Static posturography across the EDSS scale in people with multiple sclerosis: a cross sectional study.

Alon Kalron,Anat Achiron,Dalia Nitzani

doi:10.1186/s12883-016-0603-6

Alon Kalron, Anat Achiron + Show 1 more

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https://doi.org/10.1186/s12883-016-0603-6

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Journal: BMC neurology	Publication Date: May 20, 2016
Citations: 56	License type: cc-by

Affiliation: Sheba Medical Center, Tel Aviv University

Abstract

BackgroundPosturography is considered the gold standard objective measure of standing postural control in people with multiple sclerosis (PwMS). This reliable tool provides quantitative data related to risk of falling and white and gray matter brain damage due to MS. Nevertheless, it remains unclear whether and to what extent, postural control declines throughout the disease process.We therefore examined the impact of disability on posturography measures in PwMS.MethodsIn this cross-sectional study, the data pool was divided into seven levels of disability based on the Expanded Disability Status Scale (EDSS) score. The study group comprised 464 PwMS, mean disease duration was 6.2 (SD = 7.5) years and mean age 42.6 (SD = 14.1). Static postural control parameters were obtained from the Zebris FDM-T instrumented Treadmill (Medical GmbH, Germany).ResultsA significant positive correlation between the EDSS and posturography parameters was found. Scores for the ellipse area, center of pressure (CoP) path length and sway rate with eyes open were Spearman’s rho =0.512, 0.527, 0.528; (P-value < 0.001), respectively. Non-significant differences were observed between the EDSS subgroups at the lower end of the spectrum (EDSS 0–2.5) in all posturography parameters. In contrast, MS patients with an EDSS score of 3.0–3.5 demonstrated a significant increase in the ellipse area with eyes open (~108 %) and closed (~169 %), CoP path length with eyes open (~83 %) and closed (~88 %) and sway rate with eyes open (~39 %) and closed (~148 %), compared with those who scored within the range of 0–2.5 in the EDSS. Non-significant differences were observed between MS patients with an EDSS score of 3.0–5.5. MS patients with an EDSS score of 6.0–6.5 were significantly poorer in 4 (out of 6) balance measures compared to other disability subgroups.ConclusionsPosturography CoP trajectories are appropriate outcome measures indicating disability deterioration in PwMS.

Highlights

Posturography is considered the gold standard objective measure of standing postural control in people with multiple sclerosis (PwMS)
MS patients with an Expanded Disability Status Scale (EDSS) score of 3.0–3.5 demonstrated a significant increase in the ellipse area with eyes open (~108 %) and closed (~169 %), center of pressure (CoP) path length with eyes open (~83 %) and closed (~88 %), and sway rate with eyes open (~39 %) and closed (~148 %) compared with those who scored in the 0–2.5 EDSS range
With the exception of the ellipse area during eyes open, MS patients with an EDSS score of 6.0–6.5 were significantly poorer in all balance measures compared to other disability subgroups

Summary

Introduction

Posturography is considered the gold standard objective measure of standing postural control in people with multiple sclerosis (PwMS). This reliable tool provides quantitative data related to risk of falling and white and gray matter brain damage due to MS. Balance deterioration negatively effects mobility and independence, leading to falls and injuries, adversely affecting the overall quality of life [1] This deterioration appears in MS individuals with minimal or no clinically assessable impairments [2], Balance relies on integration of inputs from the visual, somatosensory and vestibular systems, which are frequently impaired in PwMS [4]. Muscle weakness and spasticity further compromise the Kalron et al BMC Neurology (2016) 16:70 ability to balance by affecting the sequencing and force of muscle contraction [7]

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