2024/12/10 by Syamala Buragadda, Michelle Ploughman · 1 voice
Medicine · Health Professions · #Multiple Sclerosis Research Studies #Balance, Gait, and Falls Prevention #Amyotrophic Lateral Sclerosis Research
paper · doi:10.1016/j.gaitpost.2024.12.003
openalex publication_date 2024/12/10 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/04
Gait is typically symmetrical and consistent and subtle increases in gait variability can suggest loss of neural control. In multiple sclerosis (MS), covert walking changes precede clinical signs, often not detectable on observation, and measurement of gait variability could be a potential biomarker of covert neurodegeneration. Both cognition and fitness could influence changes in gait variability. This study aimed to examine gait variability over two years in clinically stable people with MS and determine whether fitness or cognition could predict change in gait variability. Does gait variability serve as a longitudinal biomarker in people with MS, and is fitness or cognition protective against changes in gait variability? 49 people with stable MS (65.3 % females) were recruited from MS clinics. At the initial assessment (T1), cognition was assessed using the Montreal Cognitive Assessment, and fitness was measured as maximal oxygen update (VO 2max ) during a graded exercise test using a whole-body recumbent stepper. They performed self-selected walking on an instrumented walkway at initial assessment (T1) and after two years (T2), and stride time variability (STV) was measured as the coefficient of variation of stride time. The average age of the participants was 45.86 ± 12.18 years, and the average time between assessments was 17.7 ± 5.0 months. The average STV was 7.33 % at T1 and increased to 8.13 % at T2 (p = 0.042). After controlling for age, sex, time between assessments, cognition and STV at T1, VO 2max at T1 was a significant predictor of STV at T2 (β = −0.395, p = .014), accounting for 11.4 % of the variance. Cognition at T1 did not predict changes in STV. Lower cardiorespiratory fitness, but not cognition, predicted worsening gait variability over two years. Gait variability may be a sensitive biomarker of covert gait changes not apparent to an observer. • Covert walking changes in multiple sclerosis precede clinical signs, often not detectable on observation. • Gait variability changes over time without clinically documented relapse or progression. • Gait variability could be a potential biomarker of covert neurodegeneration. • Higher fitness level predicts the preservation of gait variability over time.