Understanding the Relationship Between Cutaneous Sensation, Balance, and Falls in People With Multiple Sclerosis

Area of Science:

• Neuroscience
• Clinical Neurology
• Biomechanics

Background:

• Falls are a significant, undertreated issue for people with multiple sclerosis (PwMS).
• Understanding the neurophysiological pathways contributing to balance deficits and falls is crucial for effective treatment.
• Altered balance and falls in PwMS are hypothesized to be linked to sensory changes.

Purpose of the Study:

• To examine the relationship between specific balance aspects (reactive balance and sway) in PwMS.
• To determine if balance deficits mediate the link between neurophysiological changes (foot cutaneous sensation) and falls.
• To investigate the role of reactive stepping and sway in the sensory-falls relationship.

Main Methods:

• An observational, cross-sectional study involving 121 PwMS and 48 controls.
• Data collection included cutaneous sensation, reactive balance (step latency/length), and standing sway.
• Correlation and mediation analyses were used to assess relationships and mediating effects.

Main Results:

• Significant correlations were found between reactive step latency and standing sway in PwMS, but not controls.
• Mediation models revealed that reactive step latency and sway significantly mediate the relationship between cutaneous sensation and falls in PwMS.
• Reactive step latency, not length, was significantly related to balance outcomes and falls.

Conclusions:

• Reactive stepping latency, standing sway, and foot cutaneous sensation are interconnected in PwMS.
• Reduced sensation contributes to increased sway and delayed reactive stepping, thereby increasing fall risk.
• These findings quantitatively support hypotheses on sensory deficits' role in MS-related falls.