RELATIONSHIP BETWEEN WALKING DISABILITY AND COMMON SLEEP DISORDERS AMONG PEOPLE WITH MULTIPLE SCLEROSIS

M. Aldughmi¹, F. Jamali², A. Al-Sharman³

¹UJ: The University of Jordan, Department of Physiotherapy, Amman, Jordan, ²UJ: The University of Jordan, Cell Therapy Center, Amman, Jordan, ³University of Sharjah, Department of Physiotherapy, Sharjah, United Arab Emirates

Background: Walking difficulties are common functional impairments among people with multiple sclerosis (PwMS). The 12-item MS walking scale (MSWS-12) is a widely used self-reported measure of the impact of MS on walking ability and is highly recommended for use by the neurology section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE). It is important to understand factors that might be associated with walking disability among this population to enhance assessment and treatment outcomes. Non-motor symptoms specifically sleep disturbances are highly prevalent in the MS population that negatively affect their quality of life. Sleep disorders such as insomnia and obstructive sleep apnea (OSA) are the most common sleep disorders affecting PwMS. Understanding the impact of these disorders on walking abilities is crucial.

Purpose: The purpose of this study was to explore the relationship between walking limitations measured using the MSWS-12 and risk for insomnia and OSA among PwMS.

Methods: Sixty-six MS individuals with a mean age 41.2 (SD=11.2) and mild-moderate disease severity PDDS (Median=2, Q1-Q3=0-4) participated in this study. All participants completed the MSWS-12 to assess walking limitations, Insomnia severity Index (ISI) to assess risk for insomnia, and the STOP-bang questionnaire to assess risk for OSA. Spearman’s rank correlations were utilized to examine the associations between MSWS-12 and risk for sleep disorders.

Results: Average MSWS-12 score was 32.1 (SD=14.9). There was a significant moderate association between MSWS-12 and risk for sleep apnea (r=.308, p=.011), no significant association found between MSWS-12 and risk for insomnia (r=.094, p=.460).

Conclusions: The results of this study demonstrate that PwMS who have a high risk for OSA perceive a higher impact of MS on their walking abilities.

Implications: Although our study sample had no official diagnosis of OSA but our findings indicate that those who were screened for having a risk for OSA perceive higher walking limitations. This highlights the impact sleep disturbances may have on the functional life of these individuals. It also emphasizes the important role of physical therapists to screen such common symptoms to provide effective and comprehensive assessment and treatment plan for PwMS. Future studies can use objective measures of sleep and gait and explore other possible associated factors with OSA such as fatigue and cognitive function to further understand this relationship. Large scale longitudinal studies are needed to confirm these findings.

Funding acknowledgements: This project was funded by the MENACTRIMS and University of Jordan Deanship of scientific research

Keywords:
Multiple sclerosis
Sleep
Walking

Topics:
Neurology: multiple sclerosis
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: University of Jordan

Committee: IRB committee of the cell therapy center

Ethics number: IRB/CTC/1-2020/04