Article

Multiple Sclerosis (MS) results in postural instability and gait
abnormalities which are associated with accidental falls. This systematic review and meta-analysis aims to quantify the effect of MS on gait to
inform the development of falls prevention interventions. METHODS: A systematic
literature search identified case-control studies investigating differences in
gait variables between people with MS and healthy controls. Meta-analysis
examined the effect of MS on gait under normal and fast paced conditions.
RESULTS: Forty-one studies of people with Expanded Disability Status Scale (EDSS)
1.8 to 4.5 were included, of which 32 contributed to meta-analysis. A large
effect of MS was found on stride length (Standardised Mean Difference, SMD=1.27,
95% CI{0.93, 1.61}), velocity (SMD=1.12, 95% CI{0.85, 1.39}), double support
duration (SMD=0.85, 95% CI{0.51, 1.2}), step length (SMD=1.15, 95% CI{0.75,
1.5})and swing phase duration (SMD=1.23, 95% CI{0.06, 2.41}). A moderate effect
was found on step width and stride time with the smallest effect found on cadence
(SMD=0.43, 95% CI{0.14, 0.72}). All effect sizes increased for variables
investigated under a fast walking pace condition (for example the effect on
cadence increased to SMD=1.15, 95% CI{0.42, 1.88}). CONCLUSIONS: MS has a
significant effect on gait even for those with relatively low EDSS. This effect
is amplified when walking at faster speeds suggesting this condition may be more
beneficial for assessment and treatment. No studies investigated the association
between these deficits and falls. Further investigation relating to the
predictive or protective nature of these deficits in relation to falls is
warranted.
CI - Copyright A(c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS