Gait analysis in children with multiple sclerosis

BACKGROUND: According to various sources, children account for 3 to 10% of all patients diagnosed with multiple sclerosis. In 75% of all affected individuals, gait abnormalities are present even at early disease stages. However, the 2022 clinical guidelines issued by the Ministry of Health of the Russian Federation do not address the use of instrumental gait analysis in pediatric patients. AIM: To investigate the motor status of children with relapsing-remitting multiple sclerosis using instrumental gait analysis and surface electromyography. Materials and METHODS: Our study was an observational, single-center, prospective, and continuous study. The study population consisted of patients (n=38), aged 9–17 years, from the department of psychoneurology at the Russian Children’s Clinical Hospital with a confirmed diagnosis of multiple sclerosis. All patients underwent the following assessments: instrumental gait analysis using surface electromyography of the lower limb muscles, the 6-minute walk test, contrast-enhanced MRI of the brain and spinal cord. RESULTS: Patients exhibited low disability levels (EDSS ≤2.5) and maintained independent ambulation. The 6-minute walk test demonstrated an average walking distance of 520.92 m, consistent with age norms. surface electromyography analysis revealed characteristic abnormalities in 44.74% of cases, particularly in the gastrocnemius muscles during the single-support phase, manifesting as premature activation and sustained activation with a secondary peak in the electromyography signal. CONCLUSION: The study documented decreased tolerance to physical exertion, along with characteristic surface electromyography changes in the gastrocnemius muscles, specifically: sustained activation during the resting phase of the gait cycle and premature activation during the stance phase. These findings may serve as biomarkers for rehabilitation indications and treatment effectiveness assessment. However, further studies are required due to the limited sample size.