Gait Variability, Not Walking Speed, Is Related to Cognition in Adolescents With Multiple Sclerosis

Abstract

Gait variability is associated with cognitive performance in people with central neurologic damage illnesses, which includes multiple sclerosis. However, presently, there have been no data available as to whether this association exists in adolescents with multiple sclerosis. Therefore, our objective was to investigate the association between gait variability and cognition in adolescents with multiple sclerosis encompassing 48 recently diagnosed adolescents with multiple sclerosis (26 girls; 22 boys), average age of 16.0 years (SD ¼ 2.2), and an Expanded Disability Status Scale (EDSS) score of 1.6 (SD ¼ 1.3). Walking speed and gait variability expressed by the coefficient of variation of the mean step time was studied using an electronic walkway. A computerized cognitive battery of tests evaluated cognition. Cognitive outcome measurements included verbal and nonverbal memory, executive function, visual spatial processing, verbal function, attention, information processing speed, and motor skills. Mean walking speed was 76.9 cm/s (SD ¼ 57.6); mean step time variability was 3.5 (SD ¼ 1.3) and the global cognitive score was 93.9 (SD ¼ 12.5). According to linear regression analysis, a significant association was found between step time variability, cognitive subdomains of attention, and information processing speed. After incorporating walking speed into the model, the association remained significant. Increased gait variability, not walking speed, is suggested as a clinical marker of cognitive performance in minimally disabled adolescents with multiple sclerosis.

Cognitive Functioning in Patients with Pediatric-Onset Multiple Sclerosis, an Updated Review and Future Focus

“…Sandroff and colleagues reviewed how exercise/physical activity affects cognition in patients with MS and found evidence to support a positive effect [135]. Physical functioning and gait variability (variation in mean step time), but not gait speed, were also found be associated with cognitive outcome in patients with POMS with minimal disability (EDSS mean of 1.6) [136] and may be able to be used as an early clinical marker of cognitive performance.…”

Six-Minute Walk Performance and Related Factors in Pediatric-Onset Multiple Sclerosis

“…Motor disorders such as loss of strength, gait impairment, and spasticity; sensory problems such as pain, numbness, and tingling; and cognitive problems are frequently encountered. [5][6][7][8] Low levels of physical activity and fatigue are observed in patients with pediatric-onset multiple sclerosis, and they frequently experience balance and walking problems. [9][10][11] Because of these symptoms, the participation in daily living activities and the quality of life of the patients may also be affected.…”