Bilateral differences in lower-limb performance in individuals with multiple sclerosis

Bilateral differences in lower-limb strength in people with multiple sclerosis (MS) have been clinically observed. The objectives of this study were to quantify bilateral differences in lower-limb performance and metabolism during exercise. Eight ambulatory individuals with mild MS with an Expanded Disability Status Scale score of 2.6 +/- 1.6 and seven non-MS controls completed bilateral assessments of muscle strength and incremental cycling. Individuals with MS had significant (p < 0.05) between-leg differences in leg strength (strong leg: 43.3 +/- 12.7 kg vs weak leg: 37.7 +/- 15.2 kg), peak oxygen uptake (strong leg: 13.7 +/- 3.2 mL/kg/min vs weak leg: 10.6 +/- 3.0 mL/kg/min), and peak workload (strong leg: 73.4 +/- 22.3 W vs weak leg: 56.3 +/- 26.2 W). No between-leg differences were found in controls (p > 0.05). As anticipated, individuals with MS exhibited significantly greater asymmetry for strength, oxygen uptake, and workload than controls (p < 0.05). The differences between legs varied from 2% to 30% for maximal strength and 4% to 66% for cycling workload in the MS group and 4% to 24% and 0% to 8% for the control group, respectively. Preliminary evidence suggests that the magnitude of differences may be related to limitations in aerobic function.