Energetic Cost of Walking and Its Physiological Correlates in Persons With Multiple Sclerosis Who Have Moderate Mobility Disability

Background Persons with multiple sclerosis (pwMS) experience walking impairments, characterized by decreased walking speeds. In healthy subjects, the self-selected walking speed is the energetically most optimal. In pwMS, the energetically most optimal walking speed remains underexposed. Therefore, this review aimed to determine the relationship between walking speed and energetic cost of walking (Cw) in pwMS, compared with healthy subjects, thereby assessing the walking speed with the lowest energetic cost. As it is unclear whether the Cw in pwMS differs between overground and treadmill walking, as reported in healthy subjects, a second review aim was to compare both conditions. Method PubMed and Web of Science were systematically searched. Studies assessing pwMS, reporting walking speed (converted to meters per second), and reporting oxygen consumption were included. Study quality was assessed with a modified National Heart, Lung and Blood Institute checklist. The relationship between Cw and walking speed was calculated with a second-order polynomial function and compared between groups and conditions. Results Twenty-nine studies were included (n = 1535 pwMS) of which 8 included healthy subjects (n = 179 healthy subjects). PwMS showed a similar energetically most optimal walking speed of 1.44 m/s with a Cw of 0.16, compared with 0.14 mL O2/kg/m in healthy subjects. The most optimal walking speed in treadmill was 1.48 m/s, compared with 1.28 m/s in overground walking with a similar Cw. Conclusion Overall, the Cw is elevated in pwMS but with a similar energetically most optimal walking speed, compared with healthy subjects. Treadmill walking showed a similar most optimal Cw but a higher speed, compared with overground walking.

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Pilot randomized controlled trial of functional electrical stimulation cycling exercise in people with multiple sclerosis with mobility disability

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2018.08.020 ◽

2018 ◽

Vol 26 ◽

pp. 103-111 ◽

Cited By ~ 8

Author(s):

Thomas Edwards ◽

Robert W. Motl ◽

Emerson Sebastião ◽

Lara A. Pilutti

Keyword(s):

Multiple Sclerosis ◽

Randomized Controlled Trial ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Controlled Trial ◽

Mobility Disability ◽

Cycling Exercise ◽

Randomized Controlled ◽

Pilot Randomized Controlled Trial

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Living With Multiple Sclerosis in New South Wales, Australia, at the Beginning of the 21st Century: Impact of Mobility Disability

International Journal of MS Care ◽

10.7224/1537-2073-8.1.19 ◽

2006 ◽

Vol 8 (1) ◽

pp. 19-30 ◽

Cited By ~ 8

Author(s):

K.L. Tribe ◽

W.A. Longley ◽

G. Fulcher ◽

R.J. Faine ◽

L. Blagus ◽

...

Keyword(s):

Multiple Sclerosis ◽

New South ◽

New South Wales ◽

Full Time ◽

Mobility Disability ◽

Initial Report ◽

Personal Support ◽

South Wales ◽

Part Time ◽

Full Time Employment

This article is the initial report on the Multiple Sclerosis (MS) Society of New South Wales (NSW) Client Census Database study, a telephone-based cohort study of registered clients of the society in 2001. The final database sample comprised 2618 respondents with a diagnosis of MS from the registered client database, representing 73% of this target client population and an estimated 70% of all people with MS in NSW, Australia. The mean age was 49 years, and mean time since diagnosis was 11 years, with 36% diagnosed in the past 5 years. Approximately three-quarters (74%) were women. The mobility disability profile of the sample covered the entire spectrum, with half reporting being able to walk without a mobility aid and only 17% being confined to a wheelchair. The average age of respondents confined to a wheelchair was 56 years. Most respondents reported other MS symptoms they felt were disabling, such as fatigue and abnormal sensory symptoms. Most were living with a partner or spouse but were less likely to be living with children in the family home than the general NSW population. Only 5% were living in supported accommodations. Only a third of respondents were employed, with greater levels of disability leading to greater levels of unemployment—full-time employment being more adversely affected than part time and men being more disadvantaged than women with MS compared with their general NSW population counterparts. Essential medical care and personal support needs were mostly well met but less reliably so for the most severely disabled respondents and those living farther from major cities. The most frequently reported unmet needs were for breaks from home and employment support. Less than half of the sample reported being on immunotherapy. Those who were on immunotherapy were more likely to be women, employed part time, and experiencing only mild or moderate mobility disability.

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