title: Six minutes of walking leads to reduced lower limb strength and increased postural sway in people with Multiple Sclerosis.
abstract: BACKGROUND
  Fatigue, lower limb weakness and poor balance can significantly limit safe mobility in people with Multiple Sclerosis (MS). Further research is required to elucidate relationships among these factors.
  
  
  OBJECTIVE
  To investigate the effect of walking-induced fatigue on lower limb strength and postural sway in people with moderately disabling MS.
  
  
  METHODS
  Thirty-four people (26 female) with moderate MS (mean Expanded Disability Status Scale of 3.7 ± 0.7) underwent assessments of acute fatigue, postural sway and lower limb strength before and after six-minute conditions of seated rest and walking. A matched sample of 10 healthy controls also undertook identical assessments before and after a six-minute walk.
  
  
  RESULTS
  Significant time by condition effects for all assessment measures indicated the six-minute walk induced fatigue with associated increases in postural sway and reductions in lower limb strength in people with MS. Increases in sway with eyes closed correlated with increases in acute fatigue and self-reported impact of fatigue on physical and psychological functioning. No changes were observed in healthy controls.
  
  
  CONCLUSIONS
  People with MS show signs of fatigue after 6 minutes of walking, including strength and balance deficits. These findings have implications for both mobility and fall risk in this group.
authors.affiliation: Flinders University, South Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: J V
authors.initials: JV
authors.lastname: McLoughlin
authors.affiliation: Flinders University, South Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: Barr
authors.affiliation: Flinders University, South Australia.
authors.forename: M
authors.initials: M
authors.lastname: Crotty
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: D L
authors.initials: DL
authors.lastname: Sturnieks
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: S R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000503:physiopathology*; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D004856:Postural Balance; D016138:Walking
keywords: Multiple Sclerosis; accidental falls; fatigue; mobility limitation; muscle strength; postural balance