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 O 2 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 ), O 2 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.