Balance Changes in Patients With Relapsing-Remitting Multiple Sclerosis: A Pilot Study Comparing the Dynamics of the Relapse and Remitting Phases

• Published in: Frontiers in neurology Vol. 9; p. 686
• Main Authors: Findling, Oliver, Rust, Heiko, Yaldizli, Özgür, Timmermans, Dionne P H, Scheltinga, Alja, Allum, John H J
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 21.08.2018
• Subjects: balance control; EDSS scores; multiple sclerosis; Neurology; relapse-phase multiple sclerosis; remitting-phase multiple sclerosis; trunk sway; remitting-phase multiple sclerosis; EDSS scores; multiple sclerosis; relapse-phase multiple sclerosis; balance control; trunk sway
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2018.00686

To compare balance changes over time during the relapse phase of relapsing-remitting multiple sclerosis (RRMS) with balance control during the remitting phase. Balance control during stance and gait tasks of 24 remitting-phase patients (mean age 43.7 ± 10.5, 15 women, mean EDSS at baseline 2.45 ± 1.01) was examined every 3 months over 9 months and compared to that of nine relapsing patients (age 42.0 ± 12.7, all women, mean EDSS at relapse onset 3.11 ± 0.96) examined at relapse onset and 3 months later. Balance was also compared to that of 40 healthy controls (HCs) (age 39.7 ± 12.6, 25 women). Balance control was measured as lower-trunk sway angles with body-worn gyroscopes. Expanded Disability Status Scale scores (EDSS) were used to monitor, clinically, disease progression. Remitting-phase patients showed more unstable stance balance control than HCs ( < 0.04) with no worsening over the observation period of 9 months. Gait balance control was normal ( > 0.06). Relapsing patients had stance balance control significantly worse at onset compared to remitting-phase patients and HCs ( < 0.04). Gait tasks showed a significant decrease of gait speed and trunk sway in relapsing patients ( = 0.018) compatible with having increased gait instability at normal speeds. Improvement to levels of remitting patients generally took longer than 3 months. Balance and EDSS scores were correlated for remitting but not for relapse patients. Balance in remitting RRMS patients does not change significantly over 9 months and correlated well with EDSS scores. Our results indicate that balance control is a useful measure to assess recovery after a relapse, particularly in patients with unchanged EDSS scores. Based on our results, balance could be considered as additional measurement to assess recovery after a relapse, particularly in patients with unchanged EDSS.