Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation Science

Background:

• Multiple sclerosis (MS) is a progressive neurological disease impacting balance and increasing fall risk.
• Postural control deficits are a significant concern for individuals with MS, affecting daily function and quality of life.

Purpose of the Study:

• To systematically review and meta-analyze studies on postural control in people with MS compared to healthy controls.
• To identify specific postural control deficits in MS across different task conditions and sensory environments.

Main Methods:

• A systematic literature search identified case-control studies comparing postural control in MS and healthy individuals.
• Meta-analysis was performed on variables reported in at least four studies, focusing on quiet stance conditions.
• Forty-three studies encompassing 105 measurement variables were included, with a mean Expanded Disability Status Scale (EDSS) range of 1.0 to 6.0.

Main Results:

• Meta-analysis revealed significant deficits in postural control for people with MS in quiet stance, including center of pressure path length (SMD=1.04), medio-lateral velocity (SMD=1.35), and 95% confidence ellipse (SMD=0.83).
• These deficits were evident across various task complexities and sensory conditions.
• Eleven studies contributed to the meta-analysis for quiet stance measures.

Conclusions:

• People with MS demonstrate substantial impairments in postural control compared to healthy controls.
• These deficits persist irrespective of task complexity or sensory input, highlighting a fundamental challenge in MS management.
• Standardization of reporting is needed to facilitate future data synthesis and research in MS-related postural control.