Bilateral coordination of gait at self-selected and fast speed in patients with multiple sclerosis: a case-control study

Background: Multiple sclerosis (MS) is characterized by progressive demyelinating deterioration of nervous tis-sues in the brain and cord, leading to a disruption in the ability of parts of the nervous system to transmit signals. Although dorsal column pathways are compromised in neuropathological studies, gait control assessments, especially on speed effects, have been understudied in MS. Objective: This study aimed to compare bilateral coordination of gait in subjects with MS at self-selected and fast speed and to relate these findings to disease severity (Expanded Disability Status Scale (EDSS)) and age. Methods: An age-matched and sex-matched case-control study was performed to assess the bilateral coordination of gait of 26 MS subjects by evaluating the gait spatiotemporal parameters captured by an inertial measurement unit sensor. The bilateral variability, accuracy, and overall coordination (the sum of variability and accuracy) were assessed at a self-selected and fast speed, and correlated with disease severity and age. Results: All gait control parameters improved at the fast speed compared to the self-selected walking speed (p < 0.05 for all comparisons). The bilateral coordination of gait was moderately related to disease severity and age (p < 0.05), and the gait spatiotemporal parameters were related to disease severity (p < 0.001, from R=0.66 to R=0.70). Conclusion: Patients with MS showed significant impairment in the bilateral coordination of gait at self-selected compared to fast speed. Functional mobility tests and locomotor interventions should be cautious when analyzed at different paces. Interventions aiming to increase speed can be a proper and safe strategy in locomotor studies.