Highlights
- •Individuals with MS demonstrate impaired plantar vibration perception
- •MS cohort increased plantar pressures during barefoot walking vs. healthy controls
- •Vibration perception threshold positively correlated with plantar pressures
- •Increased plantar pressures may represent a sensation-seeking adaptation
- •Alternatively, impaired proprioception may reduce foot placement accuracy
Abstract
Background
Balance and mobility impairment are two of the most common and debilitating symptoms
among people with multiple sclerosis (MS). Somatosensory symptoms, including reduced
plantar cutaneous sensation, have been identified in this cohort. Given the importance
of the somatosensory system in gait, it is likely that impaired plantar sensation
may play a role in the walking adaptations commonly observed in people with MS, including
decreased stride length and increased stride width and dual support time, often described
as a cautious gait strategy. Understanding the contributions of plantar sensation
to these alterations may provide targets for interventions that seek to improve sensory
feedback and normalize gait patterns. This cross-sectional study determined whether
individuals with MS who demonstrate reduced sensitivity of the plantar surfaces also
demonstrate altered plantar pressure distributions during walking compared to a control
cohort.
Methods
Twenty individuals with MS and twenty age- and sex-matched control participants walked
barefoot at preferred and three matched speeds. Participants walked across a walkway
with an embedded pressure plate used to quantify pressures within ten plantar zones.
In addition, vibration perception thresholds were assessed at four sites on the plantar
surface.
Results
Individuals with MS demonstrated increased peak total plantar pressures compared to
control participants, that increased with walking speed. For the MS group, plantar
pressures were higher on the less sensitive foot, although pressures on both feet
exceeded those of the control cohort. Positive correlations between vibration perception
threshold and peak total pressure were evident, although generally stronger in the
MS cohort.
Conclusion
A relationship between plantar vibration sensitivity and pressure could indicate that
individuals with MS seek to increase plantar sensory feedback during walking. However,
because proprioception may also be impaired, increased plantar pressure could result
from inaccurate foot placement. Interventions targeting improved somatosensation may
have the potential to normalize gait patterns and should be investigated.
Keywords
Abbreviations:
MS (Multiple Sclerosis), CON (Control Group), EDSS (Self-Report Expanded Disability Status Scale), VPT (Vibration perception threshold), PTP (Peak Total Pressure), LPP (Local Peak Pressure)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 16, 2023
Accepted:
May 15,
2023
Received in revised form:
April 5,
2023
Received:
November 25,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
