Trunk and pelvis movement compensation in people with multiple sclerosis: Relationships to muscle function and gait performance outcomes

M M Mañago; P W Kline; E Alvarez; C L Christiansen

doi:10.1016/j.gaitpost.2020.03.006

Trunk and pelvis movement compensation in people with multiple sclerosis: Relationships to muscle function and gait performance outcomes

Gait Posture. 2020 May:78:48-53. doi: 10.1016/j.gaitpost.2020.03.006. Epub 2020 Mar 12.

Authors

M M Mañago¹, P W Kline², E Alvarez³, C L Christiansen²

Affiliations

¹ Physical Therapy Program, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop C244, 13121 E 17th Ave., Room 3108, Aurora, CO, 80045, United States; Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop B182, Research Complex 2, 12700 East 19th Ave., Aurora, CO, 80045, United States. Electronic address: mark.manago@cuanschutz.edu.
² Physical Therapy Program, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop C244, 13121 E 17th Ave., Room 3108, Aurora, CO, 80045, United States; Geriatric, Research, Education, and Clinical Center, VA Eastern Colorado Healthcare System, 1700 N Wheeling St., Aurora, CO, 80045, United States.
³ Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop B182, Research Complex 2, 12700 East 19th Ave., Aurora, CO, 80045, United States.

PMID: 32200163
DOI: 10.1016/j.gaitpost.2020.03.006

Abstract

Background: Problems with gait are common in people with multiple sclerosis (MS), but little is known about pelvis and trunk kinematics, especially in the frontal plane.

Research question: Are pelvis and trunk kinematics in people with MS related to muscle function, spatiotemporal parameters, and gait performance?

Methods: In this cross-sectional study, 20 people with MS (Expanded Disability Status Scale 1.5-5.5) and 10 people with comparable age and sex (CTL) underwent threedimensional gait analysis, muscle function assessments (hip and trunk strength and endurance), and gait performance measures (Timed 25-Foot Walk - T25FW, 2-Minute Walk Test - 2MWT). Frontal and sagittal plane pelvis and trunk excursion during the stance period of walking were compared between groups; and in the MS group, associations were determined between kinematic variables, muscle function, spatiotemporal parameters, and gait performance.

Results: Compared to the CTL group, the MS group had significantly greater sagittal plane trunk and pelvis excursion for both the stronger (p = 0.031) and weaker (p = 0.042) sides; less frontal plane trunk and pelvis excursion for both the stronger (p = 0.008) and weaker (p = 0.024) sides; and more sagittal plane trunk excursion for the stronger side (p = 0.047) during stance phase. There were low-to-moderate correlations in the MS group for sagittal plane pelvis excursion with muscle function (p = 0.019 to 0.030), spatiotemporal parameters (p < 0.001 to 0.005), and gait performance (p = < 0.001 to 0.001). Using linear regression, frontal and sagittal plane pelvis excursion were significant predictors of both T25FW and 2MWT, explaining 34 % and 46 % of the variance of each gait performance measure, respectively.

Significance: Rehabilitation interventions may consider addressing pelvis movement compensations in order to improve spatiotemporal parameters and gait performance in people with MS.

Keywords: Biomechanics; Endurance; Gait; Kinematics; Multiple sclerosis; Rehabilitation; Strength.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomechanical Phenomena
Cross-Sectional Studies
Female
Gait*
Humans
Male
Middle Aged
Movement / physiology
Multiple Sclerosis / physiopathology*
Muscle, Skeletal / physiology*
Pelvis / physiology*
Torso / physiology*