[What compensatory motor strategies do patients with multiple sclerosis develop for balance control?]

Area of Science:

• Neuroscience
• Biomechanics
• Clinical Neurology

Context:

• Multiple sclerosis (MS) is characterized by axonal deterioration in motor and sensory pathways.
• Postural control is crucial for daily activities and can be affected by neurological damage.
• Assessing upright stance provides insights into sensori-motor integration and dysfunction.

Purpose:

• To investigate how different sensori-motor deficits in multiple sclerosis (MS) impact postural control strategies during an undisturbed upright stance.
• To differentiate postural sway characteristics between ataxo-spastic and spastic MS patient subgroups.
• To evaluate the utility of sensori-motor testing using an upright stance paradigm for diagnosing MS-related deficiencies.

Summary:

• Patients with ataxo-spastic (SEP-AS) and spastic (SEP-S) multiple sclerosis (MS) showed increased center of gravity (CG) and center of pressure (CP)-CG movements compared to healthy controls.
• The ataxo-spastic (SEP-AS) group exhibited significantly larger CP-CG movements (higher RMS) than the spastic (SEP-S) group, indicating greater reliance on exaggerated horizontal forces and increased energy expenditure.
• Despite challenges, the ataxo-spastic (SEP-AS) group demonstrated compensatory control mechanisms for managing center of gravity (CG) movements.

Impact:

• This study validates the upright stance paradigm as a simple, non-invasive method for assessing sensori-motor deficits in multiple sclerosis (MS).
• Findings can aid clinicians in better diagnosing and understanding the specific postural challenges faced by different MS patient subgroups.
• Results contribute to the understanding of neuro-muscular adaptations and energy expenditure in maintaining balance with neurological impairment.