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The Romberg ratio in people with multiple sclerosis
1Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel-HaShomer, Israel.
Gait & Posture
|March 28, 2017
Summary
The Romberg ratio, an indicator of vestibular and proprioceptive function, is elevated in people with Multiple Sclerosis (PwMS) who fall. This elevated ratio correlates with poorer walking and balance, highlighting its utility in assessing MS-related postural control deficits.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Postural control in Multiple Sclerosis (MS) is compromised due to sensory system impairments (visual, somatosensory, vestibular).
- The Romberg ratio offers a quantifiable measure of vestibular and proprioceptive contributions to balance.
- Assessing the Romberg ratio may help identify fall risk and functional decline in people with MS (PwMS).
Purpose of the Study:
- To investigate differences in the Romberg ratio between MS fallers and non-fallers.
- To examine Romberg ratio variations across different neurological disability levels in PwMS.
- To determine the association between Romberg ratio values and established gait and balance assessments.
Main Methods:
- Calculated Romberg ratio using sway rate, total sway area, and center of pressure (CoP) path length.
- Analyzed data from 542 PwMS (337 women, mean age 42.3), categorizing them by fall status and disability level.
- Employed statistical analyses including t-tests and correlation coefficients (Pearson's rho).
Main Results:
- A significantly larger Romberg ratio-ellipse sway area was found in fallers (2.76) compared to non-fallers (2.24) (P=0.01).
- Romberg ratio quotients increased significantly with greater neurological disability severity.
- Weak, but significant, correlations (rho 0.172-0.270) existed between Romberg ratio-ellipse sway area and gait/balance measures.
Conclusions:
- An elevated Romberg ratio, particularly the sway area component, indicates impaired postural control and increased fall risk in PwMS.
- The Romberg ratio serves as a valuable, albeit gross, indicator of vestibular and proprioceptive deficits impacting mobility in MS.
- These findings support the clinical utility of the Romberg ratio in evaluating balance and fall risk in the Multiple Sclerosis population.
