Biomechanical disorders of foot in multiple sclerosis.

Multiple sclerosis (MS) has a multifactorial etiology located at the interaction point of environmental factors--nutritional, geographic, infectious, etc.--with genetic factors, which confers susceptibility to disease or alters its development. This research presents a case study focused on complex assessment of a patient using clinical and functional assessment, biomechanical gait evaluation using RSScan force plate. Biomechanical parameters (contact area, load, impulse, force, pressure, foot balance) are the parameters that we obtain after force plate measurements. Analyzing the results of the functional assessment, it is found an anatomical functional abnormality with a tendency to increase. Biomechanical tests show an asymmetric gait due to the impact of neurological disorders generated in the proprioceptive system. Global analysis of values (surface contact, pressure, force, load, impulse, active contact area) indicates the fact that there is a tendency to develop a higher pressure in the anterior-medial region of the plant in an attempt to maintain balance. It is a tendency to increase the active contact area in the forefoot region; this increase is explained by the body tendency to develop compensatory mechanisms to maintain balance.

Morphofunctional aspects of lower limb in multiple sclerosis.

Gait, as an expression of the locomotive system, needs a complex biomechanical analysis, which allows the description of multiple sclerosis (MS) specific patterns, MS patients having a polymorphism of motion patterns. The studied group consisted of 13 MS patients with gait disorders, average age of the group was of 36 years. The evaluation of the subjects comprises: clinical evaluation (anamnesis, neurological examination), paraclinical evaluation (MRI), functional evaluation, neuro-physiologic evaluation and biomechanical evaluation. Biomechanical examination was completed using the force and pressure-measuring platform of plantar pressure distribution Footscan Scientific Version, RSscan. The studied parameters were: contact area, active contact area, heel rotation, foot balance, foot angle. The evaluated zones during a gait cycle were: the heel, medial foot, antefoot. Although the analysis of contact area in the lateral foot did not show any significant differences between the right and the left foot, it nonetheless underlined a major difference in the expression of maximum and minimum values, which meant that MS patients with clinically detectable gait disorders had a tendency to increase contact area to maintain balance. Examining the foot positions in relation to the movement direction and to the foot vertical axis, we noticed the existence of certain elements indicating an orientation tendency of the foot. This tendency had to be related to neutral position (corresponding to anatomical position) of the foot. We also noticed a foot deviation in abduction, associated with visible pronation and decrease of the contact area corresponding to medial plantar zone.

Neuromuscular assessment in the study of structural changes of striated muscle in multiple sclerosis.

UNLABELLED: The aim of this research is to present the results of neuromuscular assessment using tensiomyography (TMG) in multiple sclerosis for prediction the muscle changes. This study consists of 20 patients, selected conform to certain criteria. Thus, according to diagnosis and MS level, the studied group was divided into two subgroups: subgroup A, consisting of 13 MS patients with clinically detectable gait disorders, and subgroup B, made up of seven MS patients without clinically detectable gait disorders. TMG determines the diagnosis of a certain muscular type and muscular status÷condition (fatigue, stress influence on the body, etc.), the diagnosis of a functional muscular symmetry. The investigation has been performed on the shank muscles. The parameters evaluated through TMG were: contraction time (Tc) and the amplitude of muscular displacement in transverse direction - Dm (mm) a parameter which is also correlated with Tc values and depends on the flexibility of muscular tissue. RESULTS: Dm in the case of gastrocnemius muscles (mG) data analysis shows an evolution of functional bilateral right-left asymmetry, which is more pronounced in subgroup A. At the level of posterior shank, Dm values in subgroup A are lower, which means that patients in subgroup A have a higher muscular tone and a maximum response to stimulation. Concerning Tc values, this parameter indicates muscular fatigue at the level of anterior tibialis. CONCLUSIONS: TMG, besides classical methods of paraclinical investigation, improves data generation, standardization, identifies correlations, which may facilitate a precocious diagnosis in morphofunctional changes evolution at muscular level at MS patients.