Biomechanical Characterization of the Locomotion in Multiple Sclerosis Patients

Study Overview
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Brief Summary
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Multiple sclerosis (MS) is an inflammatory chronic disease of the central nervous system. Patients are suffering from balance and gait impairments at the early stage of the disease. 85 % of the MS patients report gait disorders, which impact their autonomy and their quality of life and increase the risk of fall. The three-dimensional analysis of the walking by a motion capture system associated with force platforms allows the quantification of the complex walking disorders, to look for the cause, as well as side effects such as compensation strategies. According to the 2006 report of the French National Authority for Health, the 3D analysis of walking is essential in chronic pathologies to evaluate and quantify gait disorders. This analysis allows the functional follow-up of the patients throughout their rehabilitation. Some studies, on a small and heterogeneous population of MS patients, showed changes during the walking concerning spatiotemporal, kinematic, dynamic parameters and muscular activation of lower limbs at early stages of the disease. Only two studies evaluate the joint power during walking in MS patients. However, these studies have some limits. The 3D analysis of the walking proposed in this study would allow the biomechanical characterization of the gait impairments of MS patients through tasks such as walking, gait initiation and orthostatic posture. This methodology would contribute to adapt treatments and the rehabilitation care, at an early stage of the disease. From a functional point of view, the gait initiation is an interesting dynamic task to be evaluated. Indeed, it represents the transition between the upright posture and the stabilized walking. Throughout this complex task, a stereotypical motor program is set up during a first phase of anticipatory postural adjustments, which allows the creation of dynamic conditions essential for the execution of the first step. The gait initiation is little documented for MS patients despite the risk of fall clinically highlighted. The articular power during the gait initiation was never estimated in MS patients. On the other hand, there is no study establishing correlations between the Expanded Disability Status Scale functional features and the impairments of the gait initiation.

Official Title
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Biomechanical Characterization of the Locomotion in Multiple Sclerosis Patients : Determination of Indicators of the Premature Degradation of the Orthostatic Posture, Gait Initiation and Walking

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Diagnostic Test: Motion Analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for MS patients : EDSS < 4.5 Stable disease for at least 6 weeks No injection of botulinum toxin in the past 4 months no specific inclusion criteria for healthy volunteers Exclusion Criteria for MS patients : Neurological disease other than MS Disabling pathologies of the locomotor apparatus Non-stabilized Respiratory, Cardiovascular disease Pregnant or breastfeeding women Patient with cognitive impairment Recent modification of MS treatment (<3 months) Exclusion Criteria for Healthy Volunteers : Neurological disease Rheumatological disease Sprain of the lower limbs in the last 3 months Fracture of the lower limbs in the last year Pregnant or breastfeeding women

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Multiple sclerosis patients<br>Analysis of orthostatic posture, initiation of walking and walking in MS patients with an EDSS between 0 and 4 (included) by a motion analysis system | Diagnostic Test: Motion Analysis<br>* Analysis of orthostatic posture, initiation of walking and walking by a motion analysis system<br>|
| Healthy volunteers<br>Analysis of orthostatic posture, initiation of walking and walking in a group of healthy volunteers | Diagnostic Test: Motion Analysis<br>* Analysis of orthostatic posture, initiation of walking and walking by a motion analysis system<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinematics of lower limbs articulations | Kinematics of lower limbs will be performed by a motion analysis system. The analysis will be carried out with 4 infrared cameras, 2 force platforms, an electromyographic recording system, a computer system for signal analysis and data management. The optoelectronic system used is the 3D Vicon® system, which is based on passive stereovision. motive tasks (orthostatic posture, walking initiation, and the walking). | at inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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3D analysis, Biomarkers, Rehabilition, Locomotion