Effects of lower limb Spasticity on Gait in People with Multiple Sclerosis; Review

Abstract

Objective: The aim of this paper is to review literature systematically and quantify the effects of leg spasticity on gait parameters in PwMS. Methods and Materials:This study is a systematic review and meta-analysis of observational studies. Articles were included if they met the following inclusion criteria: They were original, observational studies, participants were PwMS, study the effects of leg spasticity on gait in MS patients compared with MS patients without spasticity. The included articles were assessed by modified Downs and Black checklist. The difference between the groups using standardized mean differences and 95% confidence intervals were calculated for meta-analyses. Results:The review included 3 studies with a total of 156 participants; 78 participants were with spasticity, and 78 without spasticity. The lower limb spasticity was detected by modified Ashworth scale self-rating spasticity. The gait was assessed by clinical scales, spatial and temporal gait analyses, free-living walking for a 7 days, O2 consumption during gait, kinematic parameters within the gait, and lower limb muscles range of motion and activity. The included studies and meta-analyses show that the spasticity affected negatively gait with significant differences in comparison with non-spasticity PwMS.Conclusion: Spasticity affects negatively on gait and walking mobility. Those walking impairments lead to increase level of disability, and risk of fall. Gait training is required in MS rehabilitation protocols especially for PwMS with spasticity

Association Between Lower Limb Spasticity and Falls in Persons with Multiple Sclerosis

“…The prevalence of spasticity ranges from 52% to 84% in the MS population (5,6). Although spasticity occurs in the upper limbs, lower limb spasticity is predominant in MS. Several studies have revealed that lower limb spasticity related to walking, postural control, and severe disability profoundly affects the quality of life in persons with multiple sclerosis (pwMS) (7,8). Furthermore, spasticity affects daily life activities in those with MS (9).…”