Gaze Stability, Dynamic Balance and Participation Deficits in People with Multiple Sclerosis at Fall-Risk

Area of Science:

• Neuroscience
• Ophthalmology
• Physical Therapy

Background:

• Multiple sclerosis (MS) commonly causes dizziness and demyelination affecting vestibular pathways.
• This can impair the angular vestibulo-ocular reflex (aVOR) and vestibulo-spinal function.
• Gaze stability and dynamic balance deficits in persons with MS (PwMS) remain understudied.

Purpose of the Study:

• To compare gaze stability, dynamic balance, and participation between PwMS and controls.
• To investigate the relationships between gaze stability, dynamic balance, and participation in PwMS.

Main Methods:

• Nineteen ambulatory PwMS at fall-risk and 14 age-matched controls were assessed.
• Gaze stability was measured using aVOR gain, compensatory saccades (CS), CS latency, gaze position error, and CV of aVOR gain.
• Dynamic balance was evaluated using the Functional Gait Assessment (FGA) and Four Square Step Test; participation was assessed via the Dizziness Handicap Inventory and Activities-Specific Balance Confidence scale.

Main Results:

• PwMS exhibited significant impairments (P < 0.05) in gaze stability, dynamic balance, and participation compared to controls.
• The coefficient of variation (CV) of aVOR gain and CS latency were significantly correlated with FGA scores.
• PwMS reported an average of 4.2 falls per year.

Conclusions:

• PwMS demonstrate widespread deficits in gaze stability, dynamic balance, and participation.
• These impairments are linked to functional gait limitations.
• Assessment of gaze and dynamic balance is crucial for understanding disability in PwMS.