Psarakis, M., Greene, D., Moresi, M. P, Baker, M. K, Stubbs, P., Brodie, M., Lord, S. & Hoang, P. (2017). Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis [accepted manuscript]. Clinical Biomechanics,49(November, 2017), 96-100. Retrieved from https://doi.org/http://dx.doi.org/10.1016/j.clinbiomech.2017.08.012
Background: Gait impairment in people with Multiple Sclerosis results from neurological impairment, muscle weakness and reduced range of motion. Restrictions in passive ankle range of motion can result in abnormal heel-to-toe progression (weight transfer) and inefficient gait patterns in people with Multiple Sclerosis. The purpose of this study was to determine the associations between gait impairment, heel-to-toe progression and ankle range of motion in people with Multiple Sclerosis. Methods Twelve participants with Multiple Sclerosis and twelve healthy age-matched participants were assessed. Spatiotemporal parameters of gait and individual footprint data were used to investigate group differences. A pressure sensitive walkway was used to divide each footprint into three phases (contact, mid-stance, propulsive) and calculate the heel-to-toe progression during the stance phase of gait. Findings Compared to healthy controls, people with Multiple Sclerosis spent relatively less time in contact phase (7.8% vs 25.1%) and more time in the mid stance phase of gait (57.3% vs 33.7%). Inter-limb differences were observed in people with Multiple Sclerosis between the affected and non-affected sides for contact (7.8% vs 15.3%) and mid stance (57.3% and 47.1%) phases. Differences in heel-to-toe progression remained significant after adjusting for walking speed and were correlated with walking distance and ankle range of motion. Interpretation Impaired heel-to-toe progression was related to poor ankle range of motion in people with Multiple Sclerosis. Heel-to-toe progression provided a sensitive measure for assessing gaitimpairments that were not detectable using standard spatiotemporal gait parameters.
School of Exercise Science
Open Access Journal Article