Longitudinal relationships between disability and gait characteristics in people with MS

David Magalashvili,Sapir Dreyer-Alster,Shay Menascu,Anat Achiron,Mark Dolev,Alon Kalron,Uri Givon

doi:10.1038/s41598-022-07734-y

David Magalashvili, Sapir Dreyer-Alster + Show 5 more

Open Access

https://doi.org/10.1038/s41598-022-07734-y

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Journal: Scientific Reports	Publication Date: Mar 7, 2022
Citations: 3	License type: open-access

Affiliation: Sheba Medical Center, Tel Aviv University

Abstract

Longitudinal data are vital in order to understand intra individual gait changes with the progression of multiple sclerosis (MS). Therefore, the primary aim of this study was to explore the relationship between changes in disability with changes in major spatio-temporal parameters of gait in people with MS (PwMS). PwMS (n = 83) completed two gait assessments performed at separate time points (M1, M2). For each individual, the absolute difference between the Expanded Disability Status Scale (EDSS) score, key spatio-temporal parameters of gait, Falls Efficacy Scale International (FES-I), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12), were calculated. The mean time difference between M1 and M2 was 2.5 (SD = 1.7) years. At M2, PwMS presented with shorter strides, a wider base of support, increased perceived mobility difficulties and fear of falling compared with M1. According to the odds ratio (OR) analysis, the odds of experiencing an increase in the EDSS score was significantly higher once the MSWS-12 score increased at M2 compared with M1 (OR = 7.930, p = 0.004). This observation was highlighted specifically in people with mild-moderate MS (OR = 12.427, p < 0.001). The increase in the EDSS score was not associated with changes in key spatio-temporal parameters of gait. The present study provides a better understanding of gait and disease progression in PwMS, highlighting the significant role of the MSWS-12.

Highlights

Longitudinal data are vital in order to understand intra individual gait changes with the progression of multiple sclerosis (MS)
A computerized questionnaire helped in choosing people with MS (PwMS) according to the following inclusion criteria: (i) participants were > 18 years old; (ii) no restrictions for MS subtypes; (iii) a neurologist (Neurostatus certified) confirmed diagnosis of definite MS according to the revised McDonald c riteria[17]; (iv) disease severity was measured by the Expanded Disability Status Scale (EDSS); ≤ 6.5 equivalent to walking ~ 20 m with bilateral support[9]; (v) completion of two computerized gait assessments performed at separate time points (M1, M2) between 1/2012 and 8/2021; and (vi) the computerized gait assessments and a full neurological examination occurred within a 6 month period
All PwMS included in the sample have been treated with a disease modifying drug for a minimum period of 6 months

Summary

Introduction

Longitudinal data are vital in order to understand intra individual gait changes with the progression of multiple sclerosis (MS). The absolute difference between the Expanded Disability Status Scale (EDSS) score, key spatio-temporal parameters of gait, Falls Efficacy Scale International (FES-I), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12), were calculated. Compared with healthy adults, PwMS usually walk at a slower speed, reduced cadence, shorter strides, a prolonged double support phase, increased step time variability and a wider base of support[6]. Numerous studies have confirmed a positive linear relationship between gait parameters and disability in PwMS6,12–15 mainly determining that increased disability is associated with a slower walking speed, reduced cadence, shorter stride length, longer stride time, prolonged double support phase and increased step time variability. There is a consensus amongst the MS scientific community that in order to understand intra individual gait changes with progression of disability, additional longitudinal data are vital

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