All ETDs from UAB

Advisory Committee Chair

James H Rimmer

Advisory Committee Members

Matthew P Ithurburn

Robert W Motl

Laura Q Rogers

Brian M Sandroff

Document Type

Dissertation

Date of Award

2022

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Multiple sclerosis (MS) is a chronic, neurological disease characterized by demyelination and transection of axons as well as loss of neurons in the central nervous system that may result in poor walking efficiency, indicated by an increase in the oxygen cost of walking (Cw). The Cw is defined as the amount of oxygen consumed per kilogram of body weight per unit distance walked and reflects disability-related gait abnormalities and manifestations and its interaction with the environment. This dissertation involved four research projects. The first project provided an overview of existing research on the Cw in MS and established a research agenda directed toward better understanding the factors related to the Cw in persons with MS. The second project examined objective measures of fitness (i.e., aerobic capacity, muscular strength, and postural control) as pu-tative modifiable variables associated with the Cw in adults with MS who had moderate disability. The third project examined the associations among Cw, spasticity of the ankle plantarflexors, and spatiotemporal gait parameters in persons with MS who had moderate disability. The last project examined the relationship among Cw, body composition metrics, and disease-related outcomes among persons with MS with a wide distribution of body composition profiles. Collectively, this line of research provided critical information on the Cw and its correlates and potential consequences in MS, and the findings may guide the design and development of targeted approaches for managing the Cw and its secondary consequences in MS such as disability and physical well-being.

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