# Joint Kinematics and Gait Pattern in Multiple Sclerosis: A 3D Analysis Comparative Approach

## TL;DR

This study compares gait patterns and joint movements in people with multiple sclerosis and healthy individuals using 3D motion analysis.

## Contribution

The study identifies the ankle as the most affected joint in MS patients during gait, highlighting impaired fine-tuning motor control.

## Key findings

- The ankle joint shows the most significant kinematic impairment in pwMS compared to knee and hip.
- Swing phase exhibits greater left-right asymmetry in pwMS than stance phase.
- MS affects motor control rather than structural joint integrity.

## Abstract

This cross-sectional study analyzed the lower limb (LL) behavior in terms of gait asymmetry and joints’ kinematic parameters, comparing people with multiple sclerosis (pwMS) and unaffected individuals. Methods: Data from 15 patients, EDSS ≤ 4.5, and 15 healthy control volunteers were gathered. The VICON Motion Capture System (14 infrared cameras), NEXUS software, Plug-in–Gait skeleton model and reflective markers were used to collect data for each subject during five gait cycles on a plane surface. Biomechanical analysis included evaluation of LL joints’ range of motion (ROM) bilaterally, as well as movement symmetry. Results: Comparative biomechanical analysis revealed a hierarchy of vulnerability between the groups: the ankle is the most affected joint in pwMS (p = 0.008–0.014), the knee is moderately affected (p = 0.015 in swing phase), and the hip is the least affected (p > 0.05 in all phases). The swing phase showed the most significant left–right asymmetry impairment, as reflected by root mean square error (RMSE) values: swing-phase RMSE = 9.306 ± 4.635 (higher and more variable) versus stance-phase RMSE = 6.363 ± 2.306 (lower and more consistent). Conclusions: MS does not affect the joints structurally; rather, it eliminates the ability to differentiate the fine-tuning control between them. The absence of significant left–right joint asymmetry differences during complete gait cycle indicates dysfunction in the global motor control.