BIOMS Doctoral Dissertation Defense
Wednesday, January 25, 2006 at 3:15pm CSB 003
Stephanie J. Crenshaw Marchesi
Advisor: Royer
Title: Effects of Fatigue and Disease Severity on Gait Mechanics in Subjects with
Multiple Sclerosis
Abstract:
Multiple sclerosis (MS), an autoimmune disease of the central nervous system,
affects approximately 400,000 Americans. The disease is characterized by
breakdown of myelin, the protective sheath surrounding nerves. Symptoms of
MS can be sensory and/or motor and depend on the location of the broken down
myelin patches (called lesions). Symptoms vary both within and between
patients with MS, making the disease progress highly variable. The most
common symptom complaints are fatigue and difficulty walking. Fatigue often
increases throughout the day, making walking even more difficult. The high
degree of variability due to both symptoms and fatigue may make it difficult to
track changes over time.
The proposed research plan aims to determine the effects of fatigue and disease
severity on gait in subjects with Multiple Sclerosis. We want to know if the
variable nature of the disease affects gait mechanics and whether the changes
are related to fatigue. Prior work has suggested that discrete parameters and
variability measures might not be sufficient to distinguish among the different
levels of fatigue and disease severity. Therefore, a new analysis method was
developed in order to assess joint symmetry and normalcy values. The analysis
method utilizes the entire waveform to compare two limbs to determine symmetry
(the two limbs are intra-subject) and normalcy (the two limbs inter-subject).
The aims of the study are:
1. To determine the differences in gait between subjects with Multiple Sclerosis
and healthy controls
2. To determine the effects of fatigue on gait parameters in subjects with MS
3. To determine the relationship between disease severity and gait patterns in
subjects with MS
4. To determine the relationship between disease severity and change from fresh
to fatigue
Thirty subjects with MS and thirty healthy control subjects will participate in this
study. Subjects will be tested on a treadmill walking at a self-selected
comfortable pace. A three dimensional gait analysis with will be conducted for
each subject under both fresh and fatigued conditions.