Postural Control in Relapsing-Remitting Multiple Sclerosis

Flavia Salvaterra Cusin; Andreza Tomaz; Maurício Malavasi Ganança; Enedina Maria Oliveira; Alessandra Billi Falcão Gonçalves; Heloisa Helena Caovilla

doi:10.1055/s-0041-1741026

International Archives of Otorhinolaryngology, Table of Contents

CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e592-e604
DOI: 10.1055/s-0041-1741026

Original Research

Postural Control in Relapsing-Remitting Multiple Sclerosis

Authors

Flavia Salvaterra Cusin

¹Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
Andreza Tomaz

¹Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
Maurício Malavasi Ganança

¹Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
Enedina Maria Oliveira

²Department of Neurology and Neurosurgery, Demyelinating Diseases Outpatient Clinic, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
Alessandra Billi Falcão Gonçalves

²Department of Neurology and Neurosurgery, Demyelinating Diseases Outpatient Clinic, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
Heloisa Helena Caovilla

¹Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

Abstract

Introduction Postural instability is considered one of the most disabling symptoms of relapsing-remitting multiple sclerosis (RRMS).

Objective To evaluate postural control in patients with RRMS.

Method A total of 79 individuals between 18 and 65 years old, of both genders, were distributed into an experimental group composed of patients with RRMS (n = 51) and in a control group composed by healthy individuals (n = 28). The evaluation consisted of anamnesis, Dizziness Handicap Inventory (DHI), visual vertigo analog scale (VVAS), and static posturography (Tetrax IBS).

Results Patients with RRMS presented mild degree in the DHI and in the VVAS; in Tetrax IBS, they presented higher or lower values of the indices of general stability, weight distribution, synchronization of postural oscillation, fall risk, and frequency bands of postural oscillation in two, five or all eight sensory conditions, in relation to the control group. Vestibular, visual and/or somatosensory dysfunction of peripheral type (51.0%) prevailed over the central type. The RRMS group, with an expanded scale of disability status > 3 points, presented a higher fall risk than with a score ≤ 3 points (p = 0.003). There was a positive correlation of the Fall Risk Index with the total DHI Score (s = 0.380; p = 0.006) and with the VVAS score (s = 0.348; p = 0.012).

Conclusion Patients with RRMS may present with inability to maintain postural control due to general instability, desynchronization and increased postural oscillation at frequencies that suggest deficiencies in the vestibular, visual, and somatosensory systems; as well as fall risk related to the state and intensity of functional disability and self-perception of the influence of dizziness on quality of life.

Keywords

multiple sclerosis - relapsing-remitting - postural balance - dizziness - quality of life

Full Text

References

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