ABSTRACT
OBJECTIVE: To measure the knee range of motion (ROM) in the sagittal plane by video analysis in patients with multiple sclerosis (MS) after a course of medical rehabilitation and determine the minimal clinically important differences (MCID). MATERIAL AND METHODS: We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary-progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded on video analysis system Physiomed Smart («Physiomed¼, Germany, the Davis protocol). RESULTS: The course of complex medical rehabilitation contributes to an increase knee ROM in MS patients in a wide range of disability (EDSS <6.5 points). MCID is estimated as 7.14° in mild (EDSS ≤4.0) and as 7.67° in moderate (EDSS=4.5-5.5) gait impairment. CONCLUSION: The results will assist clinicians and researchers in interpreting the significance of observed kinematic changes in the knee joint in MS patients after medical intervention.
Subject(s)
Multiple Sclerosis, Chronic Progressive , Multiple Sclerosis, Relapsing-Remitting , Multiple Sclerosis , Male , Humans , Female , Knee Joint , Gait , Range of Motion, ArticularABSTRACT
The most common and important consequence of multiple sclerosis (MS) is impaired walking, which limits daily activities and increases the risk of falling. This article provides an overview of the main non-pharmacological methods of medical rehabilitation of gait disorders in people with MS (aerobic and strength training, robotic technologies, orthotics and functional electrical stimulation), which have an evidence base on systematic reviews and meta-analyses. Special attention is paid to the approach to rehabilitation in people with severe disabilities. Methods for determining gait parameters using tests and high-tech devices are considered, which serve as the basis for the routine assessment of the domains of the International Classification of Functioning (ICF) and the effectiveness of interventions.
