Leg Power Asymmetry and Postural Control in Women with Multiple Sclerosis

Chung, Linda H.; Remelius, Jebb G.; Emmerik, Richard E.A. van; Kent‐Braun, Jane A.

doi:10.1249/mss.0b013e31817e32a3

Cited by 147 publications

(151 citation statements)

References 39 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…Participants stood quietly on the force plate for 20 seconds with eyes open and directed forward gaze. Overall, the women with MS had greater Center-of-Pressure (COP) sway in the antero-posterior direction (mean=7.52 mm) than the age-matched controls (mean=4.33 mm) [21]. Another study of 16 persons with MS and 16 sex-matched controls used a similar static posturography protocol (i.e., participants stood quietly on a force plate with eyes open and directed forward for 30 seconds) [22].…”

Section: Evidence For Physiological Deconditioning In Msmentioning

confidence: 99%

“…Another study reported that persons with mild MS-related disability who had a higher O 2 cost of walking took slower (r=-0.25) and shorter (r=-0.32) steps, while spending a greater percentage of time in double support (r=0.27), based on measurements from a GaitRite electronic walkway during comfortable walking pace [39]. Other studies have reported that lesser peak isometric torque and greater torque asymmetries were associated with worse timed 25-foot walking (T25FW) performance in MS [20,21]. One study examined the association of peak torque in knee flexors and extensors with 2-minute walk test (2MWT) distance in 52 persons with mild and moderate MS disability.…”

Section: Walking Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

The Importance of Physical Fitness in Multiple Sclerosis

Motl¹

2013

J Nov Physiother

View full text Add to dashboard Cite

Multiple Sclerosis (MS) is a common and life-altering neurological disease among adults in the United States and worldwide. This disease has an estimated prevalence of 1 per 1,000 adults in the United States [1] with the majority of cases occurring in women of European descent. The MS pathophysiology initially involves episodic periods of immune-mediated demyelination and transection of axons within the Central Nervous System (CNS). This results in the disruption of saltatory conduction of action potentials along myelinated axonal pathways in the brain, spinal cord, and optic nerves. The MS pathophysiology later transitions into a neurodegenerative disease process, presumably associated with insufficient neurotrophic support, and results in the accumulation of irreversible neurologic disability. The degree and location of axonal and neuronal damage within the CNS result in the heterogeneous expression of symptomatic, functional, and participatory consequences among persons with MS [2]. Such manifestations might be initiated or worsened by physical inactivity and resulting physiological deconditioning.We have previously described a model of physical inactivity, deconditioning, and worsening MS [3,4], and this was based on a similar framework for persons with chronic disease conditions [5] including MS [6]. The model is displayed in figure 1 and indicates that MS onset results in physical inactivity [7,8] that initiates physiological deconditioning (i.e., compromised or reduced physical fitness). This physiological deconditioning, in turn, results in worsening of MS, as indicated by loss of brain structure and function as well as symptomatic (e.g., fatigue) and functional (e.g., walking impairment) manifestations. The worsening of MS results in further physical inactivity and subsequent physiological deconditioning thereby yields a cycle of associations among physical inactivity, deconditioning, and worsening MS that develops over time. This model is important as it conceptualizes the importance of maintaining and improving physical fitness levels in persons with MS. Physical fitness might provide a form of "physiological reserve" that is protective of disease consequences and worsening of MS and this is consistent with other literatures such as cancer [9].To that end, this paper provides a comprehensive review of research on physical fitness in persons with MS. We begin by defining physical fitness and its domains as well as differentiating it from physical activity. We then present research on physiological deconditioning (i.e., detraining that manifests as a reduction in domains of physical work capacity or fitness) in persons with MS as well as evidence on the association between markers of physical fitness and consequences of MS. We lastly review research regarding the effects of exercise training on physical fitness and consequences of MS, and conclude with recently developed exercise recommendations for improving physical fitness. Our goal is the provision of a paper that underscores the (a) importance of p...

show abstract

Section: Evidence For Physiological Deconditioning In Msmentioning

confidence: 99%

Section: Walking Outcomesmentioning

confidence: 99%

The Importance of Physical Fitness in Multiple Sclerosis

Motl¹

2013

J Nov Physiother

View full text Add to dashboard Cite

show abstract

“…Measurements of height, weight, leg spasticity (using the MASS), comfortable walking speed, and muscle strength preceded 15 min of treadmill walking. The more-and lessaffected sides of patients with MS and strong/weak sides of nondisabled controls were determined from cumulative leg strength since it is known that leg muscle groups are most commonly affected in patients with MS [6,[24][25][26]. The maximal voluntary contraction forces for knee extension and flexion of both legs were summed for each participant, and the leg with the highest additive forces was classified as the stronger/less-affected leg.…”

Section: Experimental Protocolmentioning

confidence: 99%

“…Lower-limb muscle weakness [2], with greater weakness on one side of the body [3][4], is a common symptom and may contribute to the walking difficulties frequently experienced by patients with MS [5]. Moreover, patients with MS have been shown to exhibit decreased postural and trunk control [6][7], although very little is known about core muscle activity during walking in this population.…”

Section: Introductionmentioning

confidence: 99%

Core muscle characteristics during walking of patients with multiple sclerosis

et al. 2015

View full text Add to dashboard Cite

Abstract-The purpose of this study was to investigate core muscle characteristics during walking in patients with multiple sclerosis (MS). Eight patients (4 men) with relapsing-remitting MS (aged 44.9 +/-8.6 yr) and sex-matched controls (37.9 +/-8.4 yr) walked on a treadmill for 15 min at a self-selected speed. Positron emission tomography/computed tomography imaging was used to measure core muscle activity immediately after walking based on glucose uptake. Activity was not different between the MS and control group for any of the identified muscles (p > 0.28). Within the MS group, side differences in activity were identified in the lateral flexor group, the external and internal obliques, and the rectus abdominis (p < 0.05), with the lessaffected side being activated more. Furthermore, greater muscle volume was found on the more-affected side of the transversus abdominis, quadratus lumborum, and the low-back extensor group (p < 0.03). These muscle characteristics suggest patients with MS utilize compensatory mechanisms during walking to maintain balance and posture. These strategies likely result in increased muscle energy cost and early fatigability.

show abstract

“…For this study, we used dynamic posturography to objectively quantify balance in PwMS because this is the gold standard objective measure of standing postural control and because this has been used previously to quantify balance in PwMS [3][4][11][12]. Recent posturography studies have demonstrated specific performance abnormalities on posturography in PwMS, including delayed automatic postural responses to backward translations [13] and abnormal postural sway when sensory inputs are removed [5].…”

Section: Introductionmentioning

confidence: 99%

Objective and subjective measures reflect different aspects of balance in multiple sclerosis

Cameron¹,

Huisinga

2013

J Rehabil Res Dev

View full text Add to dashboard Cite

Abstract-The objective of this study was to evaluate relationships between subjective and objective measures of balance in multiple sclerosis (MS). In 54 subjects with MS, balance was measured objectively with the Sensory Organization Test (SOT) using dynamic posturography and subjectively with the Activitiesspecific Balance Confidence (ABC) Scale and the Falls Efficacy Scale-International (FES-I). MS-related disability was assessed with the Expanded Disability Status Scale (EDSS). Relationships between the magnitude (root mean square, range, and area) as well as velocity of center of pressure sway (calculated from the center of pressure signal from the SOT), composite SOT, ABC Scale, FES-I, and EDSS scores were assessed. The magnitude and velocity of center of pressure sway was statistically significantly correlated with the ABC Scale (rho = 0.2 to 0.5), FES-I (rho = 0.3 to 0.5), and EDSS (rho = 0.3 to 0.4). The composite SOT was also statistically significantly correlated with the ABC Scale, FES-I, and EDSS. Objective balance measures, as reflected by posturography, were significantly related to subjective reports of imbalance and clinical measures of disability in MS. The relationships are moderate to weak, indicating that a comprehensive description of balance problems in people with MS likely requires both objective and subjective balance measures.

show abstract

Leg Power Asymmetry and Postural Control in Women with Multiple Sclerosis

Abstract: These data provide new evidence of a potential role for KE strength asymmetries in the symptomatic fatigue and physical dysfunction of persons with MS, possibly through an effect on postural stability.

Cited by 147 publications

References 39 publications

The Importance of Physical Fitness in Multiple Sclerosis

The Importance of Physical Fitness in Multiple Sclerosis

Core muscle characteristics during walking of patients with multiple sclerosis

Objective and subjective measures reflect different aspects of balance in multiple sclerosis

Contact Info

Product

Resources

About