Elsevier

Gait & Posture

Volume 41, Issue 3, March 2015, Pages 860-862
Gait & Posture

Short Communication
Reliability of gait in multiple sclerosis over 6 months

https://doi.org/10.1016/j.gaitpost.2015.02.006Get rights and content

Highlights

  • We estimated reliability of gait over 6 months in the absence of an intervention.

  • Gait parameters of persons with MS had excellent reliability over 6 months.

  • Experimentally determined reliability estimates will inform sample size estimates.

Abstract

Gait impairment is ubiquitous in multiple sclerosis (MS) and is often characterized by alterations in spatiotemporal parameters of gait. There is limited information concerning reliability of spatiotemporal gait parameters over clinical timescales (e.g. 6 months). The current report provides novel evidence that gait parameters of 74 ambulatory persons with MS with mild-to-moderate disability are reliable over 6-months (ICC's for overall sample range from 0.56 to 0.91) in the absence of any intervention above and beyond standard care. Such data can inform clinical decision-making and power analyses for designing RCTs (i.e., sample size estimates) involving persons with MS.

Section snippets

Participants

Participants were 74 ambulatory persons with MS. Inclusion criteria were: (1) MS diagnosis; (2) relapse free for 30 days prior to both testing sessions; (3) ability to travel to the research facility twice over a 6-month period; (4) age between 18 and 64 years of age; and (5) ambulatory with or without aid.

Procedures

The procedure was reviewed and approved by the local Institutional Review Board, and all participants provided written informed consent. Participants initially provided basic demographic

Results

The overall sample had an average age of 49.2 ± 9.0 years and was primarily female (80%). The average duration since diagnosis of MS was 11.8 ± 8.2 years. 78% of the sample reported having relapse remitting MS, 14% reported secondary progressive and 8% reported primary progressive MS. The median PDDS score was 3.0 (IQR = 3.0) and ranged from 0 to 6.

Descriptive statistics for spatiotemporal gait parameters per assessment are presented in Table 1. Gait velocity was significantly increased over time by

Discussion

The current investigation provides estimates of reliability for common spatiotemporal parameters of gait in MS. Gait velocity, FAP score, step length, time and cadence were all reliable over 6-months. Double support percentage and base of support had lower reliability over 6-months. Such results generally confirm the reliability of this gait behavior over a clinically feasible time scale of 6-months. By comparison, other investigations have typically established reliability of various walking

Funding

This project was funded in part by the National Multiple Sclerosis Society (PP 1695).

Conflict of interest statement

The authors have no conflicts of interest to report.

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  • Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population

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    In accordance with the present results, previous studies have demonstrated that spatiotemporal parameters are reliable and highly repeatable in the healthy population [32], along with cadence and walking speed (ICC range 0.76–0.95) for children with CP [20,33]. Although estimates of reliability for gait kinematics have not been reported in the MS population, a study by Sosnoff et al. [34] examined the reliability of walking speed, cadence and step length. They reported that in a group of pwMS with a varied disability level [Patient Determined Disease Steps (PDSS) range 0–6] there were excellent ICC values (0.91) for the spatiotemporal parameters similar to our findings for both groups.

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    These results satisfied the criteria for acceptable reliability in the subsamples [39]. This complements previous studies [15,16,18,32,38,40]. As shown before [15], reliability was better in the group with MS than in the control population.

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