The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis

Association of Postural Sway with Disability Status and Cerebellar Dysfunction in People with Multiple Sclerosis

“…30 Demyelination in the cerebellum is prominent in people with MS, 31 and lesions in the brainstem and cerebellum have been shown to be associated with increased sway and number of falls over a 6-month period. 32 Standing sway measures have previously been shown to be positively correlated with gray and white matter lesions in the cerebellum and its connections as measured using magnetic resonance imaging in people with MS. 33 Sway with EO has also been shown to be associated with cerebellar atrophy in people with MS. 34 These studies confirm that cerebellar dysfunction plays a major role in the observed increase in EO and EC postural sway in people with MS, with the present study indicating that cerebellar dysfunction is likely to have a major influence on the relationship between increased postural sway and total EDSS scores.…”

Effect of Tai Chi Chuan on balance in women with multiple sclerosis

“…Ambulation problems in people with MS can range from a mild difficulty to a complete inability to stand or walk independently [4]. Balance can be defined either as "the ability to maintain the body's center of gravity within the base of support with minimal sway" [8] or "the ability to maintain body equilibrium, postural stability during quiet standing or perturbed standing with voluntary movement" [9]. The control of human balance during upright stance depends on the integration of visual, vestibular and somatosensory (proprioception) inputs reaching the CNS [8,10].…”

“…Because bone mineral density is reduced in most MS patients [8], the high incidence of falls increases the risk of fractures in these subjects, especially those with osteoporosis [8]. A decrease in mobility is strongly associated with osteoporosis aggravation and muscle wasting as well as more frequent falls.…”

Falls in People With Multiple Sclerosis Who Use a Walking Aid: Prevalence, Factors, and Effect of Strength and Balance Interventions

“…The factors that are most common are deficits of balance (7 studies), 1,2,4,[12][13][14][15] walking aid use and lower mobility status (6 studies 2,5,12,14,16,17 ), and a higher Expanded Disability Status Score (6 studies 4,5,10,13,14,17 ). Other authors have found that impairments of muscle tone and proprioception, 5 continence, 1 brainstem and middle cerebellar peduncal lesions, 13 and increasing numbers of symptoms 16 are associated with falls. Fear of falling and activity curtailment, 18 and cognitive deficits 17 are also associated with falls in people with MS.…”