Gait Parameters with and without Balance-Based Torso Weighting (BBTW)
in People with Multiple Sclerosis (PwMS)
Anna-Maria
1Kinesiology
1
Gorgas,
Department SFSU,
Introduction
● Up to 85% of PwMS experience balance and walking
impairments related to muscle weakness, ataxia, or
spasticity
● These impairments can cause frequent falls and
limitations in activities and participation in daily life.1
● Evidence suggests that sensori-motor control is a
crucial parameter for maintaining stability during gait.
● The purpose of this study was to highlight effects of
BBTW on spatio-temporal gait parameters in PwMS.
Gail L.
2Samuel
2
Widener,
2
Gibson-Horn,
Cynthia
Merritt University,
3Graduate
Diane D.
Program in Physical Therapy UCSF/SFSU
Discussion
● Data collection and analysis:
● Participants walked across a 26-foot GaitRite
instrumented gait mat
● The gait mat is computerized with sensors
arranged in a grid-like pattern to identify the
pressure applied by each foot as it steps
● The software program calculates multiple spatiotemporal parameters of the person’s gait,
averaged across all steps for a particular trial
● The increase in velocity in our sample was not
considered clinically significant at less than 3%.
● The change confirms previous studies recording
immediate velocity improvement with BBTW in PwMS
with more significant gait impairments (average
unweighted fast-walk velocity 110 cm/sec).2-4
● Our data provide insight regarding the gait parameters
that change along with velocity (SLS, DLS) in PwMS
even when they have minimal gait dysfunction.
● Dependent variables
● Parameters of interest included velocity, cadence,
step length, between-foot support base, and the
percentage of the gait cycle spent in single and
double limb support
● The present study approach differs from previous
research in the following points:
● Demanded walking velocity5-6
● The sample’s average age and age range5-6
● Investigation of effects of an intervention (BBTW)
on spatio-temporal gait parameters
● Statistical Analysis
● Comparisons of the means and standard deviations for
each variable based on the averaged values of the
trials without weights vs. with weights.
● Paired t-tests to evaluate differences in gait parameters
between the 2 conditions. Alpha value was set at .05.
BalanceWear
Vest
3
Allen
Conclusion
http://www.emsphysio.co.uk/32_gaitrite-platinum.htm
Methods
● Subjects: 18 volunteers (16 females, 2 males)
Age in years, mean (SD),
range
Years with diagnosis, mean
(SD)
EDSS score equivalent
Number (%) claiming falls
in the past 6 months
Number (%) female
People with MS (n=14)
Healthy controls
(n=4)
52 (13), 25-68
53 (10), 41-54
11.3 (8.8)
-
range 2-6,
10 with EDSS ≤3
-
6 (42.9)
-
13 (92.9)
3 (75)
● Procedure
● Medical questionnaire prior to data recording
● Recent fall history
● Experienced MS symptoms
● Walking trials
● Instruction: “Walk as fast as you can safely”
before each trial
● Three trials without weight applied to the vest
● Weighting procedure used the BBTW
protocol2-4
● Three trials with specifically adjusted light
weights
● Healthy controls performed additional trials
after the fast walk trials in each condition –
asked to attain the averaged velocity
walked by the matched PwMS.
● The evidence indicates that BBTW can affect gait
parameters in PwMS; these parameters may be
associated with improved balance.
Results
● In PwMS mean velocity and percentage of gait cycle in single (SLS) and
double (DLS) limb support showed statistically significant results:
● mean (SD) velocity of 182.3 (27.6) cm/sec for the weighted trials and
177.5 (26.4) cm/sec for the non-weighted trials.
● SLS averaged 41.2% (1.4) with weights and 40.8% (1.4) without
weights.
● DLS averaged 17.2 (2.9) with versus 17.9 (2.9) without weights
● Cadence, step length, and step width showed no significant difference
between the two conditions
● Without weights, none of the variables were significantly different
between PwMS and controls at matched velocities.
Variable (PwMS)
Mean ± SD
p-value
Walking w/o
weights
Walking with
weights
Velocity (cm/s)
177.5 ± 29.2
182.3 ± 28.0
˂ 0.05
Cadence (steps/min)
144.3 ± 15.0
145.9 ± 14.9
0.11
Step length (cm)
72.7 ± 6.2
73.5 ± 7.3
0.10
Base of support (cm)
11.1 ± 2.9
10.3 ± 2.0
0.14
Single support (%GC)
40.8 ± 1.4
41.2 ± 1.4
˂ 0.02
Double support (%GC)
17.9 ± 2.8
17.2 ± 2.8
˂ 0.02
Acknowledgement: This study was supported by Award Number
R15HD066397 from the Eunice Kennedy Shriver National Institute of
Child Health and Human Development. The content is solely the
responsibility of the authors and does not necessarily represent the
official views of the Eunice Kennedy Shriver National Institutes of Child
Health and Human Development or the National Institutes of Health.
References
1. Cromwell, R.L., and Newton, R.A. (2004). Relationship between
balance and gait stability in healthy older adults. Journal of Aging
and Physical Activity, 11: 90-100
2. Gibson-Horn, C. (2008). Balance-Based Torso Weighting in a
person with ataxia and multiple sclerosis: A case report. Journal of
Neurologic Physical Therapy, 32: 139-146
3. Widener, G.L., Allen, D.D., and Gibson-Horn, C. (2009). BalancedBased Torso-Weighting may enhance balance in persons with
multiple sclerosis: Preliminary evidence. Arch Phys Med Rehabil,
90: 602-609
4. Widener, G.L., Allen, D.D., and Gibson-Horn, C. (2009).
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improving upright mobility in people with multiple sclerosis.
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