Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

Static posturography across the EDSS scale in people with multiple sclerosis: a cross sectional study

Authors: Alon Kalron, Dalia Nitzani, Anat Achiron

Published in: BMC Neurology | Issue 1/2016

Login to get access

Abstract

Background

Posturography is considered the gold standard objective measure of standing postural control in people with multiple sclerosis (PwMS). This reliable tool provides quantitative data related to risk of falling and white and gray matter brain damage due to MS. Nevertheless, it remains unclear whether and to what extent, postural control declines throughout the disease process.
We therefore examined the impact of disability on posturography measures in PwMS.

Methods

In this cross-sectional study, the data pool was divided into seven levels of disability based on the Expanded Disability Status Scale (EDSS) score. The study group comprised 464 PwMS, mean disease duration was 6.2 (SD = 7.5) years and mean age 42.6 (SD = 14.1). Static postural control parameters were obtained from the Zebris FDM-T instrumented Treadmill (Medical GmbH, Germany).

Results

A significant positive correlation between the EDSS and posturography parameters was found. Scores for the ellipse area, center of pressure (CoP) path length and sway rate with eyes open were Spearman’s rho =0.512, 0.527, 0.528; (P-value < 0.001), respectively. Non-significant differences were observed between the EDSS subgroups at the lower end of the spectrum (EDSS 0–2.5) in all posturography parameters. In contrast, MS patients with an EDSS score of 3.0–3.5 demonstrated a significant increase in the ellipse area with eyes open (~108 %) and closed (~169 %), CoP path length with eyes open (~83 %) and closed (~88 %) and sway rate with eyes open (~39 %) and closed (~148 %), compared with those who scored within the range of 0–2.5 in the EDSS. Non-significant differences were observed between MS patients with an EDSS score of 3.0–5.5. MS patients with an EDSS score of 6.0–6.5 were significantly poorer in 4 (out of 6) balance measures compared to other disability subgroups.

Conclusions

Posturography CoP trajectories are appropriate outcome measures indicating disability deterioration in PwMS.
Literature
1.
Matsuda PN, Shumway-Cook A, Ciol MA, Bombardier CH, Kartin DA. Understanding falls in multiple sclerosis: association of mobility status, concerns about falling, and accumulated impairments. Phys Ther. 2012;92:407–15.CrossRefPubMed
2.
Kalron A, Achiron A, Dvir Z. Effect of a cognitive task on postural control in patients with a clinically isolated syndrome suggestive of multiple sclerosis. Eur J Phys Rehabil Med. 2011;47:579–86.PubMed
3.
Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, et al. Mobility, balance and falls in persons with multiple sclerosis. PLoS One. 2011;6:e28021.CrossRefPubMedPubMedCentral
4.
Cattaneo D, Jonsdottir J. Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult Scler. 2009;15:59–67.CrossRefPubMed
5.
Cameron MH, Horak FB, Herndon RR, Bourdette D. Imbalance in multiple sclerosis: a result of slowed spinal somatosensory conduction. Somatosens Mot Res. 2008;25:113–22.CrossRefPubMedPubMedCentral
6.
Fling BW, Dutta GG, Schlueter H, Cameron MH, Horak FB. Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis. Front Hum Neurosci. 2014;8:814.CrossRefPubMedPubMedCentral
7.
Sosnoff JJ, Gappmaier E, Frame A, Motl RW. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011;35:129–32.CrossRefPubMed
8.
Cattaneo D, Jonsdottir J, Repetti S. Reliability of four scales on balance disorders in persons with multiple sclerosis. Disabil Rehabil. 2007;29:1920–5.CrossRefPubMed
9.
Prosperini L, Pozzilli C. The clinical relevance of force platform measures in multiple sclerosis: a review. Mult Scler Int. 2013;2013:756564.PubMedPubMedCentral
10.
Daley ML, Swank RL. Quantitative posturography: use in multiple sclerosis. IEEE Trans Biomed Eng. 1981;28:668–71.CrossRefPubMed
11.
Prosperini L, Petsas N, Raz E, Sbardella E, Tona F, Mancinelli CR, et al. Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis. Mult Scler. 2014;20:81–90.CrossRefPubMed
12.
Prosperini L, Sbardella E, Raz E, Cercignani M, Tona F, Bozzali M, et al. Multiple sclerosis: white and gray matter damage associated with balance deficit detected at static posturography. Radiology. 2013;268:181–9.CrossRefPubMed
13.
Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The diagnostic accuracy of static posturography in predicting accidental falls in people with multiple sclerosis. Neurorehabil Neural Repair. 2013;27:45–52.CrossRefPubMed
14.
Kalron A, Achiron A. Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. J Neurol Sci. 2013;335:186–90.CrossRefPubMed
15.
Fritz NE, Newsome SD, Eloyan A, Marasigan RE, Calabresi PA, Zackowski KM. Longitudinal relationships among posturography and gait measures in multiple sclerosis. Neurology. 2015;84:2048–56.CrossRefPubMedPubMedCentral
16.
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69:292–302.CrossRefPubMedPubMedCentral
17.
Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology. 1983;33:1444–52.CrossRefPubMed
18.
Martin CL, Phillips BA, Kilpatrick TJ, Butzkueven H, Tubridy N, McDonald E, et al. Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult Scler. 2006;12:620–8.CrossRefPubMed
19.
Kalron A, Achiron A. Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. J Neurol Sci. 2013;335:186–190.CrossRefPubMed
20.
Cao H, Peyrodie L, Agnani O, Cavillon F, Hautecoeur P, Donzé C. Evaluation of an Expanded Disability Status Scale (EDSS) modeling strategy in multiple sclerosis. Med Biol Eng Comput. 2015;53:1141–51.CrossRefPubMed
21.
Cao H, Peyrodie L, Boudet S, Cavillon F, Agnani O, Hautecoeur P, et al. Expanded Disability Status Scale (EDSS) estimation in multiple sclerosis from posturographic data. Gait Posture. 2013;37:242–5.CrossRefPubMed
22.
Boes MK, Sosnoff JJ, Socie MJ, Sandroff BM, Pula JH, Motl RW. Postural control in multiple sclerosis: effects of disability status and dual task. J Neurol Phys Ther. 2012;315:44–8.
23.
Gunn H, Markevics S, Haas B, Marsden J, Freeman J. Systematic review: The effectiveness of interventions to reduce falls and improve balance in adults with multiple sclerosis. Arch Phys Med Rehabil. 2015;296:1898–912.CrossRef
24.
Denommé LT, Mandalfino P, Cinelli ME. Understanding balance differences in individuals with multiple sclerosis with mild disability: an investigation of differences in sensory feedback on postural control during a Romberg task. Exp Brain Res. 2014;232:1833–42.CrossRefPubMed
25.
Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther. 2013;93:504–13.CrossRefPubMed
26.
Riley PO, Benda BJ, Gill-Body KM, Krebs DE. Phase plane analysis of stability in quiet standing. J Rehabil Res Dev. 1995;32:227–35.PubMed
27.
Carpenter MG, Frank JS, Winter DA, Peysar GW. Sampling duration effects on center of pressure summary measures. Gait Posture. 2001;13:35–40.CrossRefPubMed
Metadata
Title
Static posturography across the EDSS scale in people with multiple sclerosis: a cross sectional study
Authors
Alon Kalron
Dalia Nitzani
Anat Achiron
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0603-6

Other articles of this Issue 1/2016

BMC Neurology 1/2016 Go to the issue

Research article

A review of clinical trial designs used to detect a disease-modifying effect of drug therapy in Alzheimer’s disease and Parkinson’s disease

Research article

Endoscopic endonasal pituitary adenomas surgery: the surgical experience of 178 consecutive patients and learning curve of two neurosurgeons

Research article

Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis

Case report

A case report of SPG11 mutations in a Chinese ARHSP-TCC family

Research article

Persistency, medication prescribing patterns, and medical resource use associated with multiple sclerosis patients receiving oral disease-modifying therapies: a retrospective medical record review

Research article

Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity