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Jessie M. Huisinga, Mary L. Filipi and Nicholas Stergiou

Postural disturbances are one of the first reported symptoms in patients with Multiple Sclerosis (MS). The purpose of this study was to investigate the effect of supervised resistance training on postural control in MS patients. Postural control was assessed using amount of sway variability [Root Mean Square (RMS)] and temporal structure of sway variability [Lyapunov Exponent (LyE)] from 15 MS patients. Posture was evaluated before and after completion of three months of resistance training. There were significant differences between MS patients pretraining and healthy controls for both LyE (p = .000) and RMS (p = .002), but no differences between groups after training. There was a significant decrease in RMS (p = .025) and a significant increase in LyE (p = .049) for MS patients pre- to posttraining. The findings suggested that postural control of MS patients could be affected by a supervised resistance training intervention.

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Jessie M. Huisinga, Kendra K. Schmid, Mary L. Filipi and Nicholas Stergiou

Patients with multiple sclerosis (MS) experience abnormal gait patterns and reduced physical activity. The purpose of this study was to determine if an elliptical exercise intervention for patients with MS would change joint kinetics during gait toward healthy control values. Gait analysis was performed on patients with MS (n = 24) before and after completion of 15 sessions of supervised exercise. Joint torques and powers were calculated, while also using walking velocity as a covariate, to determine the effects of elliptical exercise on lower extremity joint kinetics during gait. Results show that elliptical exercise significantly altered joint torques at the ankle and hip and joint powers at the ankle during stance. The change in joint power at the ankle indicates that, after training, patients with MS employed a walking strategy that is more similar to that of healthy young adults. These results support the use of elliptical exercise as a gait training tool for patients with MS.

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Jessie M. Huisinga, Kendra K. Schmid, Mary L. Filipi and Nicholas Stergiou

Multiple sclerosis (MS) causes severe gait problems in relatively young individuals, yet there have been limited studies to quantitatively identify the specific gait parameters that are affected. The purpose of this study was to define any differences in biomechanical gait parameters between patients with MS and healthy controls. A total of 31 MS patients and 31 healthy controls were evaluated: joint torques and joint powers were calculated at the ankle, knee, and hip during the stance phase of gait. The self-selected walking velocity was used as a covariate in the analysis to ensure that group differences were not due to differences in walking velocity between the MS and healthy control groups. Reduced angular range, less joint torque, and reduced joint power were seen in patients with MS. We also found significant correlations between biomechanical gait parameters and EDSS score, which provides a clinical rating of disease severity. Our findings provide a quantitative assessment of the gait mechanics employed in patients with MS. The altered lower extremity mechanics observed in patients with MS reflect both a neurological and strength deficit compared with healthy controls during walking.