Ankle dysfunction in multiple sclerosis and the effects on walking

Abstract

Purpose

Even in the early stage of the disease, for patients suffering from multiple sclerosis (MS), the most common and reported biomechanical alterations in the lower limb are located at the ankle joint. However, the effects of these impairments on gait deterioration should be discussed.

Materials and methods

This review was written according to the PRISMA guidelines. The search focussed on biomechanical changes (kinetic, kinematic, and electromyographic data) at the ankle during gait in MS patients. The search was performed in the databases: Pubmed, Web of Science, and Cochrane Library.

Results

Eleven studies were included. The reduction in the ankle range of motion (RoM) induced by increased cocontractions of the tibialis anterior and triceps surae muscles could be a compensatory strategy to improve body-weight support and balance during the stance phase.

Conclusions

Future rehabilitation programmes should consider the control of weight support at the ankle during gait training.

Implications for rehabilitation

• The ankle supports and stabilises the body during the stance phase of gait.

• The reduced ankle range of motion in multiple sclerosis (MS), even at an early stage of the disease, is due to cocontractions of tibialis anterior and triceps surae and could be a compensatory strategy to be more stable.

• Rehabilitation programmes for MS patients should focus on the control of body segments motion during the weight transfer above the ankle.

Keywords:

• Multiple sclerosis
• gait
• ankle
• cocontractions
• locomotion
• kinematic

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

This work was supported by the ELSAT2020 project, the European Union with the European Regional Development Fund, The French State, the Region Hauts-de-France Council and La Ligue française contre la Sclérose en Plaques: the authors gratefully acknowledge the support of these institutions and association.

Disclosure statement

The authors report no conflicts of interest.