School of Kinesiology, Auburn University, Auburn, AL.
College of Health Solutions, Arizona State University, Phoenix, AZ.
Arch Phys Med Rehabil. 2023 Sep;104(9):1456-1464. doi: 10.1016/j.apmr.2023.02.018. Epub 2023 Apr 8.
To develop a multiple sclerosis (MS)-specific model of balance and examine differences between (1) MS and neurotypical controls and (2) people with MS (PwMS) with (MS-F) and without a fall history (MS-NF).
A cross-sectional study was conducted at the Gait and Balance Laboratory at the University of Kansas Medical Center. Balance was measured from the instrumented sway system (ISway) assessment.
In total, 118 people with relapsing-remitting MS (MS-F=39; MS-NF=79) and 46 age-matched neurotypical controls.
Not applicable.
A total of 22 sway measures obtained from the ISway were entered into an exploratory factor analysis to identify underlying balance domains. The model-derived balance domains were compared between (1) PwMS and age-matched, neurotypical controls and (2) MS-F and MS-NF.
Three distinct balance domains were identified: (1) sway amplitude and velocity, (2) sway frequency and jerk mediolateral, and (3) sway frequency and jerk anteroposterior, explaining 81.66% of balance variance. PwMS exhibited worse performance (ie, greater amplitude and velocity of sway) in the sway velocity and amplitude domain compared to age-matched neurotypical controls (P=.003). MS-F also exhibited worse performance in the sway velocity and amplitude domain compared to MS-NF (P=.046). The anteroposterior and mediolateral sway frequency and jerk domains were not different between PwMS and neurotypical controls nor between MS-F and MS-NF.
This study identified a 3-factor, MS-specific balance model, demonstrating that PwMS, particularly those with a fall history, exhibit disproportionate impairments in sway amplitude and velocity. Identifying postural stability outcomes and domains that are altered in PwMS and clinically relevant (eg, related to falls) would help isolate potential treatment targets.
开发一种多发性硬化症（MS）特异性平衡模型，并检验以下两个方面的差异：（1）MS 与神经典型对照组；（2）有（MS-F）和无跌倒史（MS-NF）的 MS 患者（PwMS）。
这是一项在堪萨斯大学医学中心步态与平衡实验室进行的横断面研究。通过仪器摆动系统（ISway）评估来测量平衡。
共有 118 名复发缓解型 MS 患者（MS-F=39；MS-NF=79）和 46 名年龄匹配的神经典型对照组。
不适用。
从 ISway 获得的 22 个摆动测量值被输入到探索性因素分析中，以确定潜在的平衡域。在（1）PwMS 与年龄匹配的神经典型对照组和（2）MS-F 与 MS-NF 之间比较模型衍生的平衡域。
确定了三个不同的平衡域：（1）摆动幅度和速度，（2）摆动频率和急动度横向，（3）摆动频率和急动度前后，解释了 81.66%的平衡方差。与年龄匹配的神经典型对照组相比，PwMS 在摆动速度和幅度域的表现更差（P=.003）。与 MS-NF 相比，MS-F 在摆动速度和幅度域的表现也更差（P=.046）。PwMS 与神经典型对照组之间以及 MS-F 与 MS-NF 之间，前后和横向摆动频率和急动度域没有差异。
本研究确定了一个 3 因素的 MS 特异性平衡模型，表明 PwMS，特别是有跌倒史的患者，在摆动幅度和速度方面表现出不成比例的障碍。确定 PwMS 中改变的姿势稳定性结果和与临床相关的（例如，与跌倒相关）的领域将有助于分离潜在的治疗靶点。
