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MULTIPLE SCLEROSIS: GAIT MECHANICS OF TIMED-UP AND GO AT PREFERRED AND FAST SPEEDS

Abstract

F. Akram, B. J. Bowser, J. J. Sternhagen
South Dakota State University, Brooking, SD

People with Multiple Sclerosis (MS) tend to have altered gait mechanics due to muscle weakness, postural instability, and decreased sensorimotor reflexes. Daily activities that require faster speed than preferred may potentially increase the risk of falls. Purpose: To compare Timed-Up and Go (TUG) kinematics of persons with MS at preferred vs. maximal movement speed. Methods: Six participants diagnosed with MS participated in this study (age: 51±10yrs; height: 1.71±0.1m; mass: 73.7±22kg; Expanded Disability Status Score=4.25±2.4). Gait kinematics (100Hz) were captured as participants completed the 3 meter TUG test at their preferred speed (pTUG) and at their fastest speed (fTUG). Variables of interest included TUG time, gait velocity, step width (SW), and step length (SL). TUG time was defined as the time interval from seat off to seat contact. The remaining variables of interest were calculated during the time interval from seat off to the 3m mark. Mean±SD, effect size (Cohen’s d), and percent difference were used to describe kinematic changes between the preferred and maximal speed conditions. Results: TUG time was 31% slower during pTUG (13.5±3.6s) compared to fTUG (10.3±3.0s) (d=1.71). Gait velocity was 24% slower during pTUG (1.01±0.2m/s) compared to fTUG (1.25±0.4m/s) (d=2.98). Both step width and step length were 32% and 17% greater respectively during fTUG (SW=0.15±0.1m; SL=0.60±0.2m) compared to pTUG (SW=0.12±0.04m; SL=0.52±0.1m) (SW:d=1.67; SL: d=1.12). Conclusions: Our findings indicate that persons with MS increase SL and SW when asked to perform the TUG at their maximal speed. It is not uncommon to increase gait velocity by increasing SL, however in healthy individuals SW typically decreases as SL increases. The increased SW exhibited by persons with MS in this study is likely a compensatory mechanism used to widen their base of support in an effort to increase dynamic stability when performing the TUG at speeds faster than their preferred speed.

NACSM Professional Sponsor: Bradley Bowser

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