Abstract
Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS) and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls. Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index. Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P < 0.05). MS group had higher sway velocities and diminished stability limits (P < 0.05), significant sensory impairments, high fatigue and disability levels (P < 0.05). Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance. Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease affecting the central nervous system [1]
Postural instability has been reported in mildly impaired people with MS [2, 4, 5] and even in those with normal clinical balance tests but subjective symptoms of balance impairment [3]
Several studies have highlighted the incidence of balance disorders in individuals with MS based on results of clinical balance and mobility tests
Summary
Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease affecting the central nervous system [1]. Postural imbalance is often described as one of the initial symptoms of MS [2,3,4,5] It is one of the most disabling MS symptoms that affects about 75% of patients during the course of the disease [6, 7]. Poor balance control is a significant contributing factor to the increased risk of falling in individuals with MS [2, 8,9,10,11,12, 15] and is associated with lower engagement in physical activity [16]. Fear of falling is associated with an increased risk of falls in MS [9, 17], and over 80% of people with fear report activity curtailment [17]. People with MS identify fatigue as one of the primary reasons for falling [10, 18]
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