title: Leg spasticity and ambulation in multiple sclerosis.
abstract: Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6 MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6 MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6 MW (P = 0.0001, d = -0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = -0.45), and walking velocity (P < 0.05, d = -0.53) and cadence (P < 0.05, d = -0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 231 Freer Hall, 906 South Goodwin Avenue, Urbana, IL 61801, USA.
authors.forename: Swathi
authors.initials: S
authors.lastname: Balantrapu
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 231 Freer Hall, 906 South Goodwin Avenue, Urbana, IL 61801, USA.
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: Sosnoff
authors.affiliation: Department of Neurology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Pula
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 231 Freer Hall, 906 South Goodwin Avenue, Urbana, IL 61801, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Sandroff
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 231 Freer Hall, 906 South Goodwin Avenue, Urbana, IL 61801, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl