The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

Abstract

Balance impairment and falls are frequent in patients with multiple sclerosis (PwMS), and they may occur even at the earliest stage of the disease and in minimally impaired patients. The introduction of computer-based force platform measures (i.e., static and dynamic posturography) has provided an objective and sensitive tool to document both deficits and improvements in balance. By using more challenging test conditions, force platform measures can also reveal subtle balance disorders undetectable by common clinical scales. Furthermore, posturographic techniques may also allow to reliably identify PwMS who are at risk of accidental falls. Although force platform measures offer several theoretical advantages, only few studies extensively investigated their role in better managing PwMS. Standardised procedures, as well as clinical relevance of changes detected by static or dynamic posturography, are still lacking. In this review, we summarized studies which investigated balance deficit by means of force platform measures, focusing on their ability in detecting patients at high risk of falls and in estimating rehabilitation-induced changes, highlighting the pros and the cons with respect to clinical scales.

The Impact of Dynamic Balance Measures on Walking Performance in Multiple Sclerosis

“…Fall risk in MS has been linked to reduced balance control and quality of gait 39 as well as neurological impairments that include weakness, sensory dysfunction, and poor motor planning strategies. 40 Deficits in forward limits of stability, or leaning, along with lower extremity weakness have also been associated with recurrent fallers in MS. 41-42 Kasser et al 42 also demonstrated that reduced limits of stability on voluntary movement during dynamic posturography accurately identified frequent fallers in a sample of women with MS. Slips and falls frequently occur in the anterior-posterior (forward-backward) direction; thus AP sway may be more relevant to fall risk than ML sway.…”

Direction-specific impairments of limits of stability in individuals with multiple sclerosis

“…The available literature on the impairments of the limits of stability in individuals with MS is not complete because most of the studies provide information only on the disease-related impairments of limits of stability in anterior-posterior and medio-lateral directions [4,18,19,27].…”

Oral Dalfampridine Improves Standing Balance Detected at Static Posturography in Multiple Sclerosis

“…However, the use of computer-based measures of standing balance, that are accurate and reliable in MS setting [28], provided data more objective than clinical scales.…”