Gazi University, Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Ankara, Turkey.
Gait Posture. 2011 Jun;34(2):275-8. doi: 10.1016/j.gaitpost.2011.05.015. Epub 2011 Jun 16.
The aims of the present study were to investigate the relationship between the foot sensations and standing balance in patients with Multiple Sclerosis (MS) and find out the sensation, which best predicts balance. Twenty-seven patients with MS (Expanded Disability Status Scale 1-3.5) and 10 healthy volunteers were included. Threshold of light touch-pressure, duration of vibration, and distance of two-point discrimination of the foot sole were assessed. Duration of static one-leg standing balance was measured. Light touch-pressure, vibration, two-point discrimination sensations of the foot sole, and duration of one-leg standing balance were decreased in patients with MS compared with controls (p<0.05). Sensation of the foot sole was related with duration of one-leg standing balance in patients with MS. In the multiple regression analysis conducted in the 27 MS patients, 47.6% of the variance in the duration of one-leg standing balance was explained by two-point discrimination sensation of the heel (R(2)=0.359, p=0.001) and vibration sensation of the first metatarsal head (R(2)=0.118, p=0.029). As the cutaneous receptors sensitivity decreases in the foot sole the standing balance impairs in patients with MS. Two-point discrimination sensation of the heel and vibration sensation of the first metatarsal head region are the best predictors of the static standing balance in patients with MS. Other factors which could be possible to predict balance and effects of sensorial training of foot on balance should be investigated.
本研究旨在探讨多发性硬化症(MS)患者足部感觉与站立平衡之间的关系,并找出预测平衡的最佳感觉。共纳入 27 例 MS 患者(扩展残疾状况量表 1-3.5)和 10 名健康志愿者。评估足底轻触压力阈值、振动持续时间和两点辨别觉距离。测量单腿静态站立平衡的持续时间。与对照组相比,MS 患者的足底轻触压力、振动和两点辨别觉感觉以及单腿站立平衡持续时间均降低(p<0.05)。MS 患者的足底感觉与单腿站立平衡持续时间有关。在对 27 例 MS 患者进行的多元回归分析中,单腿站立平衡持续时间的方差有 47.6%可以由足跟两点辨别觉感觉(R²=0.359,p=0.001)和第一跖骨头振动感觉解释(R²=0.118,p=0.029)。随着足底皮肤感受器敏感性降低,MS 患者的站立平衡受损。足跟两点辨别觉感觉和第一跖骨头区域的振动感觉是预测 MS 患者静态站立平衡的最佳指标。应进一步研究可能预测平衡的其他因素以及对足部感觉训练对平衡的影响。