Abstract
Objective
To characterize postural responses to forward and backward external perturbations
in people with multiple sclerosis (PwMS), and to relate performance to commonly used
clinical outcomes.
Design
Cross-sectional study. Postural responses were tested during large stepping and smaller
feet-in-place perturbations in forward and backward directions.
Setting
University research laboratory.
Participants
PwMS (n=54) and age-matched controls (n=21) (N=75).
Interventions
Not applicable.
Main Outcome Measures
Center of mass displacement and step latency after external perturbations.
Results
PwMS exhibited larger center of mass displacements and step latencies than control
participants in response to stepping perturbations (P=.003 and P=.028, respectively). Stepping deficits were more pronounced during backward stepping
and were significantly correlated to increased severity on clinical measures (European
Database for Multiple Sclerosis disability score and Timed 25-Foot Walk).
Conclusions
Compensatory stepping is impaired in PwMS and correlates with clinical disability.
Measurement of backward compensatory stepping may be more effective at identifying
postural dysfunction in PwMS than forward compensatory steps. Prolonged step latencies,
large anticipatory postural adjustments, and multiple compensatory steps are especially
altered in PwMS, suggesting possible targets for neurorehabilitation.
Keywords
List of abbreviations:
APA (anticipatory postural adjustment), COM (center of mass), COP (center of pressure), MS (multiple sclerosis), PwMS (people with multiple sclerosis), T25FW (Timed 25-Foot Walk)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: November 18, 2015
Footnotes
Supported by the National Multiple Sclerosis Society (grant no. RG 4914A1/2) and National Institutes of Health, National Center for Advancing Translational Science (grant no. 1KL2TR000119), United States Department of Veterans Affairs Rehabilitation Research and Development Service (Career Development Award 1: no. I01BX007080), Medical Research Foundation of Oregon (Early Investigator Award), the Veterans Affairs Merit Award (award no. E1075-R), and National Institutes of Health (grant no. R01 AG006457 29).
The contents do not represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.
Disclosures: F.B.H. and the Oregon Health and Science University have an equity and interest in APDM, a company that may have a commercial interest in the results of the study. This conflict of interest has been reviewed and managed by the Research and Development Committee at the Portland Veterans Affairs Medical Center and Oregon Health and Science University. The other authors have nothing to disclose.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
