Dataset Information

Effects of External Perturbations on Anticipatory and Compensatory Postural Adjustments in Patients with Multiple Sclerosis and a Fall History.

ABSTRACT:

Background

Although previous studies have investigated postural adjustment mechanisms in patients with multiple sclerosis (MS), it seems that no study has yet investigated the relationship between anticipatory and compensatory postural adjustments (APAs and CPAs, respectively) and falls.

Methods

Seventeen MS fallers, 17 MS nonfallers, and 15 controls were exposed to a series of expected and unexpected backward pull perturbations applied at the trunk level. The electrical activity of 12 leg and trunk muscles as well as center of pressure displacement were recorded.

Results

The MS fallers had delayed muscle activity onsets compared with MS nonfallers and controls. In addition, a significantly lower level of muscle activity during APAs was detected in MS fallers compared with controls. Moreover, in the unexpected condition of perturbation, significantly smaller CPA was observed in MS fallers compared with controls. Both groups of patients with MS required more time to stabilize their center of pressure after both types of perturbations compared with controls.

Conclusions

The inability to produce efficient APAs and CPAs during perturbations may explain the high rates of postural instability and falls in patients with MS. Findings from this study provide a background for the development of perturbation-based training programs aimed at balance improvement and fall prevention by restoring mechanisms underlying balance impairments.

SUBMITTER: Tajali S

PROVIDER: S-EPMC6107338 | biostudies-literature | 2018 Jul-Aug

REPOSITORIES: biostudies-literature

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Publications

Effects of External Perturbations on Anticipatory and Compensatory Postural Adjustments in Patients with Multiple Sclerosis and a Fall History.

Tajali Shirin S Rouhani Mina M Mehravar Mohammad M Negahban Hossein H Sadati Elham E Oskouei Ali E AE

International journal of MS care 20180701 4

<h4>Background</h4>Although previous studies have investigated postural adjustment mechanisms in patients with multiple sclerosis (MS), it seems that no study has yet investigated the relationship between anticipatory and compensatory postural adjustments (APAs and CPAs, respectively) and falls.<h4>Methods</h4>Seventeen MS fallers, 17 MS nonfallers, and 15 controls were exposed to a series of expected and unexpected backward pull perturbations applied at the trunk level. The electrical activity ...[more]

PMID: 30150900

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Project description:The One-Leg Stance (OLS) test is a widely adopted tool for the clinical assessment of balance in the elderly and in subjects with neurological disorders. It was previously showed that the ability to control anticipatory postural adjustments (APAs) prior to lifting one leg is significantly impaired by idiopathic Parkinson's disease (iPD). However, it is not known how APAs are affected by other types of parkinsonism, such as frontal gait disorders (FGD). In this study, an instrumented OLS test based on wearable inertial sensors is proposed to investigate both the initial anticipatory phase and the subsequent unipedal balance. The sensitivity and the validity of the test have been evaluated. Twenty-five subjects with iPD presenting freezing of gait (FOG), 33 with iPD without FOG, 13 with FGD, and 32 healthy elderly controls were recruited. All subjects wore three inertial sensors positioned on the posterior trunk (L4-L5), and on the left and right frontal face of the tibias. Participants were asked to lift a foot and stand on a single leg as long as possible with eyes open, as proposed by the mini-BESTest. Temporal parameters and trunk acceleration were extracted from sensors and compared among groups. The results showed that, regarding the anticipatory phase, the peak of mediolateral trunk acceleration was significantly reduced compared to healthy controls (p < 0.05) in subjects with iPD with and without FOG, but not in FGD group (p = 0.151). Regarding the balance phase duration, a significant shortening was found in the three parkinsonian groups compared to controls (p < 0.001). Moreover, balance was significantly longer (p < 0.001) in iPD subjects without FOG compared to subjects with FGD and iPD subjects presenting FOG. Strong correlations between balance duration extracted by sensors and clinical mini-BESTest scores were found (ρ > 0.74), demonstrating the method's validity. Our findings support the validity of the proposed method for assessing the OLS test and its sensitivity in distinguishing among the tested groups. The instrumented test discriminated between healthy controls and people with parkinsonism and among the three groups with parkinsonism. The objective characterization of the initial anticipatory phase represents an interesting improvement compared to most clinical OLS tests.

Dataset Information

Effects of External Perturbations on Anticipatory and Compensatory Postural Adjustments in Patients with Multiple Sclerosis and a Fall History.

Background

Methods

Results

Conclusions

Publications

Effects of External Perturbations on Anticipatory and Compensatory Postural Adjustments in Patients with Multiple Sclerosis and a Fall History.

Similar Datasets

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