The Effects of Axial Loading on Real-World Ambulation in Persons with Multiple Sclerosis; a Pilot Study
Conference Year
2024
Abstract
Background: Impaired sensory integration contributes to mobility challenges and increased fall risk in individuals with multiple sclerosis (MS). Interventions to improve gait through sensory modulation, such as axial loading, have been effective, although only acutely and solely in lab-based contexts. The utility of this approach for real-world ambulation remains unclear. Objective: The purpose of the study was to examine the effect of at-home axial-loading using a weighted vest on gait metrics in adults with MS. Methods: In a pre-post pilot study, real-world gait was assessed in nine participants with MS. During baseline, each participant wore a wireless body-fixed inertial sensor on their lower back for three consecutive days on two separate occasions two weeks apart. Participants then wore a weighted vest at 2.5% of body weight for thirty minutes each of three days per week for four weeks. Following the intervention, gait was reassessed similarly to baseline data collection. All walking bouts equal to or greater than thirty seconds were identified from the tri-axis accelerometry data, and developed algorithms were used to calculate gait metrics from these bouts. A linear mixed model was used to determine the effects of the intervention on gait speed and stride regularity with time and subject entered as fixed and random effects respectively. Comparisons of estimated means with Sidak correction for multiple comparisons were examined. Results: Significant differences were observed in gait speed and stride regularity between both baseline collection periods and between baseline and post-intervention testing, although the initial baseline session showed the fastest walking speed and more consistent gait. Significance: While there was no evidence to suggest the effectiveness of axial loading on real-world ambulation in this study, continued examination of torso weighting utilizing various prescriptive variables of duration, frequency and intensity may be warranted. Furthermore, differences in gait metrics across all three time points may depend on the specific purpose of the walking bout or on other contextual factors irrespective of time. As both gait speed and stride regularity significantly differed between the two baseline periods, determination of real-world ambulation as a treatment outcome must consider intra-individual variability across time and employ strategies to assure a consistent comparative baseline.
Primary Faculty Mentor Name
Susan Kasser
Graduate Student Mentors
Michael Vannostrand
Status
Undergraduate
Student College
College of Nursing and Health Sciences
Program/Major
Exercise Science
Primary Research Category
Clinical
The Effects of Axial Loading on Real-World Ambulation in Persons with Multiple Sclerosis; a Pilot Study
Background: Impaired sensory integration contributes to mobility challenges and increased fall risk in individuals with multiple sclerosis (MS). Interventions to improve gait through sensory modulation, such as axial loading, have been effective, although only acutely and solely in lab-based contexts. The utility of this approach for real-world ambulation remains unclear. Objective: The purpose of the study was to examine the effect of at-home axial-loading using a weighted vest on gait metrics in adults with MS. Methods: In a pre-post pilot study, real-world gait was assessed in nine participants with MS. During baseline, each participant wore a wireless body-fixed inertial sensor on their lower back for three consecutive days on two separate occasions two weeks apart. Participants then wore a weighted vest at 2.5% of body weight for thirty minutes each of three days per week for four weeks. Following the intervention, gait was reassessed similarly to baseline data collection. All walking bouts equal to or greater than thirty seconds were identified from the tri-axis accelerometry data, and developed algorithms were used to calculate gait metrics from these bouts. A linear mixed model was used to determine the effects of the intervention on gait speed and stride regularity with time and subject entered as fixed and random effects respectively. Comparisons of estimated means with Sidak correction for multiple comparisons were examined. Results: Significant differences were observed in gait speed and stride regularity between both baseline collection periods and between baseline and post-intervention testing, although the initial baseline session showed the fastest walking speed and more consistent gait. Significance: While there was no evidence to suggest the effectiveness of axial loading on real-world ambulation in this study, continued examination of torso weighting utilizing various prescriptive variables of duration, frequency and intensity may be warranted. Furthermore, differences in gait metrics across all three time points may depend on the specific purpose of the walking bout or on other contextual factors irrespective of time. As both gait speed and stride regularity significantly differed between the two baseline periods, determination of real-world ambulation as a treatment outcome must consider intra-individual variability across time and employ strategies to assure a consistent comparative baseline.