Contributions
Abstract: P870
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: Multiple Sclerosis (MS) results in postural instability and dynamic mobility deficits. Such impairments are associated with an increased likelihood of falls; as such an understanding of these deficits will inform both assessment and treatment.
Objective: This systematic review and meta-analysis aims to quantify the effect of MS on dynamic mobility to inform the development of falls prevention interventions.
Methods: A systematic search of the literature identified case-control studies investigating differences in variables between people with MS and healthy controls. Search terms were based on previous literature relating to similar topics and expert opinion. Meta-analysis examined the effect of MS on dynamic mobility under normal and accelerated pace conditions.
Results: Forty-one studies of people with Expanded Disability Status Scale (EDSS) 1.8 to 4.5 were included of which 32 contributed to meta-analysis. A large effect of MS was found on stride length (Standardised Mean Difference, SMD=1.27, 95% CI{0.93, 1.61}, p< 0.00), velocity (SMD= 1.12, 95% CI{0.85, 1.39}, p< 0.00), double support duration (SMD=0.85, 95% CI{0.51, 1.2}, p< 0.00), step length (SMD=1.15, 95% CI{0.75, 1.5}, p< 0.00), stance phase (SMD=0.96, 95% CI{0.36, 1.57}, p=0.002) and swing phase duration (SMD=1.23, 95% CI{0.06, 2.41}, p=0.04). A moderate effect was found on step width (SMD=0.65, 95% CI {0.36, 0.94}, p< 0.00), single support duration (SMD=0.78, 95% CI {0.35, 1.21}, p< 0.00) and stride time (SMD=0.56, 95% CI {0.35, 0.76}p< 0.00). with the smallest effect found on cadence (SMD=0.43, 95% CI {0.14, 0.72}p=0.004). All effect sizes increased for variables investigated under an accelerated walking pace (for example the effect on cadence increased to SMD=1.15, 95% CI {0.42, 1.88}, p=0.002).
Conclusions: MS has a significant effect on dynamic mobility even for those with relatively low EDSS. This effect is amplified by increasing pace suggesting this condition may be more pertinent for assessment and treatment. Further investigation relating to the predictive or protective nature of these deficits in relation to falls is warranted.
Keywords: Multiple Sclerosis; Mobility Limitations; Gait; Accidental Falls; Postural Balance
Disclosure:
Laura Comber is a PhD student funded by the MS Society of Ireland through the Ireland Fund
Associate Professor Susan Coote: Nothing to disclose
Dr. Rose Galvin: Nothing to disclose
Abstract: P870
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: Multiple Sclerosis (MS) results in postural instability and dynamic mobility deficits. Such impairments are associated with an increased likelihood of falls; as such an understanding of these deficits will inform both assessment and treatment.
Objective: This systematic review and meta-analysis aims to quantify the effect of MS on dynamic mobility to inform the development of falls prevention interventions.
Methods: A systematic search of the literature identified case-control studies investigating differences in variables between people with MS and healthy controls. Search terms were based on previous literature relating to similar topics and expert opinion. Meta-analysis examined the effect of MS on dynamic mobility under normal and accelerated pace conditions.
Results: Forty-one studies of people with Expanded Disability Status Scale (EDSS) 1.8 to 4.5 were included of which 32 contributed to meta-analysis. A large effect of MS was found on stride length (Standardised Mean Difference, SMD=1.27, 95% CI{0.93, 1.61}, p< 0.00), velocity (SMD= 1.12, 95% CI{0.85, 1.39}, p< 0.00), double support duration (SMD=0.85, 95% CI{0.51, 1.2}, p< 0.00), step length (SMD=1.15, 95% CI{0.75, 1.5}, p< 0.00), stance phase (SMD=0.96, 95% CI{0.36, 1.57}, p=0.002) and swing phase duration (SMD=1.23, 95% CI{0.06, 2.41}, p=0.04). A moderate effect was found on step width (SMD=0.65, 95% CI {0.36, 0.94}, p< 0.00), single support duration (SMD=0.78, 95% CI {0.35, 1.21}, p< 0.00) and stride time (SMD=0.56, 95% CI {0.35, 0.76}p< 0.00). with the smallest effect found on cadence (SMD=0.43, 95% CI {0.14, 0.72}p=0.004). All effect sizes increased for variables investigated under an accelerated walking pace (for example the effect on cadence increased to SMD=1.15, 95% CI {0.42, 1.88}, p=0.002).
Conclusions: MS has a significant effect on dynamic mobility even for those with relatively low EDSS. This effect is amplified by increasing pace suggesting this condition may be more pertinent for assessment and treatment. Further investigation relating to the predictive or protective nature of these deficits in relation to falls is warranted.
Keywords: Multiple Sclerosis; Mobility Limitations; Gait; Accidental Falls; Postural Balance
Disclosure:
Laura Comber is a PhD student funded by the MS Society of Ireland through the Ireland Fund
Associate Professor Susan Coote: Nothing to disclose
Dr. Rose Galvin: Nothing to disclose