Contrasting relationship between depression, quantitative gait characteristics and self-report walking difficulties in people with multiple sclerosis

Abstract

The purpose of this study was to examine the relationship between depression and walking in the multiple sclerosis (MS) community. This study included 132 people with MS (PwMS) (80 women), mean EDSS 2.9 (S.D. = 1.7). Depression was assessed by the Hospital Anxiety and Depression Scale questionnaire. Spatio-temporal parameters of gait were studied using an electronic walkway. Participants filled out a valid self-rated measure of walking ability, the Multiple Sclerosis Walking Scale (MSWS-12) questionnaire. Computerized cognitive scores were included in the analysis in a multivariable analysis. Forty PwMS (30.3%) were classified as suffering from depression. Individuals in the depressed group walked slower than those in the non-depressed group; 92.2 (S.D. = 30.5) vs. 107.9 (S.D. = 29.4)cm/s, respectively. However, after controlling for age, gender and EDSS, the difference between the groups was considered non-significant; p = 0.986. As for the MSWS-12 self-report questionnaire, regardless of the controlling factors (age, gender, EDSS), scores for participants in the depressed group were significantly elevated, indicating poor walking abilities, compared to scores in the non-depressed group; 40.8 (S.D. = 15.9) vs. 26.6 (S.D. = 13.7); p = 0.002, respectively. Furthermore, according to the linear regression model, by utilizing the self-rated measure of walking ability, we were able to explain ~20% of the variance related to depression, while spatio-temporal parameters of gait were excluded from the model. In PwMS, depressive symptoms are related to self-perception of walking, but not to quantitative gait parameters.

Keywords: Cognition; Depression; Gait; Multiple sclerosis; Walking.