Accepted Manuscript A dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with Multiple Sclerosis James McLoughlin, MSc Stephen R. Lord, DSc Christopher Barr, PhD Maria Crotty, PhD Daina L. Sturnieks, PhD. PII:
S0003-9993(14)01070-3
DOI:
10.1016/j.apmr.2014.09.005
Reference:
YAPMR 55967
To appear in:
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Received Date: 13 June 2014 Revised Date:
1 September 2014
Accepted Date: 3 September 2014
Please cite this article as: McLoughlin J, Lord SR, Barr C, Crotty M, Sturnieks DL, A dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with Multiple Sclerosis, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2014), doi: 10.1016/j.apmr.2014.09.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Running head: Orthosis assists walking in MS
A dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with
RI PT
Multiple Sclerosis James McLoughlin1,3 MSc, Stephen R Lord2,3 DSc, Christopher Barr1 PhD, Maria Crotty1 PhD, Daina L Sturnieks2,3 PhD.
Department of Rehabilitation and Aged Care, Flinders University, South Australia
2
Neuroscience Research Australia,
3
University of New South Wales, Sydney, N.S.W. Australia
M AN U
SC
1
Correspondence: James McLoughlin, Australia. Email: [email protected] Tel: +61 8 82751103
TE D
Fax: +61 8 82751130
Word Count 3,387, 2 Tables, 3 Figures
EP
Trial Registration Number: This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number
AC C
ACTRN12612000218897.
The study protocol was approved by The Repatriation General Hospital Research and Ethics Committee (registration number EC00191) and written informed consent was obtained from all participants.
Acknowledgements
We would like thank Dr Ben Patritti for his technical support and gait data extraction.
ACCEPTED MANUSCRIPT The project is funded by grants from the Multiple Sclerosis Research Australia, grant number 00045 and Foundation Daw Park, Repatriation General Hospital.
We certify that no party having a direct interest in the results of the research
RI PT
supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in
SC
the title page of the manuscript. James McLoughlin, Stephen Lord, Christopher Barr,
AC C
EP
TE D
M AN U
Maria Crotty and Daina Sturnieks.
ACCEPTED MANUSCRIPT 1
A dorsiflexion assist orthosis reduces the physiological cost and mitigates
2
deterioration in strength and balance associated with walking in people with
3
Multiple Sclerosis
Abstract
8
walking distance, physiological cost, fatigue, strength and balance measures
9
following a modified six-minute walk test (6MWT) in people with Multiple Sclerosis
RI PT
4 5 6 7
SC
Objective. To evaluate the effect of wearing a Dorsiflexion Assist Orthosis (DAO) on
(MS).
11
Design. Randomized cross-over trial.
12
Setting. Hospital Movement Laboratory.
13
Participants. 34 people (26 female) with moderate MS, Expanded Disability Status
14
Scale score (mean ± SD) of 3.7 ± 0.7.
15
Interventions. Modified 6MWT with and without a DAO worn on the weaker leg.
16
Main Outcome Measures. Distance walked, perceived fatigue and the physiological
17
cost of walking were compared between walking conditions. Pre- and post-walk
18
changes in knee extensor and ankle dorsiflexor isometric strength and standing
19
postural sway with eyes open and closed, were compared between walking
20
conditions.
21
Results. There were no differences in distance walked or perceived fatigue between
22
the two walking conditions. However, there was a reduced physiological cost of
23
walking (p
S0003-9993(14)01070-3
DOI:
10.1016/j.apmr.2014.09.005
Reference:
YAPMR 55967
To appear in:
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Received Date: 13 June 2014 Revised Date:
1 September 2014
Accepted Date: 3 September 2014
Please cite this article as: McLoughlin J, Lord SR, Barr C, Crotty M, Sturnieks DL, A dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with Multiple Sclerosis, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2014), doi: 10.1016/j.apmr.2014.09.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Running head: Orthosis assists walking in MS
A dorsiflexion assist orthosis reduces the physiological cost and mitigates deterioration in strength and balance associated with walking in people with
RI PT
Multiple Sclerosis James McLoughlin1,3 MSc, Stephen R Lord2,3 DSc, Christopher Barr1 PhD, Maria Crotty1 PhD, Daina L Sturnieks2,3 PhD.
Department of Rehabilitation and Aged Care, Flinders University, South Australia
2
Neuroscience Research Australia,
3
University of New South Wales, Sydney, N.S.W. Australia
M AN U
SC
1
Correspondence: James McLoughlin, Australia. Email: [email protected] Tel: +61 8 82751103
TE D
Fax: +61 8 82751130
Word Count 3,387, 2 Tables, 3 Figures
EP
Trial Registration Number: This trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number
AC C
ACTRN12612000218897.
The study protocol was approved by The Repatriation General Hospital Research and Ethics Committee (registration number EC00191) and written informed consent was obtained from all participants.
Acknowledgements
We would like thank Dr Ben Patritti for his technical support and gait data extraction.
ACCEPTED MANUSCRIPT The project is funded by grants from the Multiple Sclerosis Research Australia, grant number 00045 and Foundation Daw Park, Repatriation General Hospital.
We certify that no party having a direct interest in the results of the research
RI PT
supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in
SC
the title page of the manuscript. James McLoughlin, Stephen Lord, Christopher Barr,
AC C
EP
TE D
M AN U
Maria Crotty and Daina Sturnieks.
ACCEPTED MANUSCRIPT 1
A dorsiflexion assist orthosis reduces the physiological cost and mitigates
2
deterioration in strength and balance associated with walking in people with
3
Multiple Sclerosis
Abstract
8
walking distance, physiological cost, fatigue, strength and balance measures
9
following a modified six-minute walk test (6MWT) in people with Multiple Sclerosis
RI PT
4 5 6 7
SC
Objective. To evaluate the effect of wearing a Dorsiflexion Assist Orthosis (DAO) on
(MS).
11
Design. Randomized cross-over trial.
12
Setting. Hospital Movement Laboratory.
13
Participants. 34 people (26 female) with moderate MS, Expanded Disability Status
14
Scale score (mean ± SD) of 3.7 ± 0.7.
15
Interventions. Modified 6MWT with and without a DAO worn on the weaker leg.
16
Main Outcome Measures. Distance walked, perceived fatigue and the physiological
17
cost of walking were compared between walking conditions. Pre- and post-walk
18
changes in knee extensor and ankle dorsiflexor isometric strength and standing
19
postural sway with eyes open and closed, were compared between walking
20
conditions.
21
Results. There were no differences in distance walked or perceived fatigue between
22
the two walking conditions. However, there was a reduced physiological cost of
23
walking (p
