The relationship of pain, anxiety, and fatigue with knee position sense, balance, and dual task performance during menstrual cycle in females with multiple sclerosis

Abstract

Purpose This study was carried out to investigate the relationship of pain, anxiety, and fatigue with position sense, balance, and dual task performance during the menstrual cycle in females with multiple sclerosis. Methods This study included 14 females with multiple sclerosis with regular menstrual cycles. The individuals' position sense, balance, and dual task performance were evaluated with a digital inclinometer, Biodex Balance System, and the Time Up and Go Test, respectively. Pain, anxiety, and fatigue were assessed with the Visual Analogue Scale, State-Trait Anxiety Inventory, and Fatigue Severity Scale, respectively. The study protocol was registered at http://clinicaltrials.gov (NCT04408742). Results In the early follicular phase, the pain was correlated with right knee position sense, and pain + activity was correlated with right knee position sense and dual task performance (p < .05). The correlation analysis revealed that no correlation was found between pain, pain + activity, anxiety, and fatigue, and position sense, balance, and dual task performance in the ovulation phase. In the luteal phase, the right knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). Similarly, the left knee position sense was correlated with pain, pain + activity, and fatigue (p < .05). Conclusions As a result, there may be a relationship between pain and position sense in the early follicular phase and luteal phase, and a relationship between pain and motor dual task performance in the early follicular phase. Considering these changes occurring in different phases of the menstrual cycle, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis. Abbreviations: MS: multiple sclerosis; CNS: central nervous system; FwMS: females with multiple sclerosis; eFP: early follicular phase; OP: ovulation phase; LP: luteal phase