[Relationship between gait speed and strength parameters in multiple sclerosis].
BACKGROUND
Recent studies have focused on correlation between strength and gait parameters in hemiplegia, suggesting the interest for strength training in patients with central nervous system lesions. The aim of this study was to evaluate this correlation in multiple sclerosis (MS) patients with special regard to the different clinical forms including proprioceptive loss or cerebellar ataxia.


METHODS
Gait speed and muscular function were performed in 27 patients with moderate affected gait (EDDS < 6). Gait speed was evaluated with Locometre and peak-torques of quadriceps and hamstrings were evaluated with isokinetic dynamometer. Patients were separated in three groups related to their deficiency: spastic group (8 patients), spastic with proprioceptive loss (12 patients) and spastic with cerebellar ataxia (7 patients). Gait parameters were evaluated in 10 healthy subjects as control group.


RESULTS
Gait speeds (spontaneous and maximal) and peak torques of quadriceps and hamstring were similar in the three groups. In the whole patients group, gait speed was reduced and related to hamstring peak torque (r = 0.56 at spontaneous speed and 0.51 at high speed) but not with quadriceps peak torque. Patients with proprioceptive loss exhibited not only a higher correlation between gait speed and hamstring torque (r = 0.76 and 0.65 respectively) than other patients but also with quadriceps torque (r = 0.66 and 0.59 respectively) when patients in other groups did not.


CONCLUSIONS
As it was previously pointed out in hemiplegic patients, MS patients exhibit some correlation between gait speed and muscle strength, mainly with hamstrings. These correlations can change in special sensory conditions suggesting that patients with sensory loss use different muscular strategies to maintain gait speed. Strength training may therefore be discussed in MS including specific modalities as a function of clinical parameters.
Mevellec
E
E
Service de rééducation neuro-orthopédique, hôpital Rothschild, 33, boulevard de Picpus, 75012 Paris et Inserm U483, France.
Lamotte
D
D
Cantalloube
S
S
Amarenco
G
G
Thoumie
P
P
D001696:Biomechanical Phenomena; D002524:Cerebellar Ataxia; D005684:Gait; D006429:Hemiplegia / Q000209:etiology / Q000473:pathology; D006801:Humans; D007700:Kinetics; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology