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Updated: Aug 12, 2025
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Author Spotlight: Developing Low-Tech Balance Assessment Methods for Broad-Spectrum Healthcare Applications
Published on: September 1, 2023
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Dynamic balance during walking in people with multiple sclerosis: A cross-sectional study
Denise Anastasi1, Tiziana Lencioni1, Ilaria Carpinella1
1IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Summary
Dynamic balance disorders in People with Multiple Sclerosis (PwMS) were assessed using instrumented indexes. The Margin of Stability by HoF (MoS_HOF) effectively identified balance impairments and correlated with clinical measures, offering a new tool for PwMS.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Rehabilitation Science
Background:
- Dynamic balance disorders are prevalent in People with Multiple Sclerosis (PwMS), contributing to gait issues and increased fall risk.
- Assessing dynamic balance in PwMS remains challenging; instrumented indexes offer objective data on Center of Mass (CoM) and Base of Support (BoS).
- The inverted pendulum model provides a framework for understanding dynamic balance and developing quantitative assessment tools.
Purpose of the Study:
- To validate recent instrumented indexes derived from the inverted pendulum model for assessing dynamic balance in PwMS.
- To characterize the specific dynamic balance disorders present in PwMS using quantitative gait analysis.
- To compare the efficacy of different instrumented indexes in discriminating between PwMS and Healthy Subjects (HS).
Main Methods:
- Clinically assessed 20 PwMS and collected instrumented gait data using an optoelectronic system.
- Included data from 20 Healthy Subjects (HS) as a normative reference.
- Calculated Margin of Stability (MoS_HOF, MoS_TERRY) and Foot Placement Estimator (DFPE) in mediolateral (ML) and anteroposterior (AP) directions.
Main Results:
- MoS_HOF significantly discriminated between PwMS and HS (p < 0.001), followed by MoS_TERRY in the ML direction (p < 0.02).
- MoS_HOF and MoS_TERRY differentiated between less/most affected sides in PwMS, while DFPE showed no significant discrimination.
- Moderate correlations were observed between the indexes and clinical balance scales, energy recovery, single stance time, and step length.
Conclusions:
- MoS_HOF is the most effective index for describing dynamic balance disorders in PwMS, reflecting their strategies to control CoM relative to BoS.
- PwMS employ distinct preventive strategies based on lower limb impairments, altering gait mechanics, increasing energy expenditure, and reducing gait quality.
- Instrumented indexes, particularly MoS_HOF, provide valuable objective measures for understanding and potentially managing dynamic balance deficits in PwMS.
