%0 Journal Article
%T The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis
%A Neeta Kanekar
%A Alexander S. Aruin
%J Multiple Sclerosis International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/190162
%X 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 ( ). MS group had higher sway velocities and diminished stability limits ( ), significant sensory impairments, high fatigue and disability levels ( ). 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. 1. Introduction Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease affecting the central nervous system [1]. Postural imbalance is often described as one of the initial symptoms of MS [2¨C5]. It is one of the most disabling MS symptoms that affects about 75% of patients during the course of the disease [6, 7]. People with MS also fall frequently [8¨C12], experiencing injurious falls [10, 13, 14]. Poor balance control is a significant contributing factor to the increased risk of falling in individuals with MS [2, 8¨C12, 15] and is also associated with lower engagement in physical activity [16]. Likewise, fear of falling is also associated with an increased risk of falls in MS [9, 17], and over 80% of people with fear also report activity curtailment [17]. Furthermore, people with MS identify fatigue as one of the primary reasons for falling [10, 18]. Balance control in people with MS has been commonly assessed through performance-based clinical measures such as the ability to maintain steady stance under conditions of reduced base of support with and without visual inputs [19¨C21], the ability to move towards stability limits [4, 20, 21], and through clinical measures or tests of balance
%U http://www.hindawi.com/journals/msi/2013/190162/