall history and 25 patients without fall history) and 25 healthy controls participated in the present study. Three-dimensional coordinate data of the lower limbs were collected during treadmill walking at a preferred walking speed. The phasing relationship and its variability between lower limb segments were evaluated using the mean absolute relative phase (MARP) and deviation phase (DP) during the stance and swing phases of gait.
Results: Compared to healthy controls, both groups of PwMS demonstrated significantly greater shank-thigh MARP values during the stance phase (p < 0.001). In addition, MARP values of foot-shank coordination were significantly smaller in both groups of PwMS than the healthy controls during both the stance and swing phases (p < 0.001). For the DP of shank-thigh coordination, our analysis revealed greater values in both MS fallers and non-fallers compared to healthy controls during the stance (p < 0.001) and swing phases (p < 0.001, p = 0.004, respectively). Moreover, MS fallers demonstrated greater DP values than non-fallers in swing phase (p = 0.02). For the DP of foot-shank coordination, MS fallers showed greater values compared to non-fallers and healthy controls during the stance (p = 0.009, p = 0.001, respectively) and swing phases (p = 0.01, p = 0.006, respectively).
Conclusion: Our results suggest that in addition to traditional gait parameters, examining and also facilitating lower limb inter-segmental coordination should be considered in future studies aimed at improving gait performance and reducing risk of falling in PwMS.
Keywords: Fall; Gait; Inter-segmental coordination; Multiple sclerosis; Variability.
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