1Razieh Mofateh, 2Reza Salehi, 3Hossein Negahban, 1Mohammad Mehravar, 4Shirin Tajali, 1Saeideh Monjezi

1Musculoskeletal Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 2Rehabilitation Research Center, and School of Rehabilitation Sciences, Department of Rehabilitation Management, Iran University of Medical Sciences, Tehran, Iran; 3Mashhad University of Medical Sciences, Mashhad, Iran; 4Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada., Toronto, Canada


Gait disturbance is one of the most common and disabling signs in patients with multiple sclerosis (MS). Examining the lower extremities intersegmental coordination, as a higher order property of the human movement system, during walking could explore valuable information about changes in neuromuscular control of gait in patients with MS. Therefore, the aim of this study was to investigate the inter-segmental coordination of the lower extremities during walking in patients with MS.

Material(s) and Method(s):

Three-dimensional coordinate data of the lower extremities were collected from 25 patients with MS and 25 healthy controls while treadmill walking at their preferred walking speed. Mean absolute relative phase (MARP) and deviation phase (DP) were used to examine the thigh-shank and shank-foot coordination pattern and variability in stance and swing phases of the gait cycle.


For the thigh-shank coordination pattern, MARP values were significantly higher in patients with MS compared to healthy controls in stance and swing phases of the gait cycle (p< 0.01, p = 0.03, respectively). For the shank-foot, MARP values of patients with MS were significantly lower compared to healthy controls (p< 0.01). For the thigh-shank coordination variability, patients with MS showed significantly higher DP values compared to healthy controls in stance and swing phases of the gait cycle (p< 0.01). Similar results were found for the shank-foot coordination variability (p = 0.02 and p = 0.04, respectively).


Our results suggest that MS disease could affect the pattern and variability of inter-segmental coordination during walking. Therefore, examining and facilitating lower extremities inter-segmental coordination during walking could be an important factor in the development of rehabilitation interventions aimed at improving the gait pattern in patients with MS.