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Impaired speed-dependent modulation of the gait pattern in multiple sclerosis

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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.

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Acknowledgements

We thank the individuals who participated in this study. The authors are grateful to Tabea Sutter, Sandra Kapitza and Katja Reuter for their assistance with subject recruitment and assessments. This study was supported by grants from the Betty and David Koetser Foundation, the Clinical Research Priority Program (CRPP) “NeuroRehab” of the University of Zurich, the Swiss MS Society, and Biogen.

Funding

This study was supported by grants from the Betty and David Koetser Foundation, the Clinical Research Priority Program (CRPP) “NeuroRehab” of the University of Zurich, the Swiss MS Society, and Biogen.

Author information

Author notes

  1. David Weller and Linard Filli contributed equally to the study.

Authors and Affiliations

  1. Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland

    David Weller, Lilla Lörincz & Michael Weller

  2. Spinal Cord Injury Center, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland

    Linard Filli, Christian Meyer, Armin Curt & Björn Zörner

  3. Department of Neurology, University Witten/Herdecke and Evangelische Kliniken Gelsenkirchen, Munckelstraße 32, 45879, Gelsenkirchen, Germany

    Michael Linnebank

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  1. David Weller
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Contributions

DW, LF and BZ planed and designed the study, collected and analysed data, performed statistics, interpreted the data, produced figures, and prepared the manuscript. CM and LL collected and analysed data and CM produced figures. ML, MW, AC and BZ conceived and supervised the study and critically revised the manuscript.

Corresponding author

Correspondence to Björn Zörner.

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Conflicts of interest

CM received a travel grant from Biogen. ML received grants, honoraria or funding from Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Roche and Teva. MW received research grants from Abbvie, Adastra, Bristol Meyer Squibb (BMS), Dracen, Merck, Sharp & Dohme (MSD), Merck (EMD), Novocure, Piqur and Roche, and honoraria for lectures or advisory board participation or consulting from Abbvie, Basilea, Bristol Meyer Squibb (BMS), Celgene, Merck, Sharp and Dohme (MSD), Merck (EMD), Novocure, Orbus, Roche and Tocagen. BZ received honoraria, travel grants, and funding from Biogen and Roche. The other authors declare that there is no conflict of interest.

Ethics approval

The studies were approved by the Zurich cantonal ethics committee (KEK-2011-0445, KEK-2014-0004) in Switzerland.

Consent to participate

All participants gave written, informed consent.

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All authors read and approved the final manuscript and gave consent for publication.

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Weller, D., Filli, L., Meyer, C. et al. Impaired speed-dependent modulation of the gait pattern in multiple sclerosis. J Neurol 267, 2998–3007 (2020). https://doi.org/10.1007/s00415-020-09965-3

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  • DOI: https://doi.org/10.1007/s00415-020-09965-3

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