Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Lecat, Magaly; Decavel, Pierre; Magnin, Éloi; Lucas, B.; Grémeaux, Vincent; Sagawa, Yoshimasa

doi:10.1159/000480729

Cited by 18 publications

(10 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The consequence of this is impaired nerve conduction. Fampridine, a potassium channel blocker, has been demonstrated to improve gait speed with a presumed mechanism of action of sustained conduction across demyelinated axons secondary to increased potassium availability ( 16 ). We posit that the differences in the subject-specific temporal variation in gait speed may be an indicator of this recognized conduction failure in MS individuals.…”

Section: Discussionmentioning

confidence: 99%

Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

et al. 2021

View full text Add to dashboard Cite

Background: The six-minute walk (6MW) test is a validated assessment method in Multiple Sclerosis (MS) research. While the total distance covered during six minutes (6MWTD) is often used as the standard measurement of gait capacity (i.e., the maximum distance one can achieve), we hypothesize that endurance (i.e., ability to maintain speed over a prolonged time) can be inferred by the gait speed trajectory (GST) during the 6MW test (6MWGST).Objective: To characterize group differences in 6MWGST between MS patients and healthy controls (HCs), and to assess information added by 6MWGST for discerning between MS patients and HCs.Methods: We performed a secondary data analysis on a cross-sectional cohort of 40 MS and 20 HC subjects with three repeated 6MW tests. We modeled 6MWGST using a linear mixed-effects model with time in minutes and replicated walks nested within individuals. We compared the discernibility of 6MWGST with that of conventional metrics using likelihood ratio tests and receiver operating characteristic (ROC) analysis on logistic regression models.Results: MS subjects showed a concave, quadratic GST during 6MW tests, slowing down more than the HC subjects, especially at the beginning of 6MW tests. Despite accelerating at the end of the 6MW, MS subjects were unable to attain or surpass their initial 6MW gait speeds. 6MWGST added useful information (p = 0.002) to the conventional metrics (e.g., 6MWTD) for discerning between MS and HC subjects, and increased the area under the ROC curve from 0.83 to 0.93 (p = 0.037).Conclusions: The distinctive 6MWGST pattern of MS patients provided increased discernibility compared with currently used gait metrics. Both gait capacity measured by the 6MWTD, and gait endurance measured by parameters of 6MWGST, are significant functional indicators for the MS population.

show abstract

Section: Discussionmentioning

confidence: 99%

Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Gait metrics analysis utilizing single-point inertial measurement units: a systematic review mHealth 2021 | https://dx.doi.org/10.21037/mhealth-21-17 orthopedic conditions (1)(2)(3)(4)(5)(6)(7)(8) to identifying falls risk and frailty status (9,10). Qualitative and subjective measures generally constitute routine clinical gait analysis, with patient self-reporting and clinician observation sometimes integrated with clinical tests such as the Timed-Up-And-Go and 6-minute walking test (6MWT) (11).…”

Section: Review Articlementioning

confidence: 99%

Gait metrics analysis utilizing single-point inertial measurement units: a systematic review

Mobbs¹,

Perring²,

Raj³

et al. 2022

mHealth

View full text Add to dashboard Cite

Background: Wearable sensors, particularly accelerometers alone or combined with gyroscopes and magnetometers in an inertial measurement unit (IMU), are a logical alternative for gait analysis. While issues with intrusive and complex sensor placement limit practicality of multi-point IMU systems, single-point IMUs could potentially maximize patient compliance and allow inconspicuous monitoring in daily-living.Therefore, this review aimed to examine the validity of single-point IMUs for gait metrics analysis and identify studies employing them for clinical applications. Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) were followed utilizing the following databases: PubMed; MEDLINE; EMBASE and Cochrane. Four databases were systematically searched to obtain relevant journal articles focusing on the measurement of gait metrics using single-point IMU sensors.Results: A total of 90 articles were selected for inclusion. Critical analysis of studies was conducted, and data collected included: sensor type(s); sensor placement; study aim(s); study conclusion(s); gait metrics and methods; and clinical application. Validation research primarily focuses on lower trunk sensors in healthy cohorts. Clinical applications focus on diagnosis and severity assessment, rehabilitation and intervention efficacy and delineating pathological subjects from healthy controls.Discussion: This review has demonstrated the validity of single-point IMUs for gait metrics analysis and their ability to assist in clinical scenarios. Further validation for continuous monitoring in daily living scenarios and performance in pathological cohorts is required before commercial and clinical uptake can be expected.

show abstract

“…In addition, based on the sample size limitations, our RWA results should be interpreted with caution, focusing on determining which group of factors are more important than others rather than on establishing a specific rank ordering [62]. Moreover, although the patients' treatment was not modified in the six months prior to the testing, some patients in the MS3 group received 4-Aminopyridine (Table 1), which has been shown to improve the gait speed in PwMS [63]. Thus, although the MS3 group showed significantly worse gait speed and endurance scores than the other groups, gait deficit at the stage of the disease could have been underestimated.…”

Section: Limitationsmentioning

confidence: 99%

Understanding the Deterioration of Gait, Postural Control, Lower Limb Strength and Perceived Fatigue Across the Disability Spectrum of People with Multiple Sclerosis

Moreno-Navarro

Gómez-Illán

Carpena-Juan

et al. 2020

JCM

View full text Add to dashboard Cite

Disability progression is a prominent feature of multiple sclerosis (MS). However, little is known about the extent to which physical condition parameters and perceived fatigue evolve during the disease. We analyzed how strength, balance, core stability and perceived fatigue differ among different cohorts of people with MS (PwMS) with different disability degrees and how these contribute to patients’ gait speed and functional mobility. Sixty-three PwMS divided into three groups according to the “Expanded Disability Status Scale” (MS1: EDSS ≤ 1.5; MS2: 2 ≤ EDSS ≤ 3.5; MS3: 4 ≤ EDSS ≤ 6) and 22 healthy controls (HC) participated in this study. MS1 showed lower balance and hip strength compared to HC. MS2 showed lower balance, core stability, gait speed, and functional mobility than MS1. MS3 showed lower gait speed, functional mobility, balance, and knee flexion strength than MS2. No between-group differences were observed in perceived fatigue. Relative weight analysis showed that strength, balance and core stability explained 60%–70% of the variance in gait speed and functional mobility. The decline of each parameter did not evolve at the same rate across the different stages of the disease, being knee flexion strength and balance the most influential factors in the disability progression. Overall, these results provide useful information to guide exercise prescription at different stages of MS.

show abstract

Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review

Cited by 18 publications

References 42 publications

Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

Gait Speed Trajectory During the Six-Minute Walk Test in Multiple Sclerosis: A Measure of Walking Endurance

Gait metrics analysis utilizing single-point inertial measurement units: a systematic review

Understanding the Deterioration of Gait, Postural Control, Lower Limb Strength and Perceived Fatigue Across the Disability Spectrum of People with Multiple Sclerosis

Contact Info

Product

Resources

About