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

Abstract

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.

Reliability and Validity of the Computerized Dynamic Posturography Sensory Organization Test in People with Multiple Sclerosis

“…Balance f CSI is a complex physiological process that many clinical measures of postural control are unable to quantify. The computerized dynamic posturography sensory organization test (CDP-SOT) has initial support as a valid measure of balance f CSI and falls in people with MS. 7,8 It has been applied as a primary outcome in controlled trials of balance 9 and vestibular rehabilitation 10 training for individuals with MS, supporting the responsiveness of the CDP-SOT to targeted treatment of impaired balance f CSI in this patient population. The CDP-SOT has also been applied as a gold standard for the validation of novel outcome measures of postural control.…”

Relationship between postural instability and subcortical volume loss in Alzheimer's disease

“…[1,29] Considering the fact that even people with MCI or SCI have impaired balance [6,7,30] and various parameters of balance control were associated with the severity of cognitive dysfunction, [3,6,7] assessment of postural instability in AD might provide a clue for an earlier diagnosis of AD and a method to provide further individualized management. However, many of these studies [5,8–10] used self-reported questionnaires for falling or simple tests of walking abilities for given time, which provided limited information about participant performances. Thus, we adopted CDP for quantitative assessment of balance control in AD and hypothesized that CDP performance might be more impaired in AD than in controls as in the previous reports.…”

“…The assessments of posture in most previous studies [5,8–10] were subjective and non-quantitative, as they were based on self-reported questionnaires or simple neurological examinations. It is generally accepted that computerized dynamic posturography (CDP) has the ability to evaluate balance quantitatively.…”

“…It is generally accepted that computerized dynamic posturography (CDP) has the ability to evaluate balance quantitatively. [8,11,12] Thus, CDP has been widely used to diagnosis patients with postural instability and may predict the future risk of falling.…”

Psychometric Properties of Instrumented Postural Sway Measures Recorded in Community Settings in Independent Living Older Adults

“…Previous studies showed similar results when comparing center of pressure measures using a force platform with clinical-based measures such as the SPPB [36,37]. However, the moderate correlation indicates that different aspects of balance are being measured by the accelerometer- specific Balance Confidence (ABC) scale, which was highly correlated with the GES, showed a similar correlation between postural sway and the ABC scale [38].…”