Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability

Objective: Impaired balance is one of the most important risk factors for falls in persons with multiple sclerosis (pwMS). The aim was to evaluate balance and gait performance in pwMS with the absence of clinical disability (pwMS-AD) compared with pwMS with minimal disability (MD) and healthy contro...

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Main Authors: Hatice Ayan, Özge Ertekin, Turhan Kahraman, Serkan Özakbaş
Format: Article
Language:English
Published: Galenos Yayinevi 2020-09-01
Series:Türk Nöroloji Dergisi
Subjects:
Online Access:https://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-36036&look4=
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author Hatice Ayan
Özge Ertekin
Turhan Kahraman
Serkan Özakbaş
author_facet Hatice Ayan
Özge Ertekin
Turhan Kahraman
Serkan Özakbaş
author_sort Hatice Ayan
collection DOAJ
description Objective: Impaired balance is one of the most important risk factors for falls in persons with multiple sclerosis (pwMS). The aim was to evaluate balance and gait performance in pwMS with the absence of clinical disability (pwMS-AD) compared with pwMS with minimal disability (MD) and healthy controls (HC). Materials and Methods: Nineteen pwMS-AD were assessed using the Expanded Disability Status scale (EDSS) score ≤1.5, 16 pwMS-MD (2.0≤ EDSS ≤3.0), and 39 HC were assessed using a posturography. Limits of stability (LOS), postural stability (PS) and fall risk index tests were performed. The Brief-Balance Evaluation Systems Test (Brief-BESTest), Activities-Specific Balance Confidence (ABC) scale, timed 25 foot walk test (T25FW) and 12-Item MS walking scale (MSWS-12) were used. Results: Significant differences were observed between pwMS-AD and pwMS-MD in terms of PS (overall, anteroposterior, mediolateral), Brief-BESTest, T25FW, and MSWS-12 (p<0.05). The stability limits (overall, forward LOS score) of the pwMS-AD group decreased significantly compared with the HC (p<0.05). There was also a significant difference in mediolateral PS, fall risk, Brief-BESTest and T25FW scores (p<0.05), but no significant difference was found in the ABC scale score (p=0.543) between pwMS-AD and HC. Conclusion: The results showed that pwMS with the absence of clinical disability had better balance and gait performance than pwMS with minimal disability, but compared with HC, pwMS-AD have impaired balance and gait performance; however, subjective confidence in balance is not significantly different. PwMSAD should be assessed regularly for the early detection of impaired balance and fall risk, even if there are no reported problems related to balance and gait.
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spelling doaj.art-265d0ba1dea94545a0467d029a5293c52023-02-15T16:10:57ZengGalenos YayineviTürk Nöroloji Dergisi1309-25452020-09-0126322422910.4274/tnd.2020.36036Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical DisabilityHatice Ayan0Özge Ertekin1Turhan Kahraman2Serkan Özakbaş3Izmir University of Economics Vocational School of Health Services, Department of Physiotherapy, Dokuz Eylul University, Institute of Health Sciences, Izmir, TurkeyDokuz Eylul University School of Physical Therapy and Rehabilitation, Izmir, TurkeyIzmir Katip Celebi University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, TurkeyDokuz Eylul University Faculty of Medicine, Department of Neurology, Izmir, TurkeyObjective: Impaired balance is one of the most important risk factors for falls in persons with multiple sclerosis (pwMS). The aim was to evaluate balance and gait performance in pwMS with the absence of clinical disability (pwMS-AD) compared with pwMS with minimal disability (MD) and healthy controls (HC). Materials and Methods: Nineteen pwMS-AD were assessed using the Expanded Disability Status scale (EDSS) score ≤1.5, 16 pwMS-MD (2.0≤ EDSS ≤3.0), and 39 HC were assessed using a posturography. Limits of stability (LOS), postural stability (PS) and fall risk index tests were performed. The Brief-Balance Evaluation Systems Test (Brief-BESTest), Activities-Specific Balance Confidence (ABC) scale, timed 25 foot walk test (T25FW) and 12-Item MS walking scale (MSWS-12) were used. Results: Significant differences were observed between pwMS-AD and pwMS-MD in terms of PS (overall, anteroposterior, mediolateral), Brief-BESTest, T25FW, and MSWS-12 (p<0.05). The stability limits (overall, forward LOS score) of the pwMS-AD group decreased significantly compared with the HC (p<0.05). There was also a significant difference in mediolateral PS, fall risk, Brief-BESTest and T25FW scores (p<0.05), but no significant difference was found in the ABC scale score (p=0.543) between pwMS-AD and HC. Conclusion: The results showed that pwMS with the absence of clinical disability had better balance and gait performance than pwMS with minimal disability, but compared with HC, pwMS-AD have impaired balance and gait performance; however, subjective confidence in balance is not significantly different. PwMSAD should be assessed regularly for the early detection of impaired balance and fall risk, even if there are no reported problems related to balance and gait.https://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-36036&look4=multiple sclerosisbalancegaitdisability
spellingShingle Hatice Ayan
Özge Ertekin
Turhan Kahraman
Serkan Özakbaş
Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
Türk Nöroloji Dergisi
multiple sclerosis
balance
gait
disability
title Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
title_full Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
title_fullStr Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
title_full_unstemmed Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
title_short Balance and Gait Impairment in Persons with Multiple Sclerosis with the Absence of Clinical Disability
title_sort balance and gait impairment in persons with multiple sclerosis with the absence of clinical disability
topic multiple sclerosis
balance
gait
disability
url https://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-36036&look4=
work_keys_str_mv AT haticeayan balanceandgaitimpairmentinpersonswithmultiplesclerosiswiththeabsenceofclinicaldisability
AT ozgeertekin balanceandgaitimpairmentinpersonswithmultiplesclerosiswiththeabsenceofclinicaldisability
AT turhankahraman balanceandgaitimpairmentinpersonswithmultiplesclerosiswiththeabsenceofclinicaldisability
AT serkanozakbas balanceandgaitimpairmentinpersonswithmultiplesclerosiswiththeabsenceofclinicaldisability