A temporal analysis of bilateral gait coordination in people with multiple sclerosis

Abstract

Background: Gait performance often dictates an individual's ability to navigate the dynamic environments of everyday living. With each stride, the lower extremities move through phases of stance, swing, and double support. Coordinating these motions with high accuracy and consistency is imperative to constraining the center of mass within the base of support, thereby maintaining balance. Gait abnormalities accompany neurodegeneration, impeding stride to stride cohesion and increasing the likelihood of a fall. This study sought to identify the temporal actions underlying bilateral coordination in people with multiple sclerosis (PwMS) and furthermore, how bilateral coordination is affected by gait speed augmentation in these individuals. Methods: The Phase Coordination Index (PCI), a temporal analysis of left-right step pattern generations throughout the gait cycle was used to quantify bilateral coordination in twenty-nine neurotypical (21 females and 8 males) and twenty-seven PwMS (20 females and 7 males). PCI was acquired with inertial monitoring units while performing two-minute over ground gait trials while walking at a self-selected pace and at a fast pace. Results: PwMS displayed significantly worse bilateral coordination compared to neurotypical adults regardless of gait speed. The poorer left-right stepping patterns generated by PwMS were derived from significant decreases in both phase (step) generation accuracy and consistency. In addition to demonstrating poorer bilateral coordination, PwMS walked more slowly than their neurotypical peers during each walking condition. Conclusion: PwMS exhibited poorer left-right coordinated stepping patterns during gait compared to neurotypical peers across walking conditions. Beyond the novelty of this examination, this assessment highlights PCI as a potential target for future rehabilitative interventions for PwMS and individualized rehabilitation strategies aimed at improving the health span and overall quality of life for PwMS.