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09.01.2020 | Invited Review

Comfortable walking speed and energy cost of locomotion in patients with multiple sclerosis

verfasst von: Alex Buoite Stella, Maria Elisa Morelli, Fabiola Giudici, Arianna Sartori, Paolo Manganotti, Pietro Enrico di Prampero

Erschienen in: European Journal of Applied Physiology | Ausgabe 3/2020

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Abstract

Comfortable walking speed and energy cost of walking are physiological markers of metabolic activity during gait. People with multiple sclerosis are characterized by altered gait biomechanics and energetics, related to the degree of disability and spasticity, which lead to an increased energy cost of walking. Several studies concerning the energy cost of walking in multiple sclerosis have been published. Nevertheless, differences in protocols and characteristics of the sample have led to different outcomes. The aim of the present meta-analysis is to summarize results from studies with specific inclusion characteristics, and to present data about the comfortable walking speed and the energy cost of walking at that speed. Moreover, a detailed discussion of the potential mechanisms involved in the altered metabolic activity during exercise was included. A total of 19 studies were considered, 12 of which were also part of the quantitative analysis. Despite the strict selection process, high between-group heterogeneity was found for both outcomes. Nevertheless, the overall results suggest a pooled mean comfortable walking speed of 1.12 m/s (95% CI 1.05–1.18) and energy cost of 0.19 mLO₂/kg/m (95% CI 0.17–0.21). These findings support the results of previous studies suggesting that energy cost of walking may be increased by 2–3 times compared to healthy controls (HC), and encourage the use of this marker in association with other parameters of the disease.

Agiovlasitis S, Motl RW, Fernhall B (2010) Prediction of oxygen uptake during level treadmill walking in people with multiple sclerosis. J Rehabil Med 42(7):650–655. https://doi.org/10.2340/16501977-0570 CrossRefPubMed

Agiovlasitis S, Motl RW (2016) Cross-validation of oxygen uptake prediction during walking in ambulatory persons with multiple sclerosis. Neurorehabilitation 38:191–197. https://doi.org/10.3233/NRE-161310 CrossRefPubMed

American College of Sports Medicine (2009) ACSM’s Guidelines for exercise testing and prescription, 8th edn. Lippincott Williams & Wilkins, Baltimore

Cavagna GA, Thys H, Zamboni A (1976) The sources of external work in level walking and running. J Physiol 262:639–657. https://doi.org/10.1113/jphysiol.1976.sp011613 CrossRefPubMedPubMedCentral

Cavagna GA, Heglund NC, Taylor CR (1977) Mechanical work in terrestrial locomotion: two basic mechanisms for minimizing energy expenditure. Am J Physiol 233:R243–R261. https://doi.org/10.1152/ajpregu.1977.233.5.R243 CrossRefPubMed

Chaseling GK, Filingeri D, Barnett M, Hoang P, Davis SL, Jay O (2018) Cold water ingestion improves exercise tolerance of heat-sensitive people with MS. Med Sci Sports Exerc 50(4):643–648CrossRefPubMed

Chung LH, Remelius JG, van Emmerik REA, Kent-Braun JA (2008) Leg Power Asymmetry and Postural Control in Women with Multiple Sclerosis. Med Sci Sport Exerc 40:1717–1724. https://doi.org/10.1249/MSS.0b013e31817e32a3 CrossRef

Chung LH, Angelo J, van Emmerik REA, Kent JA (2016) Energy cost of walking, symptomatic fatigue and perceived exertion in persons with multiple sclerosis. Gait Posture 48:215–219. https://doi.org/10.1016/j.gaitpost.2016.05.005 CrossRefPubMed

Davis SL, Jay O, Wilson TE (2018) Thermoregulatory dysfunction in multiple sclerosis. Handb Clin Neurol 157:701–714CrossRefPubMed

Davis SL, Wilson TE, White AT, Frohman EM (2010) Thermoregulation in multiple sclerosis. J Appl Physiol 109:1531–1537. https://doi.org/10.1152/japplphysiol.00460.2010 CrossRefPubMedPubMedCentral

Dawes H, Collett J, Ramsbottom R et al (2004) Measuring oxygen cost during level walking in individuals with acquired brain injury in the clinical setting. J Sports Sci Med 3:76–82PubMedPubMedCentral

Devasahayam AJ, Kelly LP, Wallack EM, Ploughman M (2019) Oxygen cost during mobility tasks and its relationship to fatigue in progressive multiple sclerosis. Arch Phys Med Rehabil. https://doi.org/10.1016/j.apmr.2019.03.017 CrossRefPubMed

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634. https://doi.org/10.1136/bmj.315.7109.629 CrossRefPubMedPubMedCentral

Falconer K, Winter DA (1985) Quantitative assessment of co-contraction at the ankle joint in walking. Electromyogr Clin Neurophysiol 25(2–3):135–149PubMed

Franceschini M, Rampello A, Bovolenta F et al (2010) Cost of wallking, exterional dyspnea and fatigue in individuals with multiple sclerosis not requiring assistive devices. J Rehabil Med 42:719–723. https://doi.org/10.2340/16501977-0600 CrossRefPubMed

Franceschini M, Rampello A, Agosti M et al (2013) Walking performance: correlation between energy cost of walking and walking participation. new statistical approach concerning outcome measurement. PLoS ONE. https://doi.org/10.1371/journal.pone.0056669 CrossRefPubMedPubMedCentral

Grahn DA, Murray J, Heller HC (2008) Cooling via one hand improves physical performance in heat-sensitive individuals with Multiple Sclerosis: a preliminary study. BMC Neurol 8(1):14CrossRefPubMedPubMedCentral

Haugen HA, Chan L-N, Li F (2007) Indirect calorimetry: a practical guide for clinicians. Nutr Clin Pract 22:377–388. https://doi.org/10.1177/0115426507022004377 CrossRefPubMed

Hesse S, Krajnik J, Luecke D et al (1996) Ankle muscle activity before and after botulinum toxin therapy for lower limb extensor spasticity in chronic hemiparetic patients. Stroke 27:455–460. https://doi.org/10.1161/01.str.27.3.455 CrossRefPubMed

Hesse S, Konrad M, Uhlenbrock D (1999) Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects. Arch Phys Med Rehabil 80:421–427. https://doi.org/10.1016/s0003-9993(99)90279-4 CrossRefPubMed

Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560. https://doi.org/10.1136/bmj.327.7414.557 CrossRefPubMedPubMedCentral

Higgins J, Altman D, Sterne J (2011) Chapter 8: Assessing risk of bias in included studies. In: Higgins J, Green S (eds) Handbook for Systematic Reviews of Interventions, 5.1.0

Humm AM, Beer S, Kool J et al (2004) Quantification of Uhthoff’s phenomenon in multiple sclerosis: a magnetic stimulation study. Clin Neurophysiol 115:2493–2501. https://doi.org/10.1016/j.clinph.2004.06.010 CrossRefPubMed

Jeng B, Sandroff BM, Motl RW (2018) Energetic cost of walking and spasticity in persons with multiple sclerosis with moderate disability. NeuroRehabilitation 43:483–489. https://doi.org/10.3233/NRE-182498 CrossRefPubMed

Kalron A, Menascu S, Frid L et al (2019) Physical activity in mild multiple sclerosis : contribution of perceived fatigue, energy cost, and speed of walking. Disabil Rehabil 0:1–7. https://doi.org/10.1080/09638288.2018.1519603 CrossRef

Kelleher KJ, Spence W, Solomonidis S, Apatsidis D (2010) The characterisation of gait patterns of people with multiple sclerosis. Disabil Rehabil 32:1242–1250. https://doi.org/10.3109/09638280903464497 CrossRefPubMed

Kempen JCE, De GV, Knol DL (2012) Self-Reported Fatigue and Energy Cost During Walking Are. YAPMR 93:889–895. https://doi.org/10.1016/j.apmr.2011.12.013 CrossRef

Kent-Braun JA, Ng AV, Castro M et al (1997) Strength, skeletal muscle composition, and enzyme activity in multiple sclerosis. J Appl Physiol 83:1998–2004. https://doi.org/10.1152/jappl.1997.83.6.1998 CrossRefPubMed

Ketelhut NB, Kindred JH, Manago MM et al (2015) Core muscle characteristics during walking of patients with multiple sclerosis. J Rehabil Res Dev 52:713–724. https://doi.org/10.1682/jrrd.2015.01.0006 CrossRefPubMed

Khurana S, Beranger A, Felix E (2017) Perceived exertion is lower when using a functional electrical stimulation neuroprosthesis compared with an ankle-foot orthosis in persons with multiple sclerosis a preliminary study. Am J Phys Med Rehabil 96:133–139. https://doi.org/10.1097/PHM.0000000000000626 CrossRefPubMed

Kitatani R, Ohata K, Hashiguchi Y et al (2016) Clinical factors associated with ankle muscle coactivation during gait in adults after stroke. NeuroRehabilitation 38:351–357. https://doi.org/10.3233/NRE-161326 CrossRefPubMed

Knutsson E, Richards C (1979) Different types of disturbed motor control in gait of hemiparetic patients. Brain 102:405–430. https://doi.org/10.1093/brain/102.2.405 CrossRefPubMed

Kottink AIR, Oostendorp LJM, Buurke JH et al (2004) The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: a systematic review. Artif Organs 28:577–586. https://doi.org/10.1111/j.1525-1594.2004.07310.x CrossRefPubMed

Krupp L (2006) Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Mult. Scler. 12:367–368CrossRefPubMed

Lanzetta D, Cattaneo D, Pellegatta D, Cardini R (2004) Trunk control in unstable sitting posture during functional activities in healthy subjects and patients with multiple sclerosis. Arch Phys Med Rehabil 85:279–283CrossRefPubMed

Lefeber N, De Buyzer S, Dassen N et al (2019) Energy consumption and cost during walking with different modalities of assistance after stroke: a systematic review and meta-analysis. Disabil Rehabil 0:1–17. https://doi.org/10.1080/09638288.2018.1531943 CrossRef

Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700. https://doi.org/10.1136/bmj.b2700 CrossRefPubMedPubMedCentral

Llewellyn M, Yang JF, Prochazka A (1990) Human H-reflexes are smaller in difficult beam walking than in normal treadmill walking. Exp Brain Res. https://doi.org/10.1007/BF00232189 CrossRefPubMed

Malagoni AM, Felisatti M, Lamberti N et al (2013) Muscle oxygen consumption by NIRS and mobility in multiple sclerosis patients. BMC Neurol 13:1. https://doi.org/10.1186/1471-2377-13-52 CrossRef

Martin CL, Phillips BA, Kilpatrick TJ et al (2006) Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler 12:620–628. https://doi.org/10.1177/1352458506070658 CrossRefPubMed

Miller L, Rafferty D, Paul L, Mattison P (2016) The impact of walking speed on the effects of functional electrical stimulation for foot drop in people with multiple sclerosis. Disabil Rehanil Assist Technol. https://doi.org/10.3109/17483107.2015.1027296 CrossRef

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097 CrossRefPubMedPubMedCentral

Motl RW, Dlugonski D, Suh Y et al (2010a) Accelerometry and Its Association With Objective Markers of Walking Limitations in Ambulatory Adults With Multiple Sclerosis. Arch Phys Med Rehabil 91:1942–1947. https://doi.org/10.1016/j.apmr.2010.08.011.Accelerometry CrossRefPubMedPubMedCentral

Motl RW, Dlugonski D, Suh Y et al (2010b) Gait and posture multiple sclerosis walking scale-12 and oxygen cost of walking. Gait Posture 31:506–510. https://doi.org/10.1016/j.gaitpost.2010.02.011 CrossRefPubMed

Motl RW, Hall F, Ave SG et al (2011) Oxygen cost of treadmill and over-ground walking in mildly disabled persons with multiple sclerosis. Neurol Sci 32:255–262. https://doi.org/10.1007/s10072-010-0396-0.Oxygen CrossRefPubMed

Motl RW, Sandroff BM, Suh Y, Sosnoff JJ (2012) Energy cost of walking and its association with gait parameters, daily activity, and fatigue in persons with mild multiple sclerosis. Neurorehabil Neural Repair 26:1015–1021. https://doi.org/10.1177/1545968312437943 CrossRefPubMed

Motl RW, Pilutti L, Sandroff BM et al (2013) Accelerometry as a measure of walking behavior in multiple sclerosis. Acta Neurol Scand 127:384–390. https://doi.org/10.1111/ane.12036 CrossRefPubMed

Newman MA (2007) Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study. Mult Scler 13:113–119. https://doi.org/10.1177/1352458506071169 CrossRefPubMed

Nilsagård Y, Denison E, Gunnarsson L-G (2006) Evaluation of a single session with cooling garment for persons with multiple sclerosis – a randomized trial. Disabil Rehabil Assist Technol 1(4):225–233CrossRefPubMed

Olgiati R, Jacquet J, Di Prampero PE (1986) Energy cost of walking and exertional dyspnea in multiple sclerosis. Am Rev Respir Dis 134:1005–1010. https://doi.org/10.1164/arrd.1986.134.5.1005 CrossRefPubMed

Olgiati R, Burgunder JM, Mumenthaler M (1988) Increased energy cost of walking in multiple sclerosis: effect of spasticity, ataxia, and weakness. Arch Phys Med Rehabil 69:846–849PubMed

Paling D, Golay X, Wheeler-Kingshott C et al (2011) Energy failure in multiple sclerosis and its investigation using MR techniques. J Neurol 258:2113–2127. https://doi.org/10.1007/s00415-011-6117-7 CrossRefPubMed

Pandyan AD, Johnson GR, Price CIM, Curless RH, Barnes MP, Rodgers H (1999) A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clin Rehabil 13(5):373–383CrossRefPubMed

Pau M, Coghe G, Corona F et al (2015) Effect of spasticity on kinematics of gait and muscular activation in people with multiple sclerosis. J Neurol Sci 358:339–344. https://doi.org/10.1016/j.jns.2015.09.352 CrossRefPubMed

Paul L, Rafferty D, Young S et al (2008) The effect of functional electrical stimulation on the physiological cost of gait in people with multiple sclerosis. J Neurol Sci. https://doi.org/10.1177/1352458508090667 CrossRef

Perry J, Waters RL, Perrin T (1978) Electromyographic analysis of equinovarus following stroke. Clin Orthop Relat Res 131:47–53

Pilutti LA, Dlugonski D, Pula JH, Motl RW (2012) Weight Status in Persons with multiple sclerosis: implications for mobility outcomes. J Obes 2012:868256. https://doi.org/10.1155/2012/868256 CrossRefPubMedPubMedCentral

Psarakis M, Greene D, Cole MH et al (2018) Wearable technology reveals gait compensations, unstable walking patterns and fatigue in people with Multiple Sclerosis. Physiol Meas. https://doi.org/10.1088/1361-6579/aac0a3 CrossRefPubMed

Ralston HJ (1958) Energy-speed relation and optimal speed during level walking. Int Z Angew Physiol 17:277–283PubMed

Remelius JG, Hamill J, Kent-Braun J, Van Emmerik REA (2008) Gait initiation in multiple sclerosis. Mot Control 12:93–108CrossRef

Renfrew LM, Paul L, Mcfadyen A et al (2019) The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial. Clin Rehabil 33(7):1150–1162. https://doi.org/10.1177/0269215519842254 CrossRefPubMed

Reynolds LF, Short CA, Westwood DA, Cheung SS (2011) Head pre-cooling improves symptoms of heat-sensitive multiple sclerosis patients. Can J Neurol Sci 38(1):106–111CrossRefPubMed

Rizzo MA, Hadjimichael OC, Preiningerova J, Vollmer TL (2004) Prevalence and treatment of spasticity reported by multiple sclerosis patients. Mult Scler 10:589–595. https://doi.org/10.1191/1352458504ms1085oa CrossRefPubMed

Rosa MCN, Marques A, Demain S, Metcalf CD (2014) Lower limb co-contraction during walking in subjects with stroke: a systematic review. J Electromyogr Kinesiol 24:1–10. https://doi.org/10.1016/j.jelekin.2013.10.016 CrossRefPubMed

Sandroff BM, Klaren RE, Pilutti LA, Motl RW (2014) Oxygen cost of walking in persons with multiple sclerosis: disability matters, but why? Mult Scler Int 2014:162765. https://doi.org/10.1155/2014/162765 CrossRefPubMedPubMedCentral

Sebastião E, Bollaert RE, Hubbard EA, Motl RW (2018) Gait variability and energy cost of oveground walking in persons with multiple sclerosis. Am J Phys Med Rehabil 97:646–650. https://doi.org/10.1097/PHM.0000000000000935 CrossRefPubMed

Sheean GL, Murray NM, Rothwell JC et al (1997) An electrophysiological study of the mechanism of fatigue in multiple sclerosis. Brain 2:299–315. https://doi.org/10.1093/brain/120.2.299 CrossRef

Sosnoff JJ, Gappmaier E, Frame A, Motl RW (2011) Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther 35:129–132. https://doi.org/10.1097/NPT.0b013e31822a8c40 CrossRefPubMed

Stoeckmann TM, Sullivan KJ, Scheidt RA (2009) Elastic, viscous, and mass load effects on poststroke muscle recruitment and co-contraction during reaching: a pilot study. Phys Ther 89:665–678. https://doi.org/10.2522/ptj.20080128 CrossRefPubMedPubMedCentral

Tantucci C, Massucci M, Piperno R et al (1996) Energy cost of exercise in multiple sclerosis patients with low degree of disability. Mult Scler 2:161–167. https://doi.org/10.1177/135245859600200307 CrossRefPubMed

Thompson AJ, Baranzini SE, Geurts J et al (2018) Multiple sclerosis. Lancet 391:1622–1636. https://doi.org/10.1016/S0140-6736(18)30481-1 CrossRefPubMed

Thoumie P, Lamotte D, Cantalloube S et al (2005) Motor determinants of gait in 100 ambulatory patients with multiple sclerosis. Mult Scler 11:485–491. https://doi.org/10.1191/1352458505ms1176oa CrossRefPubMed

Tucker MG, Kavanagh JJ, Barrett RS, Morrison S (2008) Age-related differences in postural reaction time and coordination during voluntary sway movements. Hum Mov Sci 27:728–737. https://doi.org/10.1016/j.humov.2008.03.002 CrossRefPubMed

van der Walt WH, Wyndham CH (1973) An equation for prediction of energy expenditure of walking and running. J Appl Physiol 34:559–563. https://doi.org/10.1152/jappl.1973.34.5.559 CrossRefPubMed

Viswanathan M, Ansari MT, Berkman ND, et al (2008) Assessing the risk of bias of individual studies in systematic reviews of health care interventions. Rockville (MD)

Waters RL, Mulroy S (1999) The energy expenditure of normal and pathologic gait. Gait Posture 9:207–231CrossRefPubMed

Waters RL, Hislop HJ, Perry J, Antonelli D (1978) Energetics: application to the study and management of locomotor disabilities. Energy cost of normal and pathologic gait. Orthop Clin North Am 9:351–356PubMed

White AT, Vanhaitsma TA, Vener J, Davis SL (2013) Effect of passive whole body heating on central conduction and cortical excitability in multiple sclerosis patients and healthy controls. J Appl Physiol 114:1697–1704. https://doi.org/10.1152/japplphysiol.01119.2012 CrossRefPubMedPubMedCentral

Zamparo P, Pagliaro P (1998) The energy cost of level walking before and after hydro-kinesi therapy in patients with spastic paresis. Scand J Med Sci Sports 8(4):222–8CrossRefPubMed

Titel: Comfortable walking speed and energy cost of locomotion in patients with multiple sclerosis
verfasst von: Alex Buoite Stella
Maria Elisa Morelli
Fabiola Giudici
Arianna Sartori
Paolo Manganotti
Pietro Enrico di Prampero
Publikationsdatum: 09.01.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Applied Physiology / Ausgabe 3/2020
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-019-04295-3

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