Influence of Multiple Sclerosis on Spatiotemporal Gait Parameters: A Systematic Review and Meta-Regression |
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| Institution: | 1. Faculty of Medicine, University of Toronto, Rehabilitation Sciences Institute, Toronto, Ontario;2. Sunnybrook Health Sciences Centre, Hurvitz Brain Sciences Program, Sunnybrook Centre for Independent Living, Toronto, Ontario;3. KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada;4. Faculty of Medicine, University of Toronto, Department of Occupational Science & Occupational Therapy, Toronto, Ontario;5. Faculty of Medicine, University of Toronto, Department of Physical Therapy, Toronto, Ontario;1. Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy;2. Multiple Sclerosis Centre, Department of Medical Sciences and Public Health University of Cagliari, Cagliari, Italy;1. Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy;2. Multiple Sclerosis Centre, Department of Medical Sciences and Public Health University of Cagliari, Cagliari, Italy;1. Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy;2. Multiple Sclerosis Centre, Department of Medical Sciences and Public Health University of Cagliari, Cagliari, Italy;1. Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Australia;2. Australian Rehabilitation Research Centre (ARRC), Royal Melbourne Hospital, Australia;3. Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, the Netherlands;4. Department of Rehabiliation Medicine (Royal Melbourne Hospital), Australia;1. Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States;2. Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530W 15th St, Lawrence, KS 66045, United States;3. Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States |
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| Abstract: | ObjectiveTo quantify the effect of multiple sclerosis (MS) on spatiotemporal gait characteristics accounting for disability severity and fall classification.Data SourcesMEDLINE (1946-August 2018), Allied and Complementary Medicine Database (1985-2018 August), and PsycINFO (1806-August 2018) were searched for terms on MS and gait.Study SelectionDual independent screening was conducted to identify observational, cross-sectional studies that compared adults with MS grouped according to Expanded Disability Status Scale (EDSS) level or fall history, reported on spatiotemporal gait characteristics, and were published in English. The search retrieved 5891 results, of which 12 studies satisfied the inclusion criteria.Data ExtractionTwo authors worked independently to extract and verify data on publication details, study methodology, participant characteristics, gait outcomes, conclusions, and limitations. Risk of bias was assessed using the QualSyst critical appraisal tool. A random-effects meta-regression and meta-analysis were conducted on pooled data.Data SynthesisAll studies received quality ratings of very good to excellent and collectively examined 1513 individuals with MS. With every 1-point increase in EDSS, significant changes (P<.05) were observed in gait speed (?0.12 m/s; 95% confidence interval (CI), 0.08-0.15), step length (?0.04 m; 95% CI, 0.03-0.05), step time (+0.04 seconds; 95% CI, 0.02-0.06), step time variability (+0.009 seconds; 95% CI, 0.003-0.016), stride time (+0.08 seconds; 95% CI, 0.03-0.12), cadence (?4.4 steps per minute; 95% CI, 2.3-6.4), stance phase duration (+0.8% gait cycle; 95% CI, 0.1-1.5), and double support time (+3.5% gait cycle; 95% CI, 1.5-5.4). Recent fallers exhibited an 18% (95% CI, 13%-23%) reduction in gait speed compared with nonfallers (P<.001).ConclusionsThis review provides the most accurate reference values to-date that can be used to assess the effectiveness of MS gait training programs and therapeutic techniques for individuals who differ on disability severity and fall classification. Some gait adaptations could be part of adopting a more cautious gait strategy and should be factored into the design of future interventions. |
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| Keywords: | Accidental falls Gait Multiple sclerosis Rehabilitation Spatio-temporal analysis CI"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"confidence interval EDSS"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"Expanded Disability Status Scale MS"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"multiple sclerosis |
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