Assessment of biomechanical parameters of feet in patients with multiple sclerosis during walking

Abstract

Rationale. Walking and balance disorders, modi fi ed foot muscles kinematics and walking stereotypes are typical for the patients with Multiple Sclerosis (MS).Objective. To assess the biomechanical parameters of the feet in MS patients with diff erent neurological status during walking.Material and methods. Data analysis of 102 patients with relapsing-remitting MS was carried out for two groups depending on the value of the Expanded Disability Status Scale (EDSS). Plantar pressure distribution was measured on with the pedographic platform emed, novel gmbh, Munich, Germany, using a “fi rst step” protocol.Results and conclusion. Loading of the heel, the area of central metatarsal heads is decreased and loading of the toes is increased during walking in MS patients. Diff erences were found for the spreading coeffi cient (the ratio of the width to the length of the foot), the dynamic width of the foot in patients with an EDSS ≥ 4 is signi fi cantly less in the instep, in the middle and in the narrowest parts of the foot, which leads to the decrease of the contact area. It has been shown that patients with MS who are mobile or walk without assistance are more likely to have pes cavus foot compared to MS patients with minor impairments. The load of the medial side of the foot is greater than the lateral side, which indicates the predominance of the valgus foot. The pronation-supination index is signi fi cantly higher in the patients with moderate impairments in toe-off phase. Evaluation of foot deformity based on the measurement of biomechanical parameters of plantar pressure distribution makes it possible to plan the treatment and rehabilitation tactics in MS patients.