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Volume : 25 Issue : 4 Year : 2019

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Investigation of Adaptation to Successive Postural Perturbations in Patients with Multiple Sclerosis [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-34392

Investigation of Adaptation to Successive Postural Perturbations in Patients with Multiple Sclerosis

Yeliz Salcı1, Ecem Karanfil1, Ender Ayvat1, Ayla Fil Balkan1, Jale Karakaya2, Songül Aksoy3, Kadriye Armutlu1, Aslı Kurne4, Rana Karabudak4
1Faculty Of Physical Therapy And Rehabilitation, Hacettepe University, Ankara, Turkey
2Department Of Biostatistics, Hacettepe University, Ankara, Turkey
3Department Of Audiology, Faculty Of Health Sciences, Hacettepe University, Ankara, Turkey
4Department Of Neurology, Faculty Of Medicine, Hacettepe University, Ankara, Turkey

Objective: It is well known that abnormal automatic postural responses impair balance control in patients with Multiple Sclerosis (PwMS) as well these responses can be ameliorated with training. However, the difference between MS patients and healthy population on the adaptation capacity of postural responses to perturbations remains unclear. The present study’s aim is to evaluate the adaptation capability to postural perturbations in PwMS and to reveal differences between healthy controls.
Materials and Methods: Sixty-nine ambulatory PwMS with the Expanded Disability Status Scale (EDSS) score below or equal to 5.5 and 61 healthy subjects were recruited for the study. Adaptation Test with NeuroCom Smart Balance Master System, Berg Balance Scale (BBS), and EDSS were administered. The adaptation test was performed in the toes up and toes-down directions, 5 consecutive perturbations were given for each direction. The sway energy score was calculated for postural sway that were released during these perturbations
Results: According to the adaptation test results, healthy volunteers’ sway energy scores were significantly lower than PwMS in five consecutive perturbation. (toes-up P: 0.0001, toes-down p> 0.001). Healthy volunteers and PwMS were adapted in trial 3 for both directions. The toes-up adaptation rate in PwMS (17%) was statistically lower than the healthy group (31%) (p: 0.026) while the toes-down adaptation rate was similar (p: 0.175). BBS and EDSS had significant correlation with average toes -up sway energy score. (r: -0.402, r: 0.392 respectively)
Conclusion: Ambulatory PwMS have preserved adaptation to automatic postural responses, with higher sway energy scores. Low adaptation rate in toes-up direction should be taking into account when planning the motor strategy training.

Keywords: Multiple Sclerosis, Automatic Postural Responses, Adaptation, Fall Risk




Corresponding Author: Yeliz Salcı, Türkiye


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