Increased ankle muscle coactivation in the early stages of multiple sclerosis

Background: Neural damage at early stages of multiple sclerosis (MS) can subtly affect gait muscle activation patterns. Detecting these changes using current clinical tools, however, is not possible. We propose using muscle coactivation measures to detect these subtle gait changes. This may also help in identifying people with MS (PwMS) that may benefit from strategies aimed at preventing further mobility impairments.

Objective: We aimed to determine if coactivation of ankle muscles during gait is greater in PwMS with Expanded Disability Status Scale (EDSS) score <3.5. A secondary aim is to determine whether coactivation increases are speed dependent.

Methods: For this study 30 PwMS and 15 healthy controls (HC) walked on a treadmill at 1.0 m/s, 1.2 m/s and 1.4 m/s. Electromyography was recorded from the tibialis anterior (TA), soleus (SO) and lateral gastrocnemius (LG). The coactivation index was calculated between SO/TA and LG/TA. Ankle kinematics data were also collected.

Results: Compared with HC, PwMS exhibited significantly greater SO/TA and LG/TA coactivation, which was greater during early stance and swing phases (p < .01). Speed did not affect coactivation except during early stance. Ankle kinematic changes were also observed.

Conclusion: PwMS exhibited greater ankle muscles coactivation than controls regardless of the speed of walking. These changes in muscle activation may serve as a biomarker of neurodegeneration occurring at early stages of the disease.