Kinematic Gait Analysis in People with Mild-Disability Multiple Sclerosis Using Statistical Parametric Mapping: A Cross-Sectional Study.

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. Gait abnormalities, such as altered joint kinematics, are common in people with MS (pwMS). Traditional clinical gait assessments may not detect subtle kinematic alterations, but advances in motion capture technology and analysis methods, such as statistical parametric mapping (SPM), offer more detailed assessments. The aim of this study was to compare the lower-limb joint kinematics during gait between pwMS and healthy controls using SPM analysis. Methods: A cross-sectional study was conducted involving pwMS and healthy controls. A three-dimensional motion capture system was used to obtain the kinematic parameters of the more affected lower limb (MALL) and less affected lower limb (LALL), which were compared using the SPM analysis. Results: The study included 10 pwMS with mild disability (EDSS ≤ 3) and 10 healthy controls. The results showed no differences in spatiotemporal parameters. However, significant differences were observed in the kinematics of the lower-limb joints using SPM. In pwMS, compared to healthy controls, there was a higher anterior pelvis tilt (MALL, p = 0.047), reduced pelvis elevation (MALL, p = 0.024; LALL, p = 0.044), reduced pelvis descent (MALL, p = 0.033; LALL, p = 0.022), reduced hip extension during pre-swing (MALL, p = 0.049), increased hip flexion during terminal swing (MALL, p = 0.046), reduced knee flexion (MALL, p = 0.04; LALL, p < 0.001), and reduced range of motion in ankle plantarflexion (MALL, p = 0.048). Conclusions: pwMS with mild disability exhibit specific kinematic abnormalities during gait. SPM analysis can detect alterations in the kinematic parameters of gait in pwMS with mild disability.

Muscle Coactivation Index during Walking in People with Multiple Sclerosis with Mild Disability, a Cross-Sectional Study.

BACKGROUND: Multiple sclerosis (MS) is a progressive neurodegenerative disease characterized by axonal degeneration and demyelination. Changes in gait, related to joint kinematics and kinetics, especially at the ankle and knee, have been observed in people with MS (pwMS). Muscle coactivation plays an important role in joint stabilization; however, excessive coactivation may interfere with gait. The aim of this study was to analyze the differences in muscle activation during gait in pwMS compared to healthy individuals. METHODS: A cross-sectional study was conducted involving pwMS and healthy controls. Surface electromyography was used to record muscle activity during gait. The main outcome measures were the coactivation index (CI) and the area under the curve (AUC), which were calculated for several pairs of lower extremity muscles. RESULTS: Nine pwMS and nine healthy controls were included. When comparing the MS group to the control group, the AUC was significantly higher in the lateral gastrocnemius (p = 0.023) and the CI for the lateral gastrocnemius-anterior tibialis (p = 0.022) and gluteus maximus-lateral gastrocnemius (p = 0.047). CONCLUSION: Mildly affected pwMS have altered muscle coactivation patterns during gait, especially in the most affected limb. The results highlight the importance of muscle coactivation in pwMS and its possible role in the early detection of gait abnormalities.