Adaptations to stride patterns and head movements during walking in persons with and without multiple sclerosis
Many people with multiple sclerosis (MS) have difficulty with walking, which can decrease their sense of mobility. Gait stability was investigated by studying stride parameters and head movements at preferred and fixed speeds in those with MS. First, walking gait data were recorded at preferred and fixed walking speeds from 19 individuals with MS and 19 controls. Traditional gait parameters were compared, as was swing foot to center of mass (CoM) timing at mid-swing. Second, walking gait data in healthy young adults (n=20) were recorded at preferred speed and while stepping over an obstacle. Study 2 developed novel swing definitions, measures of coordination between the swing foot and body CoM, and head movements as they pertain to field of view orientation during walking. Third, these novel measures were used to study the swing phase of walking in people with MS. The first investigation revealed that the MS group walked with lengthened dual support times across all speeds, but shortened swing time and altered swing foot timing at fixed speeds in comparison to controls. Those with MS adopted a gait strategy with increased dual support time, despite forcing changes to swing that may reduce gait stability. In the second investigation, novel measures of swing showed alterations to phases of swing and in coordination between the swing foot and CoM under different gait tasks. This study also showed that the field of view was closer to the body during obstacle condition steps compared with unobstructed gait. In the third study, these novel measures showed that at all speeds the MS group shortened early swing and lengthened mid swing while late swing remained unchanged compared with controls. Coordination measures illustrated adaptations in swing foot dynamics that may partially ameliorate altered swing foot timing. The MS group oriented the field of view closer to the body earlier in swing compared with controls. Those with MS have functionally adapted swing to increase time over the stance foot and rely more on visual perception, yet shorter early swing may afford fewer opportunities to plan a step or cope with gait disturbances while walking.
Remelius, Jebb G, "Adaptations to stride patterns and head movements during walking in persons with and without multiple sclerosis" (2012). Doctoral Dissertations Available from Proquest. AAI3498368.