Abstract
Subtle gait and balance dysfunction is a precursor to loss of mobility in multiple sclerosis (MS). Biomechanical assessments using advanced gait and balance analysis technologies can identify these subtle changes and could be used to predict mobility loss early in the disease. This update critically evaluates advanced gait and balance analysis technologies and their applicability to identifying early lower limb dysfunction in people with MS. Non-wearable (motion capture systems, force platforms, and sensor-embedded walkways) and wearable (pressure and inertial sensors) biomechanical analysis systems have been developed to provide quantitative gait and balance assessments. Non-wearable systems are highly accurate, reliable and provide detailed outcomes, but require cumbersome and expensive equipment. Wearable systems provide less detail but can be used in community settings and can provide real-time feedback to patients and clinicians. Biomechanical analysis using advanced gait and balance analysis technologies can identify changes in gait and balance in early MS and consequently have the potential to significantly improve monitoring of mobility changes in MS.
Highlights
Mobility loss in people with multiple sclerosis is a major contributor to decreased quality of life, disruption to employment, and increased financial burden [1, 2]
Subtle gait and balance changes are apparent in people with multiple sclerosis (pwMS) even at the earliest disease stages and can be measured using advanced movement analysis techniques [3,4,5]
We review both non-wearable and wearable gait analysis systems and discuss the variables measured by these systems as well as advantages, disadvantages, sensitivity, and accuracy
Summary
Mobility loss in people with multiple sclerosis (pwMS) is a major contributor to decreased quality of life, disruption to employment, and increased financial burden [1, 2]. Clinical assessment of gait in pwMS often involves visual evaluation and walking performance, tests of maximum distance walked, or timed walks [7]. Both visual and performance tests are relatively reliable over time [8, 9]; reliability varies with the degree of disability [8,9,10], and the tests are insensitive to subtle changes early in the disease [3,4,5, 7, 11]
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