Core Stability, Trunk Position Sense, Balance and Functional Mobility in Patients With Multiple Sclerosis
Condition: Physical Therapy
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      The aim of this study is to compare balance, functional mobility, core stability and trunk
      position sense in patients with Multiple Sclerosis (PwMS) and healthy controls and
      investigate the relationship between core stability and trunk position sense with balance and
      functional mobility in PwMS.

      Balance and mobility disorders are seen in various degrees in patients with Multiple
      Sclerosis (PwMS). Balance and mobility impairments are observed in the beginning with the
      early period and are one of the most common causes of disability in PwMS.

      Coordination between the peripheral sensory system, the central sensory-motor system and the
      musculoskeletal system which generates motor responses is required to provide balance. If one
      or more of these systems do not function properly, this results in deficiency in trunk
      stability and also causes balance and mobility disorders.

      It has been shown that balance and mobility disorders are mostly associated with loss of
      strength, spasticity, coordination disorders and sensory loss. Especially, it is known that
      strength of core are related to balance and mobility. Although core muscle strength is a
      significant element of trunk stability, position sense is also responsible for trunk
      stability. When literature is examined, there is no study which examines the relationship
      between balance and mobility with core muscles' strength and trunk position sense in PwMS.
      For all these reasons, we think that balance and functional mobility may be related to core
      stability and trunk position sense in PwMS
    

Detailed description: 
      Our study was carried out with the purpose of comparing balance, functional mobility, core
      stability and trunk position sense in PwMS and healthy controls and investigating the
      relationship between core stability and trunk position sense with balance and functional
      mobility in PwMS.

      45 PwMS and 29 healthy volunteers with matching ages and genders were included the study.
      Balance was assessed by Biodex Biosway Portable Balance System (Biodex Medical Systems Inc.,
      Shirley, New York). Timed Up and Go (TUG) tests were used to evaluate functional mobility.
      Core endurance and core strength, which are two specific components of core stability, were
      evaluated separately. Trunk flexor, trunk extensor, right and left side bridge and prone
      bridge tests were applied to assess the endurance of the core muscles. The power of core
      muscles was evaluated with sit-ups and modified push-ups tests. Trunk position sense was
      evaluated by the trunk reposition test with Dualer IQ digital inclinometer (J-TECH medical,
      Salt Lake City, UK, USA).
    

Intervention name(s): Balance; Functional mobility; Core stability; Trunk position sense
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Balance was assessed by Biodex Biosway Portable Balance System (Biodex Medical Systems Inc., Shirley, New York). Postural Stability (PS), Limits of Stability (LOS) and Modified Sensory Organization Tests (MSOT) were evaluated with this system. PS test assesses static balance during standing up by the ability to hold the center of gravity on the support surface. The test was performed on both feet and on the left and right foot separately. LOS test assesses how much the center of gravity is displaced on the support surface without losing balance during the standing position. MSOT assesses the effects of somatosensory, visual and vestibular senses on postural control during the standing position. It evaluates the sensory component of balance in two different visual conditions and on two different support surfaces.; Timed Up and Go (TUG) tests were used to evaluate functional mobility. The TUG measures the time it takes a subject to stand up from an armchair, walk a distance of 3 m, turn, walk back to the chair and sit down. Time was recorded in seconds with a stopwatch.; Core endurance and core strength, which are two specific components of core stability, were evaluated separately. Trunk flexor, trunk extensor, right and left side bridge and prone bridge tests were applied to assess the endurance of the core muscles. Tests were terminated when the subjects said they could not continue the test or when the test position was broken. A stopwatch was used for the measurements and the results were recorded in seconds. The power of core muscles was evaluated with sit-ups and modified push-ups tests. It was recorded how many times the subject could do each test for 30 seconds. The tests were repeated twice and the best measurement score was recorded for use in the statistical analyses.; Trunk position sense was evaluated by the trunk reposition test with Dualer IQ digital inclinometer (J-TECH medical, Salt Lake City, UK, USA). Measurements were made in two levels: lumbosacral (LS) and thoracosacral (TS) regions. The testing took place while standing under three visual-surface conditions. Participants flexed the trunk approximately 30° in the sagittal plane, holding the position for a count of 3 seconds (position 1) and then participants attempted to repeat the previously attained angle. Participants indicated verbally when they felt they had reached the angle and held their position for a count of 3 seconds (position 2). The absolute difference in degrees between positions 1 and 2 was defined as the trunk reposition error (TRE) degree. Participants generated five scores for each visual-surface condition. For each condition, the highest and lowest scores were discarded and the mean of the remaining three scores represented the TRE score
Allocation: Non-Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: Multiple Sclerosis; Balance; Core Stability; Proprioception; Functional Mobility