The effect of fatigue on postural control in individuals with multiple sclerosis: A systematic review

Abstract

Background: Fatigue is the most disabling ‎symptom for individuals with multiple ‎sclerosis which can significantly affect postural control by impairing the ability of the central nervous system to modulate sensory inputs and coordinate motor responses. This systematic review aimed to accumulate the existing evidence. This systematic review aimed to investigate the effect of ‎fatigue on postural control in individuals with multiple ‎sclerosis.‎ Methods: This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and registered in PROSPERO with ID CRD42022376262‎. Web of Science, PubMed, Scopus, and Google Scholar was systematically searched until January 2023, and a manual search was performed using the reference lists of included studies. Two authors independently selected the studies, extracted data, and evaluated their ‎methodological quality using the Downs and Black checklist. The process was later discussed ‎with a third author.‎ Results: Five studies were included in this review, of which consistent evidence investigating a direct ‎relationship between fatigue and ‎postural control in individuals with multiple ‎sclerosis. All the studies reported negative effects on postural control. Four ‎studies executed walking tests as fatigue protocols, and one study used a strength testing protocol for both legs, which served as a fatigue-inducing activity‎. Conclusions: The available evidence suggests that individuals with multiple ‎sclerosis may experience postural control deficits due to fatigue. However, the present body of literature exhibits limitations in terms of its quality and methodology. Gender differences, balance, fatigue task, and muscle function are important factors that need to be taken into account when investigating the relationship between fatigue and postural control deficits in MS. Further high-quality research is necessary to comprehend the complex interplay between MS-related fatigue and postural control deficits after physical activity.