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Updated: Feb 2, 2026

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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Relationship between subjective visual vertical and balance in individuals with multiple sclerosis
Brooke N Klatt1, Patrick J Sparto1, Lauren Terhorst2
1Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania.
Summary
Subjective visual vertical (SVV) deviations correlate with poorer balance in multiple sclerosis (MS) patients with cerebellar involvement. This suggests SVV testing could inform physical therapy interventions for MS.
Area of Science:
- Neurology
- Physical Therapy
- Vision Science
Background:
- Subjective visual vertical (SVV) deviations are linked to cerebellar dysfunction in multiple sclerosis (MS).
- MS patients exhibit a higher prevalence of SVV abnormalities, yet this is not routinely assessed in physical therapy evaluations.
- Cerebellar involvement in MS can impact balance and spatial orientation.
Purpose of the Study:
- To investigate the relationship between SVV deviations and balance performance in individuals with MS and cerebellar involvement.
- To determine if SVV testing can predict balance deficits in this population.
- To hypothesize that greater SVV deviations correlate with worse balance outcomes.
Main Methods:
- Twenty participants (15 female, 5 male; mean age 54.5 years) with MS and cerebellar involvement were recruited.
- Computerized SVV testing was performed using rod-only and rod-and-frame conditions, with frame rotation analyzed independently for clockwise (CW) and counterclockwise (CCW) directions.
- Balance was assessed using six functional outcome measures.
Main Results:
- Significant moderate correlations were found between SVV deviations (CCW frame tilt) and all six balance outcomes (Barthel Index, Berg Balance Score, gait velocity, ICARS, SARA, Timed Up and Go).
- The Barthel Index showed a significant moderate correlation with SVV deviations during CW frame tilt.
- Increased SVV deviations, particularly with CCW frame tilt, were associated with worse functional balance outcomes.
Conclusions:
- Individuals with MS experiencing balance impairments may depend more on visual cues for orientation.
- SVV assessment can provide valuable clinical insights for identifying appropriate interventions in MS patients.
- Integrating SVV testing into physical therapy evaluations may enhance the identification of individuals at risk for balance deficits.
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