Multivariate association with disease progression and walking kinematics in relapsing-remitting multiple sclerosis

ABSTRACT

Highlights

Multiple sclerosis disease duration was not associated with gait speed

Multivariate models with gait kinematics are associated with disease duration

Disease duration is linked to step width variability and ankle pitch at toe-off

Declines in walking function commonly occur in people with multiple sclerosis (MS). Walking is a continuous movement and a complex motor task that requires precise timing and scaling of activation across many muscles. The objectives of this study were to identify kinematic gait characteristics during a 2-minute walk test that are associated with disease duration in individuals with relapsing-remitting MS (n=45). Participants were instrumented with inertial measurement units from APDM (APDM Inc, Portland, OR, USA) and performed the 2-minute walk test twice: once at their self-selected speed and another at their fastest, safe speed. Gait speed was not associated with MS disease duration (Self-selected: p= 0.180; Fast: p=0.167). Canonical correlation analysis showed that disease progression was strongly associated with lateral step width variability and ankle pitch at toe-off, which was also reflected in the multiple linear regression models. Both self-selected and fast-speed kinematics were associated with disease duration (Self-selected: p=0.007; Fast: p=0.004). Thus, we identified a multivariate model that is associated with disease duration in highly ambulatory MS individuals. Our study highlights the importance of considering individual differences in specific gait kinematics (such as lateral step width variability and ankle pitch at toe-off) when assessing disease progression in MS. This approach may provide more personalized insights into the impact of MS on mobility and help tailor interventions to improve gait and overall function in affected individuals. Future research should continue exploring these kinematic parameters to better understand their role in MS progression and develop targeted therapeutic strategies.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Sumire D. Sato was supported by National MS Society Postdoctoral Fellowship (FG-2207-40150). Kristin A. Johnson was supported by the National MS Society Postdoctoral Fellowship (MB-2205-39515). Brett W. Fling was supported by the National MS Society Grant (JF-1907-34355).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Review Board of Colorado State University gave ethical approval for this work (Protocol #1664)

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Footnotes

Disclosure of competing interests: None.

Funding sources: Sumire D. Sato was supported by National MS Society Postdoctoral Fellowship (FG-2207-40150). Kristin A. Johnson was supported by the National MS Society Postdoctoral Fellowship (MB-2205-39515). Brett W. Fling was supported by the National MS Society Grant (JF-1907-34355).

Data Availability

Data will be made available on resonable request.

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