Interlimb Coordination Performance in Seated Position in Persons With Multiple Sclerosis: Reduced Amplitude Over 6 min and Higher Coordination Variability in Persons With Walking Fatigability

Mieke Goetschalckx, Fanny Van Geel, Raf Meesen, Lisa Tedesco Triccas, Marc Geraerts, Lousin Moumdjian, Peter Feys, Mieke Goetschalckx, Fanny Van Geel, Raf Meesen, Lisa Tedesco Triccas, Marc Geraerts, Lousin Moumdjian, Peter Feys

Abstract

Background: Walking fatigability is prevalent in MS and can be measured by a percentage distance decline during a 6-min walking test. Walking is characterized by an accurate and consistent interlimb antiphase coordination pattern. A decline in coordination each minute during a 6-min walking test is observed in persons with MS (pwMS). Measuring coordination during a 6-min seated coordination task with minimized balance and strength requirements, is assumed to examine a more fundamental interlimb antiphase coordination pattern in pwMS. This research aimed to answer the following research question: How does interlimb antiphase coordination pattern change during a seated coordination task in pwMS with walking fatigability (WF), non-walking fatigability (NWF) and Healthy Controls (HC)? Methods: Thirty-five pwMS and 13 HC participated. Interlimb coordination was assessed by a seated 6-min coordination task (6MCT) with the instruction to perform antiphase lower leg movements as fast as possible. Outcomes were Phase Coordination Index (PCI) and movement parameters (amplitude, frequency). Results: Mixed models revealed a significant effect of time for the the variability of generating interlimb movements, with a difference in mean values between WF and HC. A significant group∗time interaction effect was found for movement amplitude, represented by a significant decrease in movement amplitude in the WF group from minute 1 to the end of the task. Conclusion: The higher variability in interlimb coordination and decrease in movement amplitude over time during the 6MCT in the WF group could be an indicator of decreased control of fundamental antiphase coordination pattern in pwMS with walking fatigability. Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT04142853 (registration date: October 29, 2019) and NCT03938558 (registration date: May 6, 2019).

Keywords: coordination; fatigability; multiple sclerosis; phase coordination index; seated coordination task.

Conflict of interest statement

PF was steering committee member of Neurocompass, participated to advisory board meetings of BIOGEN IDEC, and received teaching honoraria for EXCEMED and PARADIGMS. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Goetschalckx, Van Geel, Meesen, Triccas, Geraerts, Moumdjian and Feys.

Figures

FIGURE 1
FIGURE 1
Representation of the seated antiphase interlimb coordination task. Subjects make simultaneous left and right knee flexion and extension antiphase movements.
FIGURE 2
FIGURE 2
Visualization of movement cycles of left and right leg of a person with MS.
FIGURE 3
FIGURE 3
Course of the distance (meters) walked each minute during the 6MWT. Error bars represents 95% confidence intervals. Stripe pattern line represents persons with MS with walking fatigability (WF), dotted line represents persons with MS without walking fatigability (NWF) and solid line represents healthy controls (HC).
FIGURE 4
FIGURE 4
Median change in perceived fatigue (quartiles) during 6MWT and 6MCT. Full blocks represent data of healthy controls (HC); block with stripes pattern represents persons with MS with walking fatigability (WF), block with dot pattern represents persons with MS without walking fatigability (NWF). *6MCT: WF-NWF: significant difference in change in perceived fatigue between the WF and NWF group for the 6MCT (p = 0.042). *WF: 6MCT-6MWT: significant difference in change in perceived fatigue between 6MCT and 6MWT in persons with WF (p = 0.036).
FIGURE 5
FIGURE 5
(A–C) Represents, respectively, the course of absolute error of the relative phase (ABSφ, %), coefficient of variation of relative phase (CV φ; %) and the phase coordination index (PCI, %), during each minute of the 6MCT. Error bars represents 95% confidence intervals. Stripe pattern line represents persons with MS with walking fatigability (WF), dotted line represents persons with MS without walking fatigability (NWF) and solid line represents healthy controls (HC). *T2–5, *T2–6: significant main effect of time for CV(φ) from minute 2 to 5 (p = 0.0161) and minute 2 to 6 (p < 0.01).
FIGURE 6
FIGURE 6
(A,B) Represents, respectively, the course of the movement amplitude and movement frequency during each minute of the 6MCT. Error bars represents 95% confidence intervals. Stripe pattern line represents persons with MS with walking fatigability (WF), dotted line represents persons with MS without walking fatigability (NWF) and solid line represents healthy controls (HC). *WF: G*T1–5, 1–6: significant interaction effect of group*time: pwMS with WF decreased their movement amplitude significantly from minute 1 to 5 (p < 0.01) and minute 6 (p < 0.00).

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