KINESIOL 4S03 Lecture Notes - Lecture 3: Gait Training, Gait Analysis, Mcdonald Criteria
31 Jan 2017
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PURPOSE: To quantitatively assess the effects of 6 months of supervised APA that incorporates aerobic/strength
training on spatio-temporal and kinematic parameters of gait in people with MS
INTRODUCTION
• APA has been proposed as an effective approach in approving motor impairments in people with
MS/neurological disorders and is advised by physicians
○Previous studies showed improvement in CV fitness, muscle strength, mood, gait, balance, quality of life in
MS
○Previously hypothesized that APA can decrease disease progression but this requires more research
○Walking improvements is the most important because people with MS have said it’s the most disruptive
symptom and has a very big impact on their working/social life. Gait impairements impacts the disability
evaluation a lot.
• Previous evidence suggests that exercise is associated with small improvements in walking mobility (walking
speed, stride/step length, stance, swing…) especially when supervised (spatio parameters)
• Only several studies have SPECIFICALLY looked at APA on gait using OBJECTIVE QUANTITATIVE
MEASURES (e.g timed tests, human movement analysis) despire the fact that they are more sensitive to slight
changes in gait compared to functional measures
○In a few, gait is measured using Gait Analysis (3D Analysis) which is very accurate and has been used for
15+ years. It’s a combo of kinematic, kinestic and EMG data.
○Consise measures like the above one makes it easier for assess patient's status in a shorter time for
physicians, characterise gait patterns in MS, and reduce the complexity of GA output.
• The researchers hypothesized that the spatio-temporal parameters would show positive effects with respect to
untreated patients and gait kinematics would become more similar to physiological conditions.
METHODS
• 30 outpatients who were suffering from relapsing-remitting MS were informed about the study and if they met
the following criteria they were selected:
○Diagnosis of MS according to the 2005 McDonald criteria
○Age 18-65 yrs
○EDSS in the range of 1.5-5.5
○Clinically stable and stable on treatment with disease modifying agents at least from 6 months
○Absence of other associated medical conditions that would prevent participants in performing PA, like CV
and severe osteoarticular pathologies
○Not engaged in any training or rehab program in the 3 months prior to the start of the study
• Neurological assessments done by a professional expert of MS and degree of disability quantified using EDSS
score
• Interview done to see the motivation level of the potential participant
• 22 people chosen and randomly put into APA or CG in 1:1 fashion using block randomization
DESIGN OF THE STUDY/APA PROTOCOL
• Randomized control Trial
• 24 weeks of training from Jan-June
• APA group did supervised program, three 60-min sessions per week that include aerobic and strength training at
a Gym:
○10-min warm-up on ergometer at 30% max workload followed by strengthening of upper/lower body
Article 3: Reading Test
Sunday, January 22, 2017 6:59 PM
Document Summary
Purpose: to quantitatively assess the effects of 6 months of supervised apa that incorporates aerobic/strength training on spatio-temporal and kinematic parameters of gait in people with ms. Introduction: apa has been proposed as an effective approach in approving motor impairments in people with. Previous studies showed improvement in cv tness, muscle strength, mood, gait, balance, quality of life in. Previously hypothesized that apa can decrease disease progression but this requires more research. Walking improvements is the most important because people with ms have said it"s the most disruptive symptom and has a very big impact on their working/social life. Measures (e. g timed tests, human movement analysis) despire the fact that they are more sensitive to slight changes in gait compared to functional measures. In a few, gait is measured using gait analysis (3d analysis) which is very accurate and has been used for.
