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Abnormal trunk control determines postural abnormalities in Amyotrophic Lateral Sclerosis.

Iris Krieg1, Daniela Dalin1, Bernhard Heimbach1

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Amyotrophic Lateral Sclerosis (ALS) patients exhibit altered postural control, with larger sway and smaller body movements during platform tilts, suggesting central strategy changes rather than muscle weakness.

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Area of Science:

  • Neurology
  • Biomechanics
  • Motor Control

Background:

  • Postural instability is an early symptom of Amyotrophic Lateral Sclerosis (ALS), leading to falls.
  • ALS is a multisystem neurodegenerative disorder potentially affecting motor, sensory, and central processing functions.

Purpose of the Study:

  • To analyze and compare postural control between 12 ALS patients and 12 healthy controls.
  • To correlate postural control measures with clinical test scores in ALS patients.

Main Methods:

  • Characterized postural control using spontaneous sway and reactive measures to platform tilts.
  • Compared postural sway and reactions between ALS patients and age-matched controls.
  • Correlated postural control deficits with clinical assessments of motor and balance function.

Main Results:

  • ALS patients showed significantly larger sway amplitudes and velocities, and higher sway frequencies.
  • ALS patients exhibited smaller body excursions with increased upper body movement in response to platform tilts.
  • Abnormal postural reactions strongly correlated with clinical measures of motor and balance deficits.

Conclusions:

  • ALS patients' postural abnormalities stem from abnormal axial control and reduced body excursions, indicating altered central strategies.
  • The findings challenge the hypothesis that muscle weakness is the primary driver of postural deficits in ALS.
  • An altered central control strategy is proposed as the main contributor to postural instability in ALS.