Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Abstract

Gait impairments in persons with multiple sclerosis (pwMS) underlying reduced walking endurance are still poorly understood. Thus, our objective was to assessed gait asymmetry (GA) and bilateral coordination of gait (BCG), among pwMS during the six-minute walk test (6MWT) and their association with disease severity. For this aim, we recruited ninety-two pwMS (age: 46.6 {+/-} 7.9; 83% females) with a broad range of clinical disability who completed the 6MWT wearing gait analysis system. GA was assessed by comparing left and right swing times, and BCG by using the phase coordination index (PCI). Several functional and subjective gait assessments were performed. Results show that gait is more asymmetric and less coordinated as the disease progresses (p<.0001). Participants with mild MS showed significant better BCG as reflected by lower PCI values in comparison to the other two MS severity groups (severe: p =.001, moderate: p=.02). GA and PCI also deteriorated significantly with time during the 6MWT (p<.0001). GA and PCI (i.e., BCG) show somewhat weaker associations with clinical MS status than associations observed between functional and subjective gait assessments and MS status. Similar to other neurological cohorts, GA and PCI are important parameters to assess and to target in interventions among pwMS.