Multiple Sclerosis & Gait – Lauren Turner AEP

Multiple Sclerosis is a neurological condition which effects the function of the central nervous system (brain and spinal cord). An impaired immune response causes inflammation of the myelin sheath that surrounds the neural pathways which insulate the nerve fibres; resulting in multiple lesions and scarring. The myelin sheaths act as a conductive tissue to enhance electrical signals passing through the neural pathways. This allows the information processed in the brain to be passed to the appropriate body part to carry out the movement required to perform the action. Damage to these connective tissue’s neural signals within the CNS may be blocked or altered causing impaired function. Depending on the severity and location of these lesions symptoms and presentation can vary drastically between people. Multiple sclerosis is a degenerative condition and symptoms can progress over time.

 

Many people with multiple sclerosis who can self-ambulate tend to have difficulties walking and may even use ambulatory aids such as a wheelie walker, cane or trekking poles for stability. Whilst symptoms and presentation vary between people, there are some common symptoms that can be present in those who have difficulties with their gait. These include but are not limited to foot drop, circumduction and Trendelenburg sign. These patterns are evident due to a decrease in strength and stability in the lower limbs.

There is misconception that to improve gait movement and patterning, patients need to undergo gait retraining. Walking requires strength and stability of the supporting muscles to help carry out the movements involved. Therefore, when wanting to improve gait and walking ability, exercise prescription should start with developing the strength and stability of these muscles. Depending on the severity of these gait patterns, I typically prescribe the following exercises to specifically target stability of the hips and strength of the lower limbs.

 

Seated Hamstring Curls

This exercise focuses on improving the strength on the hamstring muscles. During gait, our hamstrings perform the action of lifting the foot off the ground. This exercise helps with those who are experiencing foot drop when walking.

Seated Banded March

This exercise focuses on improving the strength on the hip flexor muscles. During gait, our hip flexors perform the action of lifting the knee up into hip flexion. This exercise helps with those who are experiencing circumduction of the hip when walking.

Seated Banded Clam

This exercise focuses on improving the strength on the glute medius muscles. During gait, our glute medius muscles help stabilise the pelvis, particularly when standing on one foot. This exercise helps with those who are experiencing Trendelenburg sign.

 

If you would like to know more about how we can help those with multiple sclerosis, please call our reception on 46 383 777.