Decreased postural balance in multiple sclerosis patients with low disability

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Multiple sclerosis (MS) is a chronic neurological disease affecting balance.
• Assessing balance in early-stage MS patients with minimal disability is crucial for understanding disease progression and intervention needs.
• The Expanded Disability Status Scale (EDSS) is a common measure, but may not fully capture subtle balance deficits.

Purpose of the Study:

• To evaluate and compare the balance performance of women with multiple sclerosis (MS) and minimal clinical impairments to healthy age-matched controls.
• To investigate if low disability scores (EDSS ≤ 3.5) in MS correlate with objective balance deficits.
• To identify specific balance tasks that are more sensitive to detecting impairments in early MS.

Main Methods:

• A cohort of 67 women with MS (mean EDSS 1.8) and 45 healthy controls (age-matched) participated.
• Balance assessments were conducted using the NeuroCom Balance Master system.
• Specific tests included sensory integration on foam (eyes closed), unilateral stance (eyes open/closed), and tandem walk.

Main Results:

• The MS group exhibited significantly worse performance on multiple balance tests compared to healthy controls (P<0.01).
• Greater postural sway was observed in the MS group during sensory integration (foam, eyes closed), unilateral stance, and tandem walk.
• These deficits were evident despite the low overall disability measured by EDSS.

Conclusions:

• Women with MS, even with low disability (EDSS ≤ 3.5), demonstrate significant balance impairments and increased postural instability.
• Objective balance measures reveal deficits not fully captured by the EDSS in early MS.
• These findings underscore the importance of comprehensive balance assessment in managing MS patients.