Article

OBJECTIVES: To determine whether plantarflexor (PF) spasticity or ankle strength
best predicts variance in walking capacity or self-perceived limitations in
walking in persons with multiple sclerosis (MS) and whether persons with MS with
PF spasticity are weaker and have greater walking dysfunction than do persons
with MS without PF spasticity. DESIGN: Cross-sectional study. SETTING: University
research laboratory. PARTICIPANTS: Forty-two adults with MS (mean age,
42.9+/-10.1y; Expanded Disability Status Scale score, median=3.0, range=0-6) and
14 adults without disability (mean age, 41.9+/-10.1y). INTERVENTION: Not
applicable. MAIN OUTCOME MEASURES: PF spasticity and dorsiflexion and PF maximum
voluntary isometric torque were assessed using the modified Ashworth Scale and a
computerized dynamometer, respectively. The Timed 25-Foot Walk Test was the
primary outcome measure of walking capacity. Secondary measures included the
6-Minute Walk Test and the 12-item Multiple Sclerosis Walking Scale. RESULTS: PF
strength was the most consistent predictor of variance in walking capacity (Timed
25-Foot Walk Test: R(2) change=.23-.29, P</=.001; 6-Minute Walk Test: R(2)
change=.12-.29, P</=.012), and self-perceived limitations of walking (12-item
Multiple Sclerosis Walking Scale: R(2) change=.04-.14, P<.18). There were no
significant differences (P>.05) between persons with MS with PF spasticity and
persons with MS without PF spasticity for any of the outcome measures.
CONCLUSIONS: Our study suggests a unique contribution of PF weakness to walking
dysfunction in persons with MS, and highlights the importance of evaluating PF
strength in this clinical population.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS