Use of validated tests and scales to assess balance and risk of falling in patients with multiple sclerosis
M. Tsvetkova-Gaberska
, M. Filipova
, D. Popova
Abstract: Objective: Balance disorders are characteristic of a number of demyelinating neurological diseases, including multiple sclerosis (MS). Muscle weakness and sensory deficits in the lower limbs underlie balance, equilibrium and gait disorders increase the risk of falls in this patient population. Materials and methods: A combination of balance assessment tests and scales, routinely used in practice without the need for expensive equipment, would help professionals in the early diagnosis and prevention of fall risk. Results: Based on the results obtained using the internationally validated Berg Balance Scale (BBS) (49.7±5.7p. for males and 47.8±6.0p. for females), patients were considered to have a low risk of falling, which provides a rationale for the use of balance exercises at home from different types of starting positions using a stable support. On the other hand, the results obtained (p<0.05, Mann–Whitney U test) in the Balance Error Scoring System (BESS), where women have 25.9±4.8 postural swings at a norm of 7-15 on the scale and men 19.2±5.6 postural swings at a norm of 7-15, and the Romberg test (RT) showed significantly higher scores in females MS patients. A moderate to high negative correlation (Pearson r= -0.69, p=0.01) between the BESS and the BBS, again only in the group of women with MS, indicating that a high score on the BESS, i.e. a high number of postural swings, is associated with a low score on the Berg scale and a high risk of falling. Discussion: Many studies have focused on investigating various impairments that underlie MS-related falls. Conclusion: Тhe tests and scales used showed that females with MS are more susceptible to loss of balance and at greater risk of falling than males with the same disease.
Series on Biomechanics, Vol.38, No.3 (2024), 61-68
DOI:10.7546/SB.08.03.2024
Keywords: balance; falling risk; Multiple sclerosis; patients
| References: (click to open/close) | [1] Coote, S., Comber, L., Quinn, G., Santoyo-Medina, C., Kalron, A., Gunn, H., 2020. Falls in People with Multiple Sclerosis: Risk Identification, Intervention, and Future Directions. Int J MS Care, 22, 6, 247-255.
[2] Inojosa, H., Schriefer, D., Klöditz, A., Trentzsch, K., & Ziemssen, T., 2020. Balance Testing in Multiple Sclerosis—Improving Neurological Assessment with Static Posturography? Frontiers in Neurology, 11.
[3] Atteya, A., Elwishy, A., Kishk, N., Ismail, R. S., & Badawy, R., 2019. Assessment of postural balance in multiple sclerosis patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 55,1.
[4] Berg, К., Wood-Dauphinee, S., Williams, J, Maki, B., 1992. Measuring balance in the elderly: validation of an instrument, Canadian Journal of Public Health, 83, 2, 7-11.
[5] Prosperini, L., & Castelli, L., 2018. Spotlight on postural control in patients with multiple sclerosis. Degenerative Neurological and Neuromuscular Disease, 8, 25–34.
[6] Iverson, G. L., & Koehle, M. S., 2013. Normative Data for the Balance Error Scoring System in Adults. Rehabilitation Research and Practice, 1–5.
[7] Berge, J., Goplen, F., Aarstad, H., Storhaug, T., Nordahl, S., 2022. The Romberg sign, unilateral vestibulopathy, cerebrovascular risk factors, and long-term mortality in dizzy patients. Front Neurol. 13, 945764.
[8] Despotova, D., 2015. Biomechanical analysis of abnormal human gait: a review. Series on Biomechanics, 29, 1, 45-53.
[9] Soyuer, F., Mirza, M., Erkorkmaz, U., 2006. Balance performance in three forms of multiple sclerosis. Neurol Res, 28, 5, 555–562.
[10] Kalincik, T., Vivek, V., Jokubaitis, V., Lechner-Scott, J., Trojano, M., Izquierdo, G., Lugaresi, A., et al., 2013. Sex as a determinant of relapse incidence and progressive course of multiple sclerosis. Brain, 136, 12, 3609-3617.
[11] Cameron, M., Nilsagard, Y., 2018. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol. 159, 237-250.
[12] Tsvetkova-Gaberska, M., Pencheva, N., 2021. Assessment of knee joint position sense in patients with multiple sclerosis. J of IMAB, 27, 3, 3893-3900.
[13] Kalron, A., 2017. The Romberg ratio in people with multiple sclerosis. Gait & Posture, 54, 209–213.
[14] Tsvetkova-Gaberska, M., Pencheva, N., 2019. The force sense of knee extensors in healthy males and females. Series on Biomechanics, 33, 3, 3-13
[15] Shumway-Cook, A., Baldwin, M., Polissar, N., Gruber, W., 1997. Predicting the probability for falls in community-dwelling older adults, 77, 8, 812-819.
[16] Filipova, M., 2018. Kinesitherapy in neurological practice, Irin-Pirin, 20-55 (In Bulgarian)
|
|
| Date published: 2024-11-15
(Price of one pdf file: 39.00 BGN/20.00 EUR)
