How is your balance? Are you at risk of falls. #ClinicSpeak #MSBlog #MSRisk
“This study highlights another under-reported and managed problem in MS; balance problems. The study below uses a highly technical method to show that MSers have balance problems compared to normal control subjects. The real question is can this be corrected by rehabilitation? I suspect so provided we can switch off the on-going damage and allow the surviving circuits to adapt and compensate for the one that have been damaged (not conducting quickly enough due to demyelination) or lost (axonal loss).”
“Balance problems causes a large number of problems for MSers and is responsible for falls and fractures. Preventing or slowing down the accumulation of balance problems should reduce the number of falls. Poor balance also affects MSers who do certain types of work; for example dancers, sports man and woman and workers who need to use ladders.”
“How can you find out if you have problems with balance. The following is the Berg Balance Scale that was used in the study below to assess balance. If you are interested you can download it and complete it for yourself.”
Epub: Chua et al. Movement Strategies for Maintaining Standing Balance during Arm Tracking in People with Multiple Sclerosis. J Neurophysiol. 2014 Jun 25. pii: jn.00598.2013.
Background: The purpose of this study was to quantify hip and ankle movement strategies during a standing, arm tracking task in MSers.
Methods: Full body kinematics and kinetics were assessed using motion analysis cameras and force plates in 9 MS and 9 age-matched controls. While standing, participants used their dominant hand to track a target moving around a large horizontal or vertical figure-eight. The target moved at constant speed, or linearly increasing speeds, with a frequency between 0.05 Hz and 0.35 Hz. Hip and ankle moments and angles during tracking were calculated from kinematic and kinetic measurements. The ratio of peak-to-peak (PP) hip/ankle moments (kinetics) and angles (kinematics) were calculated to determine the strategies of the hips and ankles used to maintain balance during arm movements. The center-of-mass (CoM) root mean square (RMS) acceleration was calculated as a measure of overall balance performance.
Results: The MS group produced larger PP hip/ankle moments at all speeds, compared with the control group (p<0.05). The CoM RMS acceleration increased with tracking speed for both groups but was not significantly different between groups. Additionally, the ratios of hip/ankle moments were highly correlated with the Berg Balance Scale during horizontal steady speed tracking in MS.
Conclusions: These results suggest that MSers increase the use of the hip during standing arm tracking compared to age-matched controls. This adapted strategy might allow MSers to achieve similar balance performance to controls, possibly increasing the importance of the hip in maintaining balance during voluntary movements.