Fuzziness of muscle synergies in patients with multiple sclerosis indicates increased robustness of motor control during walking

Deficits during gait poses a significant threat to the quality of life in patients with Multiple Sclerosis (MS). Using the muscle synergy concept, we investigated the modular organization of the neuromuscular control during walking in MS patients compared to healthy participants (HP). We hypothesized a widening and increased fuzziness of motor primitives (e.g. increased overlap intervals) in MS patients compared to HP allowing the motor system to increase robustness during walking. We analysed temporal gait parameters, local dynamic stability and muscle synergies from myoelectric signals of 13 ipsilateral leg muscles using non-negative matrix factorization. Compared to HP, MS patients showed a significant decrease in the local dynamic stability of walking during both, preferred and fixed (0.7 m/s) speed. MS patients demonstrated changes in time-dependent activation patterns (motor primitives) and alterations of the relative muscle contribution to the specific synergies (motor modules). We specifically found a widening in three out of four motor primitives during preferred speed and in two out of four during fixed speed in MS patients compared to HP. The widening increased the fuzziness of motor control in MS patients, which allows the motor system to increase its robustness when coping with pathology-related motor deficits during walking.