Gait and balance impairment in early multiple sclerosis in the absence of clinical disability

This study evaluated the gait and balance performance of two clinically distinct groups of recently diagnosed and minimally impaired multiple sclerosis (MS) patients (Expanded Disability Status Scale range 0- 2.5), compared to control subjects. Ten MS patients with mild pyramidal signs (Pyramidal Fu...

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Veröffentlicht in:Multiple sclerosis 2006-10, Vol.12 (5), p.620-628
Hauptverfasser: Martin, C L, Phillips, B A, Kilpatrick, T J, Butzkueven, H, Tubridy, N, McDonald, E, Galea, M P
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container_end_page 628
container_issue 5
container_start_page 620
container_title Multiple sclerosis
container_volume 12
creator Martin, C L
Phillips, B A
Kilpatrick, T J
Butzkueven, H
Tubridy, N
McDonald, E
Galea, M P
description This study evaluated the gait and balance performance of two clinically distinct groups of recently diagnosed and minimally impaired multiple sclerosis (MS) patients (Expanded Disability Status Scale range 0- 2.5), compared to control subjects. Ten MS patients with mild pyramidal signs (Pyramidal Functional Systems 1.0), 10 MS patients with no pyramidal signs (Pyramidal Functional Systems 0) and 20 age- and gender-matched control subjects were assessed using laboratory-based gait analysis and clinical balance measures. Both MS groups demonstrated reduced speed and stride length (P < 0.001), and prolonged double limb support (P
doi_str_mv 10.1177/1352458506070658
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Ten MS patients with mild pyramidal signs (Pyramidal Functional Systems 1.0), 10 MS patients with no pyramidal signs (Pyramidal Functional Systems 0) and 20 age- and gender-matched control subjects were assessed using laboratory-based gait analysis and clinical balance measures. Both MS groups demonstrated reduced speed and stride length (P &lt; 0.001), and prolonged double limb support (P&lt;0.02), compared to the control group, along with alterations in the timing of ankle muscle activity, and the pattern of ankle motion during walking, which occurred independent of gait speed. The pyramidal MS group walked with reduced speed (P=0.03) and stride length (P=0.04), and prolonged double limb support (P=0.01), compared to the non-pyramidal group. Both MS groups demonstrated concomitant balance impairment, performing poorly on the Functional Reach Test compared to the control group (P&lt;0.05). The identification of incipient gait and balance impairment in MS patients with recent disease onset suggests that motor function may begin to deteriorate in the early stages of the disease, even in the absence of clinical signs of pyramidal dysfunction.</description><identifier>ISSN: 1352-4585</identifier><identifier>EISSN: 1477-0970</identifier><identifier>DOI: 10.1177/1352458506070658</identifier><identifier>PMID: 17086909</identifier><language>eng</language><publisher>Thousand Oaks, CA: SAGE Publications</publisher><subject>Adult ; Biological and medical sciences ; Biomechanical Phenomena ; Case-Control Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Disability Evaluation ; Electromyography - methods ; Female ; Gait - physiology ; Humans ; Immunomodulators ; Lower Extremity - physiopathology ; Male ; Medical sciences ; Middle Aged ; Multiple Sclerosis - complications ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Multivariate Analysis ; Muscle, Skeletal - physiopathology ; Neurology ; Pharmacology. 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Ten MS patients with mild pyramidal signs (Pyramidal Functional Systems 1.0), 10 MS patients with no pyramidal signs (Pyramidal Functional Systems 0) and 20 age- and gender-matched control subjects were assessed using laboratory-based gait analysis and clinical balance measures. Both MS groups demonstrated reduced speed and stride length (P &lt; 0.001), and prolonged double limb support (P&lt;0.02), compared to the control group, along with alterations in the timing of ankle muscle activity, and the pattern of ankle motion during walking, which occurred independent of gait speed. The pyramidal MS group walked with reduced speed (P=0.03) and stride length (P=0.04), and prolonged double limb support (P=0.01), compared to the non-pyramidal group. Both MS groups demonstrated concomitant balance impairment, performing poorly on the Functional Reach Test compared to the control group (P&lt;0.05). The identification of incipient gait and balance impairment in MS patients with recent disease onset suggests that motor function may begin to deteriorate in the early stages of the disease, even in the absence of clinical signs of pyramidal dysfunction.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Case-Control Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Disability Evaluation</subject><subject>Electromyography - methods</subject><subject>Female</subject><subject>Gait - physiology</subject><subject>Humans</subject><subject>Immunomodulators</subject><subject>Lower Extremity - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple Sclerosis - complications</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Multivariate Analysis</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Neurology</subject><subject>Pharmacology. 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Leukodystrophies. Prion diseases</topic><topic>Disability Evaluation</topic><topic>Electromyography - methods</topic><topic>Female</topic><topic>Gait - physiology</topic><topic>Humans</topic><topic>Immunomodulators</topic><topic>Lower Extremity - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple Sclerosis - complications</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Multivariate Analysis</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Neurology</topic><topic>Pharmacology. Drug treatments</topic><topic>Postural Balance - physiology</topic><topic>Sensation Disorders - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martin, C L</creatorcontrib><creatorcontrib>Phillips, B A</creatorcontrib><creatorcontrib>Kilpatrick, T J</creatorcontrib><creatorcontrib>Butzkueven, H</creatorcontrib><creatorcontrib>Tubridy, N</creatorcontrib><creatorcontrib>McDonald, E</creatorcontrib><creatorcontrib>Galea, M P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Multiple sclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martin, C L</au><au>Phillips, B A</au><au>Kilpatrick, T J</au><au>Butzkueven, H</au><au>Tubridy, N</au><au>McDonald, E</au><au>Galea, M P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gait and balance impairment in early multiple sclerosis in the absence of clinical disability</atitle><jtitle>Multiple sclerosis</jtitle><addtitle>Mult Scler</addtitle><date>2006-10-01</date><risdate>2006</risdate><volume>12</volume><issue>5</issue><spage>620</spage><epage>628</epage><pages>620-628</pages><issn>1352-4585</issn><eissn>1477-0970</eissn><abstract>This study evaluated the gait and balance performance of two clinically distinct groups of recently diagnosed and minimally impaired multiple sclerosis (MS) patients (Expanded Disability Status Scale range 0- 2.5), compared to control subjects. Ten MS patients with mild pyramidal signs (Pyramidal Functional Systems 1.0), 10 MS patients with no pyramidal signs (Pyramidal Functional Systems 0) and 20 age- and gender-matched control subjects were assessed using laboratory-based gait analysis and clinical balance measures. Both MS groups demonstrated reduced speed and stride length (P &lt; 0.001), and prolonged double limb support (P&lt;0.02), compared to the control group, along with alterations in the timing of ankle muscle activity, and the pattern of ankle motion during walking, which occurred independent of gait speed. The pyramidal MS group walked with reduced speed (P=0.03) and stride length (P=0.04), and prolonged double limb support (P=0.01), compared to the non-pyramidal group. Both MS groups demonstrated concomitant balance impairment, performing poorly on the Functional Reach Test compared to the control group (P&lt;0.05). 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source SAGE Complete A-Z List; MEDLINE
subjects Adult
Biological and medical sciences
Biomechanical Phenomena
Case-Control Studies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Disability Evaluation
Electromyography - methods
Female
Gait - physiology
Humans
Immunomodulators
Lower Extremity - physiopathology
Male
Medical sciences
Middle Aged
Multiple Sclerosis - complications
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Multivariate Analysis
Muscle, Skeletal - physiopathology
Neurology
Pharmacology. Drug treatments
Postural Balance - physiology
Sensation Disorders - etiology
title Gait and balance impairment in early multiple sclerosis in the absence of clinical disability
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