Morphofunctional muscle changes influence on foot stability in multiple sclerosis during gait prediction: The rehabilitation potential

BACKGROUND: Multiple sclerosis patients may suffer muscle changes that involve gait disorders of the kinetic and kinematic parameters also their gait may be clinically symmetrical or asymmetrical. OBJECTIVE: The aim of this study is to analyze how the muscle change, could affect the biomechanical parameters of foot stability during the gait, by disturb the motor control. METHODS: The study group consisted of 13 patients diagnosed with multiple sclerosis, presenting clinically detectable abnormal gait. The biomechanical evaluation included the foot axes and angles -external and internal rotation; the foot angle deviation from the gait direction; the subtalar angle. RESULTS: The values of the foot angle were between 10.74 degrees to 26.38 degrees for the left foot and between 11.16 degrees to 30.04 degrees for the right foot. The foot axis angle is the axis of the foot in relation to the gait direction, and the subtalar angle is in relation to the vertical axis of the foot. The rotation of the right foot into pronation during the initial contact phase was followed by supination in the semi-support phase, to return to the neutral position during the propulsion phase, which meant being in free zone of minimal risk. CONCLUSIONS: Biomechanical analysis of the foot angle and of subtalar angle in the patients with multiple sclerosis allows us to objectify the existence of a right-left asymmetry, the behavior ankle-foot during the gait. At the same time this evolution is closely correlated with the contact surface that tends to increase, which means involving the reflex mechanisms that place the foot in the zone of minimum risk and assure the stability of the body.