Eyes closed single-leg stance test detects subtle sensorimotor decline in early multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• High-efficacy therapies for multiple sclerosis (MS) result in patients with lower Expanded Disability Status Scale (EDSS) scores.
• There is a need for sensitive clinical assessment tools to detect early sensorimotor impairment in individuals with MS.

Purpose of the Study:

• To identify and validate a balance-based clinical assessment tool for detecting subtle sensorimotor deficits in early-stage MS.
• To evaluate the discriminative ability of various balance tasks and develop a composite score for improved diagnostic performance.

Main Methods:

• Prospective case-control study involving 71 MS patients and 45 healthy controls (HCs).
• Participants performed ten postural balance tasks using wearable inertial sensors.
• A composite score integrating sensitive measures was developed and validated in an external cohort.

Main Results:

• Eyes-closed single-leg stance (SLS) duration showed superior discriminative ability (AUC=0.75) compared to Timed 25-Foot Walk (T25FW).
• Only 19% of early MS patients completed the 30-second SLS test versus 71% of HCs.
• The composite score (SLS, 9-Hole Peg Test, T25FW) improved diagnostic performance (AUC=0.82).

Conclusions:

• The eyes-closed SLS test is a simple, cost-effective tool with clinical validity for detecting early sensorimotor impairment in people with MS (pwMS).
• Integrating SLS with standard clinical assessments optimizes diagnostic utility, supporting its use as a pragmatic outcome measure.