Doctor of Philosophy (PhD)
Medical Sciences Interdepartmental Area
Max J. Kurz
One main purpose was to explore the compensatory gait strategies of individuals with multiple sclerosis (MS). To address this purpose, we quantified the mechanical work generated by the lower extremity joints during walking. The outcomes from this investigation suggested that individuals with MS redistribute positive mechanical work during walking to the hip in order to compensate for a reduced ability of the ankle to generate positive mechanical work. Additionally, we also explored the motor control of the ankle as a potential contributing factor to the mobility limitations of individuals with MS. The outcomes from this investigation indicated that individuals with MS have reduced ankle control, which is related to the reductions in walking ability. These results suggest that poor ankle motor control may be a limiting factor to the mobility of individuals with MS.
Another main purpose was to evaluate whether novel physical therapy interventions could promote improvements in the postural control and mobility of individuals with MS. The first therapeutic intervention specifically targeted the ankle musculature with motor adaptation exercises. After completion of this program, our subjects with MS displayed clinically relevant improvements in their postural balance and mobility as well as improved ankle motor control, which was related to the improved postural balance. The second therapeutic intervention sought to interrogate whether these improvements were influenced by the type of activities performed or the unusually high dosage at which they were performed. The outcomes from this investigation found that both types of therapeutic interventions promoted similar improvements in the balance and mobility of individuals with MS. Moreover, the second therapeutic intervention promoted improvements in the control of trunk accelerations during walking. These results suggest that potentially the level of activity is more important than the type of activities being performed to attaining clinically relevant improvements. Altogether this dissertation provides novel information about the compensatory gait strategies of individuals with MS and the influence of therapeutic interventions upon these strategies. Both will be useful for the development of superior treatment options for these individuals.
Davies, Brenda L., "Mobility of Individuals with Multiple Sclerosis and the Influence of Physical Therapy" (2016). Theses & Dissertations. 70.