The Effects of Haptic Input on Walking Balance in Individuals With Multiple Sclerosis and Controls

Abstract

Research Objectives To examine sensorimotor control of walking with various haptic input modalities in people with multiple sclerosis (pwMS). Design Cross-sectional observational study. Setting Research gait laboratory. Participants Ethics approval and informed consent were obtained prior to data collection. Participants included 30 pwMS and 29 controls matched for age (±3 years) and sex. All participants were ≥ 18 years of age, and able to walk 10 m without support. Participants with conditions or injuries other than MS that could impair walking were excluded. Interventions Not applicable. Main Outcome Measures Walking without haptic input (no-touch: NT) was compared to three walking conditions with haptic input: haptic anchors (small weights on strings: HA), using a four-wheeled walker (4WW) with light touch (4WW-LT) and using a 4WW by placing weight through the handles (4WW-W). Inertial sensors (Mobility Lab, APDM) measured stride length1, gait speed2, percentage double support/stride (%DS)3, mediolateral trunk range of motion (ML-tROM)4, and lateral step variability (LSV)5. Repeated measures ANOVA examined within-and between-group differences. Results Group effects showed PwMS spent significantly greater time in %DS and had more LSV compared to controls. All participants spent less time in %DS in the 4WW-W condition compared to the other forms of haptic input. Both 4WW conditions and the haptic anchors reduced ML-tROM compared to NT. LSV was reduced with 4WW-LT and 4WW-W compared to HA and NT conditions. All participants walked significantly faster using 4WW-LT compared to all conditions. Conclusions PwMS walked with more caution and less consistent foot placement than controls. Adding only haptic input (anchors and 4WW-LT conditions) reduced ML-tROM similar to the 4WW-W condition (haptic input + mechanical support). 4WW-LT and 4WW-W demonstrated the added benefit of reducing LSV suggesting sensory information from a 4WW may improve walking balance control in pwMS; however, the reduced LSV may be due to the presence of the 4WW frame. PwMS could be encouraged to use a 4WW in different ways to support walking balance. Author(s) Disclosures Authors declare no conflict of interest. To examine sensorimotor control of walking with various haptic input modalities in people with multiple sclerosis (pwMS). Cross-sectional observational study. Research gait laboratory. Ethics approval and informed consent were obtained prior to data collection. Participants included 30 pwMS and 29 controls matched for age (±3 years) and sex. All participants were ≥ 18 years of age, and able to walk 10 m without support. Participants with conditions or injuries other than MS that could impair walking were excluded. Not applicable. Walking without haptic input (no-touch: NT) was compared to three walking conditions with haptic input: haptic anchors (small weights on strings: HA), using a four-wheeled walker (4WW) with light touch (4WW-LT) and using a 4WW by placing weight through the handles (4WW-W). Inertial sensors (Mobility Lab, APDM) measured stride length1, gait speed2, percentage double support/stride (%DS)3, mediolateral trunk range of motion (ML-tROM)4, and lateral step variability (LSV)5. Repeated measures ANOVA examined within-and between-group differences. Group effects showed PwMS spent significantly greater time in %DS and had more LSV compared to controls. All participants spent less time in %DS in the 4WW-W condition compared to the other forms of haptic input. Both 4WW conditions and the haptic anchors reduced ML-tROM compared to NT. LSV was reduced with 4WW-LT and 4WW-W compared to HA and NT conditions. All participants walked significantly faster using 4WW-LT compared to all conditions. PwMS walked with more caution and less consistent foot placement than controls. Adding only haptic input (anchors and 4WW-LT conditions) reduced ML-tROM similar to the 4WW-W condition (haptic input + mechanical support). 4WW-LT and 4WW-W demonstrated the added benefit of reducing LSV suggesting sensory information from a 4WW may improve walking balance control in pwMS; however, the reduced LSV may be due to the presence of the 4WW frame. PwMS could be encouraged to use a 4WW in different ways to support walking balance.