Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. (Short Report).

Objective: To evaluate the correlation between gait speed and strength in multiple sclerosis (MS) with particular regard to patients presenting with proprioceptive loss.

Methods: Gait evaluation and isokinetic testing of muscular function were performed in 20 patients with unaided gait (expanded disability status scale < 6). Patients were separated into two groups in relation to the occurrence of somatosensory involvement: pyramidal group (8 patients) and sensory-pyramidal group (12 patients). Ten healthy subjects of similar age, sex, and height constituted a control group to evaluate gait parameters.

Results: In the whole patient group, gait speed was reduced and strongly related to hamstring peak torque but not with quadriceps peak torque. The gait speed and peak torques of quadriceps and hamstrings were similar in both groups of patients. However, in the patients with proprioceptive loss there was both a strong correlation between gait speed and hamstring torque and a significant correlation with quadriceps torque. In the pyramidal group there was poor or no correlation.

Conclusion: In patients with undifferentiated MS there is some correlation between gait speed and muscle strength. In the case of sensory loss, a higher contribution of both flexor and extensors of the lower limbs was observed, suggesting that muscular compensation occurred in this situation to maintain gait speed. These results are relevant to assess rehabilitation modalities in MS.

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Quantitative data from both gait parameters and muscular strength have dramatically changed the conception of rehabilitation in patients suffering central nervous system lesions. Following stroke, a relation has been reported between muscular strength and gait speed, (1 2) underlining the value of muscular reinforcement in this situation. Similar results can be expected in multiple sclerosis (MS), although results from studies focusing on gait changes following rehabilitation have been contradictory, (3) which may be related to variability in clinical features. Somatosensory deficit is a common feature in MS and contributes to disability as assessed by the expanded …