Abstract:
BACKGROUND:A common and disruptive symptom of multiple sclerosis is difficulty in walking. Deficits in ankle proprioception and in plantarflexor muscle function may contribute to these mobility issues. In this study, ankle proprioceptive ability and plantarflexor performance of people with multiple sclerosis (PwMS) were compared to healthy controls to determine whether multiple sclerosis causes impairments in these systems. METHODS:PwMS (n = 30, median EDSS 4.0, IQR 2) were compared to age- and sex-matched healthy controls (n = 30) across tests of ankle proprioception and plantarflexor muscle performance. Proprioceptive tests: detection of passive movement, reaction time and ankle joint position sense. Plantarflexor performance: strength, fatigue, recovery and voluntary activation (level of neural drive) of the plantarflexor muscles, assessed through brief and sustained fatiguing (2 min) isometric maximal voluntary contractions with nerve stimulation to evoke superimposed and resting muscle twitches. RESULTS:PwMS had unimpaired movement detection and joint position sense but had a slower reaction time to respond with plantarflexion to an imposed ankle movement (between group difference = 0.11 [95% CI; 0.05 to 0.17] s). During brief, maximal contractions PwMS produced lower torque (difference = -25.1 [-42.0 to -8.2] Nm) with reduced voluntary activation (difference = -14.6 [-25.1 to -4.1]%) but no impairment of the muscle itself (resting twitch torque difference = 0.3 [-2.8 to 2.2] Nm). At the end of the fatiguing contraction, neural drive decreased for PwMS (-19.5 [-27.1 to -11.9]%, p <0.0001) but not for controls (-2.5 [-6.9 to 1.8]%, p = 0.242). Fatigue did not affect the resting twitch size for controls (-1.3 [-2.7 to -0.03] Nm, p = 0.134) or PwMS (-0.1 [-1.1 to 1.0] Nm, p = 0.90). CONCLUSIONS:PwMS showed no deficit in their ability to sense ankle position or imposed movements but were slow when a motor response was required. Their plantarflexor muscles produced similar torque with electrical stimulation but voluntary strength was impaired. Both groups experienced overall fatigue following the 2-minute maximal voluntary contraction but PwMS also had significantly reduced neural drive indicating central fatigue. PwMS showed mainly central deficits in motor output at the ankle with little impairment of proprioceptive acuity.
journal_name
Mult Scler Relat Disordjournal_title
Multiple sclerosis and related disordersauthors
Djajadikarta ZJ,Dongés SC,Brooks J,Kennedy DS,Gandevia SC,Taylor JLdoi
10.1016/j.msard.2020.102584subject
Has Abstractpub_date
2020-11-01 00:00:00pages
102584eissn
2211-0348issn
2211-0356pii
S2211-0348(20)30658-1journal_volume
46pub_type
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.06.001
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
pub_type:
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
doi:10.1016/j.msard.2017.04.009
更新日期:2017-07-01 00:00:00
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,meta分析,评审
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journal_title:Multiple sclerosis and related disorders
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journal_title:Multiple sclerosis and related disorders
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pub_type: 杂志文章,meta分析
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章
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journal_title:Multiple sclerosis and related disorders
pub_type: 杂志文章,meta分析
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