Al-Sharman A.1, Khalil H.2, El-Salem K.2, Al-Shorafat D.2, Esser P.3, Dawes H.3
1Jordan University of Science and Technology, Rehabilitation Sciences, Irbid, Jordan, 2Jordan University of Science and Technology, Irbid, Jordan, 3Oxford Brooks University, Oxford, United Kingdom
Background: Multiple sclerosis (MS) is a multi-focal progressive disorder of the central nervous system that results in diverse clinical manifestations including walking difficulties. Despite the fact that disturbances of sleep are among the most common and disabling manifestation of MS, no study has examined the association between sleep quality and mobility measures. Previous studies suggested that sleep deficits provoke cognitive changes, fatigue and depression. Because these factors have been associated with unsafe walking, we hypothesized that sleep deficits are associated with poorer walking in people with MS.
Purpose: The aim of this study was to examine the relationship between sleep quality and gait parameters in individuals with MS.
Methods: An observational cross-sectional design was used in this study to explore the association between sleep disturbances and gait measures. 38 participants with relapsing remitting MS were evaluated. Gait was assessed using an inertial measurement unit. Sleep status was evaluated using the Pittsburg Sleep Quality Index (PSQI) as well as objective measures derived from sleep monitor (Acti-watch).
Results: 38 subjects completed the assessment in this study (mean ± SD, 36.0±9.2 years; 6.5±2.5 units in EDSS scale). All participants reported poor sleep quality (PSQI >5). Sleep efficiency and waking after sleep onset (WASO) as measured by acti-watch were significantly correlated with stride length (R=0.34, p=.03; R= -0.37, p=0.02, for sleep efficiency and WASO, respectively). Sleep latency were found to negatively correlated with stride length standard deviation a reflection of gait variability (R= -0.37, p=0.02).
Conclusion(s): Poor sleep quality was found to be associated with reduced stride length and increased stride length variability.
Implications: Sleep assessment should be considered for MS individuals and intervention that could improve sleep quality and consequently improve gait performance should be considered.
Funding acknowledgements: Jordan University of Science and Technology.
Topic: Disability & rehabilitation
Ethics approval: Ethical approval was obtained from the Institutional Research Committee of Jordan University of Science and Technology.
All authors, affiliations and abstracts have been published as submitted.
