Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer Israel and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Phys Rehabil Med. 2011 Dec;47(4):579-86. Epub 2011 Feb 9.
Patients with multiple sclerosis (MS) frequently experience poor postural control affecting mobility and/or cognitive impairment, even in the early stages of the disease. As postural control consumes attentional resources, it is essential to test stability during a cognitive task.
To assess postural control and determine the effect of a cognitive task on balance in patients with a clinically isolated syndrome (CIS) suggestive of MS, within 3 months from onset.
Observational case control study
Multiple Sclerosis Center and Institute of Motor Functions, Sheba Medical Center, Tel Hashomer, Israel
Fifty-two CIS patients, aged 35.2±1.3 years, disease duration of 54±6.2 days and Expanded Disability Status Scale (EDSS) of 1.7±0.2, participated in the study. The control group consisted of 28 age and gender matched healthy subjects.
Stability was evaluated by the quantifying movement of the center of pressure (CoP) during standing under three conditions: eyes open, eyes closed, and while performing the modified Stroop test. Sway rate and CoP data was collected by a computerized force platform device.
After combining major postural control parameters, only 50% of the patients performed normally. Differences in postural variables were found between patients and healthy subjects (P<0.01). Both sway rate and standard deviation of the CoP in all test conditions were significantly higher in patients compared to controls. The cognitive task resulted in an elevated sway rate both in CIS patients and the control group when compared with the eyes open task. Within 3 months of the onset of neurological symptomatology, postural instability was detected in 50% of CIS patients using a dedicated balance measurement device.
As these findings are associated with the very early phase of MS, it appears that the ongoing pathological disease process is already taking place with regard to the balance control system.
Identification of postural abnormalities in the early stages is important in order to establish proper intervention programs.
多发性硬化症（MS）患者经常出现姿势控制不良，影响移动能力和/或认知障碍，即使在疾病的早期阶段也是如此。由于姿势控制需要消耗注意力资源，因此在进行认知任务时测试稳定性至关重要。
评估姿势控制，并确定认知任务对处于 MS 临床孤立综合征（CIS）的患者平衡的影响，这些患者在发病后 3 个月内出现症状。
观察性病例对照研究
以色列谢巴医疗中心多发性硬化症中心和运动功能研究所
52 名 CIS 患者，年龄 35.2±1.3 岁，疾病持续时间为 54±6.2 天，扩展残疾状况量表（EDSS）为 1.7±0.2，参与了研究。对照组由 28 名年龄和性别匹配的健康受试者组成。
通过在三种情况下（睁眼、闭眼和进行改良 Stroop 测试时）量化中心压力（CoP）的运动来评估稳定性。通过计算机力平台设备收集摇摆率和 CoP 数据。
结合主要姿势控制参数后，只有 50%的患者表现正常。患者与健康受试者之间的姿势变量存在差异（P<0.01）。与对照组相比，患者在所有测试条件下的摇摆率和 CoP 标准差均显著更高。与睁眼任务相比，认知任务导致 CIS 患者和对照组的摇摆率均升高。在神经系统症状出现后的 3 个月内，使用专门的平衡测量设备在 50%的 CIS 患者中检测到姿势不稳定。
由于这些发现与 MS 的早期阶段有关，因此似乎与平衡控制系统有关的正在进行的病理疾病过程已经在发生。
在早期识别姿势异常很重要，以便建立适当的干预计划。
