Early recognition of postural disorders in multiple sclerosis through movement analysis: a modeling study

Abstract

In the present study, spontaneous postural behavior has been analyzed in freely standing multiple sclerosis (MS) patients, exhibiting no clinically assessable abnormalities of postural control. This population has been compared with two other groups, healthy people and hemiparetic patients. This latter group represents a situation where the central nervous system (CNS) lesion is precisely localized in one anatomical site and no signal-conduction disorders are present; i.e., it has an opposite anatomical character with respect to the MS at a preclinical stage. The hypothesis underlying the modeling study is the presence of a controller block working in a feedback posture control system. This controller block receives the body sway as input, and produces the corresponding ankle torque stabilizing the body, the latter being modeled as an inverted pendulum. The CNS damage, caused by MS, is supposed to be reflected in some detectable change in the structure of the controller of the posture control system. The identification of the controller has been performed by means of a parametric estimation procedure which employed as input sequences, data recorded by means of a movement-analysis (MA) system. Reported findings show a structural changes of the model of the controller block in the posture control system. This result may suggest the presence of an MS-specific reorganization of the posture control system. Some speculation is finally made on the black-box approach in comparison with traditional posturography, to arrive at hypothesizing a progression path for postural disorders.

Screening for balance disorders in mildly affected multiple sclerosis patients

“…These tests are partly based on subjective ratings and provide no guarantee that there is no balance problem when the assessment is negative. There are MS patients who complain about subjective discomfort of balance even if there is no clinical evidence of any balance problem [1]. Detecting minimal impairment of balance based on observation is not easy as confirmed by our neurologists who examined the videos.…”

“…In multiple sclerosis (MS) patients detection of balance deficits is challenging because MS patients often complain about balance problems when the Romberg test is negative and gait tests are normal [1]. Other clinical tests, for example, the Berg Balance Scale and Tinetti Performance Oriented Mobility Assessment, are also not sensitive enough to detect minimal balance impairment in MS patients [2].…”

Core muscle characteristics during walking of patients with multiple sclerosis

“…Using this technique would provide objective measures of interventional changes rather than the current methods of self-report or distantly related outcomes such as walking, mobility, or balance. Furthermore, previous studies have shown the challenges of diagnosing balance impairments in patients with MS [37][38]. These studies demonstrated the limitations of current methods, such as biomechanical analysis with force platforms and EMG, to identify balance impairments in patients with MS.…”

Classification of Stabilometric Time-Series Using an Adaptive Fuzzy Inference Neural Network System

“…Regarding stabilometric data analysis, body sway parameters have been used for analysis balance-related functions [8], [9]. However, it appears that classic posturographic parameters, such as the measure of the sway of the centre of pressure [10] have failed in the detection of balance disorders [11]. The analysis of stabilometric time series using data mining techniques offers new possibilities.…”