Estimation of Postural Stability of a Patient with Multiple Sclerosis During a Rehabilitation Program - Case Study (original) (raw)
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International Journal of Physiotherapy and Research, 2019
The purpose of the study was to evaluate response of stability and postural control in patients suffering from multiple sclerosis. Thirty subjects, of both sexes ,their age ranged from 30 to 40 years shared in this study and were divided into two equal groups, the first group (GI) included normal subjects and the second group (GII) included patients suffering from multiple sclerosis. Assessment was done by Biodex balance system via the dynamic balance test which included anteroposterior, mediolatoral and overall stability index. This study was done in Biomechanics lab in Faculty of Physical Education at Kafrelsheikh University. Group II was trained for two months. The results revealed that there were slightly decrease in balance paremeters in the control group or normal subjects during assessment of balance in this study. In relation to the study group, there were no significant difference between the balance parameters post treatment than pre treatment (p >0.05), this indicates ...
Validation of the BESTest for Measuring Balance in People With Multiple Sclerosis
2021
Background: Evaluation of balance disorders and differentiation of the populations with deficits is necessary for treatment and rehabilitation. The BESTest is used to evaluate balance and posture in various populations and has been shown to distinguish between different neurological populations. This study investigated the validity of the BESTest in measuring balance in the people with multiple sclerosis (PwMS). Methods: A cross-sectional study conducted with 34 participants including 17 PwMS (42.64 ±7.8 years old, score 1-5 on the Expanded Disability Status Scale) and 17 healthy controls (42.33±8.65 years old). After a comprehensive medical history, subjective clinical balance assessment (via BESTest) was performed. Then objective measures of balance domains of Anticipatory Postural Adjustments (APAs) and Sensory Orientation were assessed using a force plate, with sway, velocity and the area of sway outcomes calculated. Correlations between the subjective and objective measures of balance were computed. Results: The anterior-posterior and the medio-lateral sway, sway velocity in the AP direction, and area of displacement were significantly different between the two groups (P<0.005). Significant correlations were found between the BESTest scores with anteriorposterior and medio-lateral sway, sway velocity in anterior-posterior direction, and area of displacement in anterior-posterior direction (p<0.005). Conclusions: Results indicated that the BESTest assessment tool has a high accuracy and sensitivity to assess balance function in PwMS. It can be used as an outcome measure to test postural balance disorders in these people.
Functional Balance Tests for Patients with Multiple Sclerosis: A Review Study
Caspian Journal of Neurological Sciences, 2022
Background: Knowledge of the functional balance tests for the patients with Multiple Sclerosis (PwMS) may provide useful and accurate information about the balance function of these patients under different situations. Objectives: This study aims to review the functional balance tests for PwMS. Materials and Methods: This is a systematic review. The search was conducted in PubMed, Scopus, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar databases on relevant studies published until November 2021. Results: Twenty-five articles and 25 different tests were found to evaluate the functional balance of PwMS. It was found that the studies used 6 tests to assess the static balance, 13 tests to assess dynamic balance, and 6 multi-item tests to assess functional balance in PwMS. Single-leg stance test, balance error scoring system test and steady stance test is a test battery for static balance; six-spot step test, timed up and go test, and figure-of-8 hop test are better for dynamic balance, and the balance evaluation systems test is a better multiitem test to assess the balance of PwMS by examining the postural control components. Conclusion: Single-limb standing test, balance error scoring system (BESS) test and steady stance test provide accurate data on static balance; six spot step test, Timed Get up and go test and figure-of-8 hop test provide valuable data on the dynamic balance and Balance Evaluation Systems Test (BESTest) is a valid test to assess the balance of PwMS from the perspective of the review of posture control components.
Balance performance in three forms of multiple sclerosis
Neurological Research, 2006
Objectives: To compare and document balance performance between patients with multiple sclerosis (MS) and healthy control subjects and balance performance among patients with different MS forms using a set of clinical balance tests. Material and Methods: Twenty eight primary progressive (PPMS), 34 secondary progressive (SPMS), and 62 relapsing remitting (RRMS), totalling 124 MS patients were included in the present study. Results from patients were compared with those of 31 healthy control subjects matching in age, gender, weight and height. Ashworth scale, mini-mental state examination and motricity index were used consecutively to evaluate spasticity, cognitive impairment and lower extremity muscle strength. Vision, sensation, proprioception, cerebellar and vestibular tests were also performed on the patients. The balance performance was evaluated using a set of clinical tests including steady stance tests (eyes in opened and closed positions, feet apart, feet together, stride stance, tandem stance and single stance), self-generated perturbations (functional reach, arm raise and step test), external perturbations, Tinetti-gait and 10 m gait time tests. Results: There were no differences in age, sex, weight, height, sense impairment and lower extremity strength in patients with the three MS forms (p.0.05). No difference was found among patients with the three MS forms and the control subjects in the test of eyes closed with feet apart (p.0.05). The PPMS patients in all the balance tests except tests of eyes closed with feet apart and eyes opened with feet together, SPMS patients in all the balance tests except that of eyes closed with feet apart and RRMS patients in tandem stance, single leg stance, self-generated perturbations, external perturbations, Tinetti-gait and 10 m gait time tests had weaker balance than the control subjects (p,0.001). There were some differences between patients in the PPMS and SPMS groups in the eyes closed and feet apart test, between patients in the PPMS and RRMS groups in all the balance tests except eyes closed and feet apart and eyes opened and feet together tests and between patients in SPMS and RRMS group in all the balance tests except right and left arm raised tests (p,0.001). Conclusion: Balance in MS patients is impaired. The results of the present study show that there is more impairment in progressive MS forms than in RRMS. Meanwhile, patients with progressive MS are more likely to fall.
2021
Objective: Upper extremity dysfunction and balance problem are two important symptoms that are common in individuals with multiple sclerosis and reduce their quality of life. However, there is limited evidence of a direct relationship between these two symptoms. Therefore, this study aims to reveal the relationship between balance and upper extremity function, which is essential for pwMS. Materials and Methods: Nine hundred and sixty-six patients were included [681 (70.5%) female, 285 (29.5%) male]. The Nine-Hole Peg Test (9HPT) was applied to evaluate upper extremity function. With the Activity-Specific Balance Confidence (ABC) Scale patients evaluated their confidence in their balance during activities and balance was tested with the The Timed Up and Go (TUG) test. Results: There was a significant moderate positive correlation between the 9HPT and TUG (rho=0.566) and a moderate negative correlation with ABC score (rho=-0.464) in total participants. However, while there was a significant moderate negative correlation between 9HPT and ABC score in relapsing form, there was no relationship between 9HPT and TUG in pwMS with progressive form. Conclusion: There is a significant relationship between upper extremity function and balance. In addition, the trunk, upper and lower extremities should be considered as a whole, since distal stabilization cannot be achieved without poximal stabilization. Consideration should be given to the upper extremity within the scope of balance assessments.
Physiotherapy, 2017
Background: The Balance Evaluation Systems Test (BESTest) measures various aspects of postural control, but little data exist in persons with multiple sclerosis (MS). The purpose of this study was to determine the psychometrics of the BESTest in MS. Design: Observational study. Methods: 21 ambulatory subjects with MS participated. In the first session, demographic data was collected; each subject completed a questionnaire of self-perceived disability level and the BESTest. The BESTest was re-administered one week later. Results: Test-retest reliability (ICC 3,1) for the total BESTest was 0.94, ranging 0.66 to 0.93 for the subsections. Internal consistency (Chronbach's alpha) for the total BESTest was 0.97; subsections scores ranged 0.79 to 0.96. Minimal detectable change (MDC) scores ranged from 2.25 to 4.58 for subsections with 9.47 points for total BESTest. Weak to moderate correlations were found between individual subsection scores (0.12 to 0.78), and BESTest total and subsection scores to fall (-0.08 to-0.62) frequency and self-perceived disability level (-0.24 to-0.64). Strongest correlations were found between BESTest total and individual subsection scores. No floor effects were found; five BESTest subsections had ceiling effects. Conclusions: The BESTest is reliable and valid in individuals with MS. Total BESTest scores demonstrated higher reliability and a lack of a ceiling effect as compared to subsection scores, suggesting that clinicians use the BESTest in its entirety. The correlations among subsection 3 scores indicate that each assesses a unique aspect of balance, supporting its construct validity. The MDC scores will assist clinicians in assessing patient change. Contributions of Paper: Individuals with multiple sclerosis demonstrate impairments of various systems important for balance control. The Balance Evaluation Systems Test can be used to identify the postural control systems underlying balance performance, yet little evidence exists to support its use in persons with multiple sclerosis. This study provides evidence that the Balance Evaluation Systems Test is reliable and valid in persons with multiple sclerosis; the minimal detectable change scores can assist clinicians in determining the effectiveness of a patient's plan of care.
Journal of neuroengineering and rehabilitation, 2014
Balance control relies on accurate perception of visual, somatosensory and vestibular cues. Sensory flow is impaired in Multiple Sclerosis (MS) and little is known about the ability of the sensory systems to adapt after neurological lesions reducing sensory impairment. The aims of the present study were to verify whether: 1. Balance rehabilitation administered in a challenging sensory conditions would improve stability in upright posture. 2. The improvement in a treated sensory condition would transfer to a non treated sensory condition. Fifty three persons with MS, median (min-max) EDSS score of 5 (2.5-6.5), participated in a RCT and were randomly assigned to two groups. The Experimental group received balance rehabilitation aimed at improving motor and sensory strategies. The Control group received rehabilitation treatment which did not include training of sensory strategies. Persons with MS were blindly assessed by means of a stabilometric platform with eyes open, eyes closed and...