Altered visual and somatosensory feedback affects gait stability in persons with multiple sclerosis |
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Institution: | 1. Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States;2. Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15th St, Lawrence, KS 66045, United States;3. Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 2002, Kansas City, KS 66160, United States;1. Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;2. Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran;3. Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;4. Department of Human Movement Sciences, Research Institute MOVE, VU University, Amsterdam, the Netherlands |
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Abstract: | Persons with multiple sclerosis (PwMS) often report problems due to sensory loss and have an inability to appropriately reweight sensory information. Both of these issues can affect individual’s ability to maintain stability when walking under challenging conditions. The purpose of the current study was to determine how gait stability is adapted when walking under challenging sensory conditions where vision and somatosensation at the feet is manipulated. 25 healthy adults and 40 PwMS (15 fallers, 25 non-fallers) walked on a treadmill at their preferred normal walking speed under 3 conditions: normal walking, altered vision using goggles that shifted visual field laterally, and altered somatosensation using shoes with compliant foam soles. Inertial measurement united recorded acceleration at the lumbar and right ankle, and acceleration variability measures were calculated including root mean square (RMS), range, sample entropy (SaEn), and Lyapunov exponents (LyE). A gait stability index (GSI) was calculated using each of the four variability measures as the ratio of lumbar acceleration variability divided by foot acceleration variability in the frontal and sagittal planes. The sagittal and frontal GSIRMS were larger in the somatosensory condition compared to the normal and visual conditions (p < 0.001). The frontal GSISaEn was greater in the visual condition compared to the somatosensory condition (p = 0.021). The frontal and sagittal GSILyE was greater in the somatosensory condition compared to the normal and visual conditions (p < 0.002). The current study showed that HC, MS non-fallers and MS fallers largely adapted to altered sensory feedback during walking in a similar manner. However, MS faller subjects may be more reliant on visual feedback compared to MS non-fallers and HC subjects. |
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Keywords: | Gait Sensory Vision Multiple sclerosis |
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