Complex assessment in progressive multiple sclerosis: a case report.
The study presents the case of a patient with progressive multiple sclerosis in relapses (PPMS) and proposes a comprehensive neuromuscular and biomechanical evaluation in order to achieve a predictive picture of gait evolution and balance disorders with disease progression.


METHODS
The evaluation included: clinical, functional and neuromuscular evaluation by tensiomyography (TMG) and biomechanics (by RSscan platform force). Elements evaluated included the calf muscle groups (tibialis anterior and gastrocnemius) and the following parameters were assessed from neuromuscular point of view: contraction time, sustain time, delay, relax time and displacement amplitude after electrical stimulation. Biomechanically, we assessed the subtalar angle, foot loading in metatarsian area, foot balance and pressure center distribution.


CONCLUSIONS
From neuromuscular point of view, we concluded that the right anterior tibial muscle developed compensatory muscle fibers resistant to fatigue. TMG analysis can estimate the possibility of developing gait disorders even in the absence of visible clinical manifestations. We also noted an increased muscle tone in the muscles of bilateral twins. Biomechanical evaluation revealed a symmetrical, abnormal gait, explained by the difference in the angle of left and right foot and in subtalar angle, which expresses the degree of coordination and control of foot gait initiation and execution. In this context, there is an exorotation of both feet.
Department of Pathologic Physiology, University of Medicine and Pharmacy of Craiova, Romania; drcristianneamtu@yahoo.com.
Marius Cristian
MC
Neamţu
Ligia
L
Rusu
Oana Maria
OM
Neamţu
Rucsandra
R
Dănciulescu Miulescu
Mihnea Ion
MI
Marin
D000328:Adult; D004576:Electromyography; D005260:Female; D005528:Foot / Q000503:physiopathology; D006365:Heel / Q000503:physiopathology; D006801:Humans; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis* / Q000503:physiopathology; D004856:Postural Balance; D011312:Pressure