P37-S Quantification of walking patterns and muscle coactivations in multiple sclerosis with kinetic and electromyographic analyses

Abstract

Multiple sclerosis(MS) is characterized by gait impairments and severely impacts the quality of life. Technological advances in biomechanics offer objective assessments of gait disabilities. Here we employed wearable sensors to measure electromyography(EMG) and body acceleration during walking and to quantify the altered gait pattern between patients with MS and healthy controls. Forty patients with MS (PwMS, mean EDSS: 5.51 ± 1) and 15 healthy controls were enrolled. Ten-meter-walking-test (10MWT) was performed with accelerators attached on the waist and electrodes (BTS bioengineering, Italy) attached on bilateral thighs (Rectus and Biceps Femoris, RF-BF) and legs (Tibialis anterior and gastrocnemius, TA-GM) for measuring body acceleration and EMG recording. The tests were performed with shoes and socks. Time, Cadence (pace/min), step length and Coactivation index (CoI) between antagonistic pairs were calculated for more and less affected side (MA/LA) for statistics. PwMS showed longer time, lower cadence, and shorter step length in both conditions than controls. Increased coactivation than controls was found in RF-BF on both sides, while only in MA of TA-GM. PwMS walked better (shorter time, higher cadence, longer step length) when wearing shoes. Higher CoI of RF-BF on MA side positively correlated with 10MWT time (r = 0.5), EDSS (r = 0.4), and negatively correlated with cadence (r = −0.6). The results quantified the altered walking pattern in PwMS, the situation worsen when walking in barefoot. Further, increased coactivation was found in both the proximal (RF-BF) and distal (TA-GM) levels and correlated with higher EDSS and worse spatial-temporal parameters. This objective assessment of gait can benefit in evaluating the efficiency of rehabilitation.