Screening for balance disorders in mildly affected multiple sclerosis patients

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation Science

Background:

• Multiple sclerosis (MS) frequently causes balance problems, often undetected by standard clinical tests like Romberg's test and tandem gait.
• Subclinical balance deficits significantly impact the quality of life and mobility for individuals with MS.

Purpose of the Study:

• To investigate the utility of trunk sway measures during various stance and gait tasks for detecting subclinical balance disorders in MS patients.
• To compare the diagnostic accuracy of trunk sway analysis with traditional neurological assessments.

Main Methods:

• Trunk angular sway (pitch and roll) was recorded from 20 MS patients and 20 healthy controls (HCs) during 12 standardized balance tasks.
• Video recordings of subject performance were assessed by two neurologists for pathological task execution.
• Multivariate analysis was employed to identify a predictive model for balance disorder detection.

Main Results:

• Significant differences in trunk sway measures between MS patients and HCs were observed in eight out of 12 tasks.
• Key discriminators included pitch angle range during single-leg stance (eyes open on firm/foam) and pitch velocity range during walking with eyes closed or on heels.
• A three-task model using trunk sway accurately identified balance disorders in 84% of MS patients, outperforming neurologists' accuracy (30%).

Conclusions:

• Trunk sway measurement during specific stance and gait tasks serves as a sensitive and objective screening tool for subclinical balance deficits in MS.
• This quantitative approach offers superior accuracy in detecting balance impairments in MS compared to subjective clinical evaluations.