Balance and walking in facioscapulohumeral muscular dystrophy: multiperspective assessment

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Facioscapulohumeral muscular dystrophy (FSHD) involves muscle weakness, impacting balance and increasing fall risk.
• Previous research focused on gait and upper body movement, neglecting static and dynamic balance assessments in FSHD.
• The influence of balance deficits on disability and quality of life (QoL) in FSHD remains unclear.

Purpose of the Study:

• To quantitatively evaluate static and dynamic balance in FSHD patients.
• To determine the relationship between balance impairments, disability, and QoL in FSHD.

Main Methods:

• A case-control study comparing 16 FSHD patients with 16 healthy controls.
• Utilized a baropodometric platform for static (plantar pressure, center of pressure) and dynamic (spatio-temporal gait parameters) balance assessments.
• Correlated balance measures with clinical severity, performance tests (10m and 2 min Walking Test), and disability/QoL scales (Berg Balance Scale, Rivermead Mobility Index, SF-36, NASS).

Main Results:

• FSHD patients demonstrated significantly reduced static balance and altered dynamic walking parameters (reduced velocity and step length, increased step width).
• Both static and dynamic balance deficits correlated with reduced performance on the 10m Walking Test.
• Dynamic balance impairments were strongly associated with increased disability and reduced QoL.

Conclusions:

• FSHD patients exhibit abnormal static and dynamic balance, employing compensatory strategies to prevent falls.
• Impaired dynamic balance exacerbates disability and negatively impacts physical QoL.
• Reduced static balance is linked to decreased performance in short-distance mobility tasks.
• Balance training and consideration of compensatory strategies in orthotic treatment are recommended for FSHD rehabilitation.