Journal of NeuroEngineering and Rehabilitation This Provisional PDF corresponds to the article as it appeared upon acceptance Fully formatted PDF and full text (HTML) versions will be made available soon Objective assessment of motor fatigue in multiple sclerosis using kinematic gait analysis: a pilot study Journal of NeuroEngineering and Rehabilitation 2011, 8:59 doi:10.1186/1743-0003-8-59 Aida Sehle (aida.sehle@uni-konstanz.de) Annegret Mundermann (annegret.muendermann@uni-konstanz.de) Klaus Starrost (k.starrost@kliniken-schmieder.de) Simon Sailer (s.sailer@kliniken-schmieder.de) Inna Becher (inna.becher@uni-konstanz.de) Christian Dettmers (c.dettmers@kliniken-schmieder.de) Manfred Vieten (manfred.vieten@uni-konstanz.de) ISSN Article type 1743-0003 Research Submission date 11 May 2011 Acceptance date 26 October 2011 Publication date 26 October 2011 Article URL http://www.jneuroengrehab.com/content/8/1/59 This peer-reviewed article was published immediately upon acceptance It can be downloaded, printed and distributed freely for any purposes (see copyright notice below) Articles in JNER are listed in PubMed and archived at PubMed Central For information about publishing your research in JNER or any BioMed Central journal, go to http://www.jneuroengrehab.com/authors/instructions/ For information about other BioMed Central publications go to http://www.biomedcentral.com/ © 2011 Sehle et al ; licensee BioMed Central Ltd This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Objective assessment of motor fatigue in multiple sclerosis using kinematic gait analysis: a pilot study Aida Sehle1, Annegret Mündermann1,2, Klaus Starrost3, Simon Sailer3, Inna Becher4 Christian Dettmers5, Manfred Vieten1 Division of Sport Science, Universität Konstanz, Konstanz, Germany School of Physiotherapy, University of Otago, Dunedin, New Zealand Kliniken Schmieder Allensbach, Allensbach, Germany Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany Kliniken Schmieder Konstanz, Konstanz, Germany AS: aida.sehle@uni-konstanz.de AM: annegret.muendermann@uni-konstanz.de KS: k.starrost@kliniken-schmieder.de SS: s.sailer@kliniken-schmieder.de IB: inna.becher@uni-konstanz.de CD: c.dettmers@kliniken-schmieder.de MV: manfred.vieten@uni-konstanz.de *Correspondence: Prof Dr C Dettmers Kliniken Schmieder Konstanz Eichhornstr.68 78464 Konstanz Phone: +49 7531 986 3536 Fax: +49 7531 986 3155 Email c.dettmers@kliniken-schmieder.de Abstract Background: Fatigue is a frequent and serious symptom in patients with Multiple Sclerosis (MS) However, to date there are only few methods for the objective assessment of fatigue The aim of this study was to develop a method for the objective assessment of motor fatigue using kinematic gait analysis based on treadmill walking and an infrared-guided system Patients and Methods: Fourteen patients with clinically definite MS participated in this study Fatigue was defined according to the Fatigue Scale for Motor and Cognition (FSMC) Patients underwent a physical exertion test involving walking at their pre-determined patient-specific preferred walking speed until they reached complete exhaustion Gait was recorded using a video camera, a three line-scanning camera system with 11 infrared sensors Step length, width and height, maximum circumduction with the right and left leg, maximum knee flexion angle of the right and left leg, and trunk sway were measured and compared using paired t-tests (α=0.005) In addition, variability in these parameters during one-minute intervals was examined The fatigue index was defined as the number of significant mean and SD changes from the beginning to the end of the exertion test relative to the total number of gait kinematic parameters Results: Clearly, for some patients [0]the mean gait parameters were more affected than the variability of their movements while other patients had smaller differences in mean gait parameters with greater increases in variability Finally, for other patients gait changes with physical exertion manifested both in changes in mean gait parameters and in altered variability The variability and fatigue indices correlated significantly with the motoric but not with the cognitive dimension of the FSMC score (R=-0.602 and R=-0.592, respectively; P