scholarly journals The Association of Obesity with Walking and Balance Control in Fully Ambulatory People with Multiple Sclerosis According to Two Different Classifications

2021 ◽  
Vol 1 (2) ◽  
pp. 44-50
Author(s):  
Asiye Tuba Özdoğar ◽  
Turhan Kahraman ◽  
Ozge Ertekin ◽  
Cavid Baba ◽  
Serkan Ozakbas
Keyword(s):  
Multiple Sclerosis ◽  
Balance Control

Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson
Keyword(s):  
Multiple Sclerosis ◽  
Measurement Errors ◽  
Balance Control ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.

scholarly journals The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Neeta Kanekar ◽  
Alexander S. Aruin
Keyword(s):  
Multiple Sclerosis ◽  
Balance Control ◽  
Clinical Test ◽  
Balance Performance ◽  
Performance Deficits ◽  
Clinical Scales ◽  
Balance Confidence ◽  
High Fatigue ◽  
Healthy Control ◽  
Stability Limits

Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS) and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls.Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index.Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P<0.05). MS group had higher sway velocities and diminished stability limits (P<0.05), significant sensory impairments, high fatigue and disability levels (P<0.05). Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance.Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.

Sensory impairments in quiet standing in subjects with multiple sclerosis

2009 ◽  
Vol 15 (1) ◽  
pp. 59-67 ◽  
Author(s):  
D Cattaneo ◽  
J Jonsdottir
Keyword(s):  
Multiple Sclerosis ◽  
Sensory Input ◽  
Balance Control ◽  
Motor Impairment ◽  
Quiet Standing ◽  
Convenience Sample ◽  
Sensory Inputs ◽  
Sensory Disorders ◽  
Sensory Impairments ◽  
The Impact

Balance disorders and falls are frequently observed in subjects with multiple sclerosis (MS). Along with motor impairment, sensory disorders and integration deficits of sensory inputs lead to inadequate motor responses. The assessment of these sensory disorders in an every day tasks, such as upright stance, increases our knowledge of postural control in this pathology, thus promoting more effective treatments. The aim of the study was to describe sensory impairments and sensory strategies in different sensory conditions. A stabilometric assessment was carried out in a consecutive convenience sample of 53 subjects. The age of the sample was 52.7 (21.1) years; the onset of pathology was 27.20 (14.5) years before the assessment. Balance was assessed in six sensory conditions. The impact of pathology on balance control was shown by the high percentage of abnormal scores: 75% of subjects with MS showed abnormal scores even in the eyes open condition. The alteration of a single sensory input led to an increase of abnormal scores in up to 82% of subjects. Almost all subjects showed abnormal scores in the vestibular conditions where 22% of them fell. The pattern of the subjects’ performance in the six sensory conditions suggests that balance control may be more correlated to the number of reliable sensory inputs than the nature of the sensory input itself.

Balance control in multiple sclerosis: Correlations of trunk sway during stance and gait tests with disease severity

2013 ◽  
Vol 37 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Sharissa H.A. Corporaal ◽  
Henrik Gensicke ◽  
Jens Kuhle ◽  
Ludwig Kappos ◽  
John H.J. Allum ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Balance Control ◽  
Trunk Sway

scholarly journals Association of Postural Sway with Disability Status and Cerebellar Dysfunction in People with Multiple Sclerosis

2015 ◽  
Vol 17 (3) ◽  
pp. 146-151 ◽  
Author(s):  
James McLoughlin ◽  
Christopher Barr ◽  
Maria Crotty ◽  
Stephen R. Lord ◽  
Daina L. Sturnieks
Keyword(s):  
Multiple Sclerosis ◽  
Postural Sway ◽  
Balance Control ◽  
Knee Extension ◽  
Ankle Dorsiflexion ◽  
Sensory Function ◽  
Sensory Loss ◽  
Cerebellar Dysfunction ◽  
Exercise Interventions ◽  
Disability Status

Background: The aims of this study were 1) to examine postural sway in the eyes open (EO) and eyes closed (EC) conditions in people with multiple sclerosis (MS) with moderate levels of disability compared with controls and 2) to examine relationships between postural sway and total Expanded Disability Status Scale (EDSS) scores, functional system subscores, and clinical measures of strength and spasticity in the MS group. Methods: Thirty-four people with moderate MS and ten matched controls completed measures of postural sway with EO and EC, knee extension and ankle dorsiflexion isometric strength, EDSS total score and subscores, and spasticity levels. Results: Participants with MS swayed significantly more with EO and EC and had reduced knee extension and ankle dorsiflexion strength compared with controls (P &lt; .001). In the MS group, increased sway was associated with higher total EDSS scores and cerebellar function subscores, whereas increased sway ratio (EC/EO) was associated with reduced sensory function subscores. Postural sway was not significantly associated with strength or spasticity. Conclusions: Participants with MS swayed more and were significantly weaker than controls. Cerebellar dysfunction was identified as the EDSS domain most strongly associated with increased sway, and sensory loss was associated with a relatively greater dependence on vision for balance control. These findings suggest that exercise interventions targeting sensory integration and cerebellar ataxia may be beneficial for enhancing balance control in people with MS.

Efficacy of Balance and Eye-Movement Exercises for Persons With Multiple Sclerosis (BEEMS)

Neurology ◽  
2018 ◽  
Vol 90 (9) ◽  
pp. e797-e807 ◽  
Author(s):  
Jeffrey R. Hebert ◽  
John R. Corboy ◽  
Timothy Vollmer ◽  
Jeri E. Forster ◽  
Margaret Schenkman
Keyword(s):  
Multiple Sclerosis ◽  
Eye Movement ◽  
Balance Control ◽  
Short Form ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Cerebellar Lesion ◽  
Dynamic Posturography ◽  
Impact Scale ◽  
Sf 36

ObjectiveTo determine whether a multifaceted vestibular-related rehabilitation program (Balance and Eye-Movement Exercises for Persons with Multiple Sclerosis; BEEMS) improves balance in persons with MS and whether there are differences in outcomes based on brainstem/cerebellar lesion involvement.MethodsA 2-arm, examiner-blinded, stratified (involvement vs no involvement of brainstem/cerebellar structures), randomized controlled trial was implemented. Eighty-eight participants were allocated to BEEMS or no treatment control. Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) measured balance control. The Dizziness Handicap Inventory (DHI), Modified Fatigue Impact Scale (MFIS), and Short Form-36 Health Status Questionnaire (SF-36) were also administered. Linear mixed models were used to investigate the primary and secondary aims.ResultsFrom baseline to 6 weeks, BEEMS participants experienced greater improvements compared to control participants in CDP-SOT composite (model-estimated difference in change 4.9, 95% confidence interval 1.39–8.38, p = 0.006), DHI total (−13.5, −17.7 to −7.25, p < 0.0001), MFIS total (−11.4, −15.7 to −7.0, p < 0.0001), SF-36 Mental (5.6, 2.43–8.71, p = 0.0006), and SF-36 Physical (3.5, 1.12–5.81, p = 0.004) scores and from baseline to 14 weeks in CDP-SOT composite (8.3, 4.73–11.9, p < 0.0001), DHI total (−13.9, −19.3 to −8.62, p < 0.0001), MFIS total (−12.3, −16.7 to −7.79, p < 0.0001), SF-36 Mental (3.9, 0.70–7.16, p = 0.02), and SF-36 Physical (3.2, 0.79–5.62, p = 0.01) scores. From baseline to 6 weeks, BEEMS participants with brainstem/cerebellar lesion involvement experienced greater improvements compared to those without in CDP-SOT composite (5.26, 0.34–10.2, p = 0.04) and MFIS total (−7.6, −14.0 to −1.33, p = 0.02) scores.ConclusionBEEMS improved multiple outcomes regardless of whether brainstem/cerebellar lesions were present, supporting the generalizability of BEEMS for ambulatory people with MS who have at least minimally impaired balance and fatigue.Clinical trials.gov identifierNCT01698086.Classification of evidenceThis study provides Class I evidence that BEEMS training improves dynamic posturography-based balance, dizziness, fatigue, and quality of life in persons with MS.

Innovative methods measure the neural correlates of proprioception in multiple sclerosis

2020 ◽  
Vol 124 (4) ◽  
pp. 1007-1009
Author(s):  
Tyler T. Whittier ◽  
Victoria Bandera
Keyword(s):  
Multiple Sclerosis ◽  
Corpus Callosum ◽  
Balance Control ◽  
Neural Correlates ◽  
Position Sense ◽  
Lower Limbs ◽  
Neural Repair ◽  
Innovative Methods ◽  
Innovative Methodology

The authors of the recently published article “Position sense deficits at the lower limbs in early multiple sclerosis: clinical and neural correlates” (Iandolo R, Bommarito G, Falcitano L, Schiavi S, Piaggio N, Mancardi GL, Casadio M, Inglese M. Neurorehabil Neural Repair 34: 260–270, 2020) provide strong evidence for the neural correlates leading to deficits in proprioception in multiple sclerosis. We believe their findings and innovative methodology show promise for how proprioception is measured in this and other clinical populations. We also suggest that further work should investigate the role of the corpus callosum in proprioceptive balance control.

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