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Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients

Year 2023, Volume: 6 Issue: 3, 457 - 462, 01.07.2023

Fatma Erdeo , Ali Ulvi Uca , Neslihan Altuntas Yılmaz , Ahmet Furkan Doğan Ahmet Şimşek

https://doi.org/10.19127/bshealthscience.1252347

Abstract

Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease that causes demyelination of nerve fibers. This neurological process causes physical and mental changes in and to the motor, sensory, and cognitive systems. This study aims to determine the relationship between balance and muscle strength in people with multiple sclerosis. This study included 36 MS patients’ ⩾18 years old who were treated and followed up according to routine clinical practice at a university hospital in Türkiye, which were observational, non-invasive, and a control group of 32 patients whose relatives were voluntarily evaluated without any neurological problems. Muscle strength was measured manually. In balance analysis, computerized balance analysis system was used. The mean age of the MS group was 46.14 (SD±7.14) and the mean age of the healthy group (HG) was 42.25 (SD±10.81). While muscles of abdominal, hamstring, hip flexor and extensor, tibialis anterior and tibialis posterior muscle strength were found to be positively significant with balance in the MS group, P<0.05, there was no significant relationship between balance and muscle strength of back extansor (P>0.05). This study revealed significant correlations between balance and strength parameters of trunk and lower extremity muscles. Our study suggests that rehabilitation protocols for MS patients should include a critical strength training program, especially for trunk and lower extremity muscles.

Keywords

Multiple sclerosis Muscle strength Balance

References

  • Abdel-Aziz K, Schneider T, Solanky BS, Yiannakas MC, Altmann DR, Wheeler-Kingshott CAM, Peters AL, Day BL, Thompson AJ, Ciccarelli O. 2015. Evidence for early neurodegeneration in the cervical cord of patients with primary progressive multiple sclerosis. Brain : J Neurol, 138(6): 1568-1582. DOI: 10.1093/BRAIN/AWV086.
  • Boes MK, Sosnoff JJ, Socie MJ, Sandroff BM, Pula JH, Motl RW. 2012. Postural control in multiple sclerosis: effects of disability status and dual task. J Neurol Sci, 315(1–2): 44-48. DOI: 10.1016/J.JNS.2011.12.006.
  • Bohannon RW. 1986. Manual muscle test scores and dynamometer test scores of knee extension strength. Arch Physical Medic Rehab, 67(6): 390-392.
  • Bohannon RW. 2005. Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehab, 19(6): 662-667. DOI: 10.1191/0269215505CR873OA.
  • Broekmans T, Roelants M, Feys P, Alders G, Gijbels D, Hanssen I, Stinissen P, Eijnde BO. 2011. Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis. Multiple Sclerosis, 17(4): 468-477. DOI: 10.1177/1352458510391339.
  • Cameron MH, Lord S. 2010. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci Rep, 10(5): 407-412. DOI: 10.1007/S11910-010-0128-0.
  • Cattaneo D, de Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R. 2002. Risks of falls in subjects with multiple sclerosis. Arch Physical Medic Rehab, 83(6): 864-867. DOI: 10.1053/APMR.2002.32825.
  • Cattaneo D, Jonsdottir J, Repetti S. 2007. Reliability of four scales on balance disorders in persons with multiple sclerosis. Disabil Rehab, 29(24): 1920-1925. DOI: 10.1080/09638280701191859.
  • Cattaneo D, Jonsdottir J. 2009. Sensory impairments in quiet standing in subjects with multiple sclerosis. Multiple Sclerosis, 15(1): 59-67. DOI: 10.1177/1352458508096874.
  • Cattaneo D, Regola A, Meotti M. 2006. Validity of six balance disorders scales in persons with multiple sclerosis. Disabil Rehab, 28(12): 789-795. DOI: 10.1080/09638280500404289.
  • Chung LH, Remelius JG, van Emmerik REA, Kent-Braun JA. 2008. Leg power asymmetry and postural control in women with multiple sclerosis. Medic Sci Sports Exerc, 40(10): 1717-1724. DOI: 10.1249/MSS.0B013E31817E32A3.
  • Citaker S, Guclu-Gunduz A, Yazici G, Bayraktar D, Nazliel B, Irkec C. 2013. Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis. Neuro Rehab, 33(2): 293-298. DOI: 10.3233/NRE-130958.
  • Claros-Salinas D, Dittmer N, Neumann M, Sehle A, Spiteri S, Willmes K, Schoenfeld MA, Dettmers C. 2013. Induction of cognitive fatigue in MS patients through cognitive and physical load. Neuropsychol Rehab, 23(2): 182-201. DOI: 10.1080/09602011.2012.726925.
  • Daley ML, Swank RL. 1981. Quantitative posturography: use in multiple sclerosis. IEEE Trans Bio-Medic Eng, 28(9): 668-671. DOI: 10.1109/TBME.1981.324761.
  • Dalgas U, Stenager E, Jakobsen J, Petersen T, Overgaard K, Ingemann-Hansen T. 2010. Muscle fiber size increases following resistance training in multiple sclerosis. Multiple Sclerosis, 16(11): 1367-1376. DOI: 10.1177/1352458510377222.
  • DeBolt LS, McCubbin JA. 2004. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Physical Medic Rehab, 85(2): 290-297. DOI: 10.1016/J.APMR.2003.06.003.
  • Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, Mobberley C, Nock A, Sims R, Thain J. 2010. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Multiple Sclerosis, 16(11): 1377-1384. DOI: 10.1177/1352458510378126.
  • Frzovic D, Morris ME, Vowels L. 2000. Clinical tests of standing balance: performance of persons with multiple sclerosis. Arch Physical Medic Rehab, 81(2): 215-221. DOI: 10.1016/S0003-9993(00)90144-8.
  • Heesen C, Böhm J, Reich C, Kasper J, Goebel M, Gold SM. 2008. Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Multiple Sclerosis, 14(7): 988-991. DOI: 10.1177/1352458508088916.
  • López-Rodríguez S, de-las-Peñas CF, Alburquerque-Sendín F, Rodríguez-Blanco C, Palomeque-del-Cerro L. 2007. Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain. J Manipulat Physiol Therap, 30(3): 186-192. DOI: 10.1016/J.JMPT.2007.01.011.
  • Lovett RW, Martin EG. 1916. Certain aspects of infantile paralysis with a description of a method of muscle testing. JAMA, 66: 729-733.
  • Mofateh R, Salehi R, Negahban H, Mehravar M, Tajali S. 2017. Effects of cognitive versus motor dual-task on spatiotemporal gait parameters in healthy controls and multiple sclerosis patients with and without fall history. Multiple Sclerosis Related Disord, 18: 8-14. DOI: 10.1016/J.MSARD.2017.09.002.
  • Önder H. 2018. Nonparametric statistical methods used in biological experiments. BSJ Eng Sci, 1(1): 1-6.
  • Penner IK, Bechtel N, Raselli C, Stöcklin M, Opwis K, Kappos L, Calabrese P. 2007. Fatigue in multiple sclerosis: relation to depression, physical impairment, personality and action control. Multiple Sclerosis, 13(9): 1161-1167. DOI: 10.1177/1352458507079267.
  • Porosińska A, Pierzchała K, Mentel M, Karpe J. 2010. Evaluation of postural balance control in patients with multiple sclerosis - effect of different sensory conditions and arithmetic task execution. A pilot study. Neurologia i Neurochirurgia Polska, 44(1): 35-42. DOI: 10.1016/S0028-3843(14)60405-9.
  • Sabapathy NM, Minahan CL, Turner GT, Broadley SA. 2011. Comparing endurance- and resistance-exercise training in people with multiple sclerosis: a randomized pilot study. Clin Rehab, 25(1): 14-24. DOI: 10.1177/0269215510375908.
  • Sagawa Y, Watelain E, Moulin T, Decavel P. 2021. Physical activity during weekdays and weekends in persons with multiple sclerosis. Sensors, 21(11): 3617. DOI: 10.3390/S21113617
  • Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, Weikert M, Balantrapu S, Morrison S, Motl RW. 2011. Mobility, balance and falls in persons with multiple sclerosis. PloS ONE, 6(11): e28021. DOI: 10.1371/JOURNAL.PONE.0028021.
  • Wens I, Dalgas U, Vandenabeele F, Krekels M, Grevendonk L, Eijnde BO. 2014. Multiple sclerosis affects skeletal muscle characteristics. PloS ONE, 9(9): e108158. DOI: 10.1371/JOURNAL.PONE.0108158.
  • Yahia A, Ghroubi S, Mhiri C, Elleuch MH. 2011. Relationship between muscular strength, gait and postural parameters in multiple sclerosis. Annals Physical Rehab Medic, 54(3): 144-155. DOI: 10.1016/J.REHAB.2011.02.004.
  • Yamout BI, Alroughani R. 2018. Multiple sclerosis. Seminars in Neurol, 38(2): 212-225. DOI: 10.1055/S-0038-1649502

Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients

Year 2023, Volume: 6 Issue: 3, 457 - 462, 01.07.2023

Fatma Erdeo , Ali Ulvi Uca , Neslihan Altuntas Yılmaz , Ahmet Furkan Doğan Ahmet Şimşek

https://doi.org/10.19127/bshealthscience.1252347

Abstract

Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease that causes demyelination of nerve fibers. This neurological process causes physical and mental changes in and to the motor, sensory, and cognitive systems. This study aims to determine the relationship between balance and muscle strength in people with multiple sclerosis. This study included 36 MS patients’ ⩾18 years old who were treated and followed up according to routine clinical practice at a university hospital in Türkiye, which were observational, non-invasive, and a control group of 32 patients whose relatives were voluntarily evaluated without any neurological problems. Muscle strength was measured manually. In balance analysis, computerized balance analysis system was used. The mean age of the MS group was 46.14 (SD±7.14) and the mean age of the healthy group (HG) was 42.25 (SD±10.81). While muscles of abdominal, hamstring, hip flexor and extensor, tibialis anterior and tibialis posterior muscle strength were found to be positively significant with balance in the MS group, P<0.05, there was no significant relationship between balance and muscle strength of back extansor (P>0.05). This study revealed significant correlations between balance and strength parameters of trunk and lower extremity muscles. Our study suggests that rehabilitation protocols for MS patients should include a critical strength training program, especially for trunk and lower extremity muscles.

Keywords

Multiple sclerosis Muscle strength Balance

References

  • Abdel-Aziz K, Schneider T, Solanky BS, Yiannakas MC, Altmann DR, Wheeler-Kingshott CAM, Peters AL, Day BL, Thompson AJ, Ciccarelli O. 2015. Evidence for early neurodegeneration in the cervical cord of patients with primary progressive multiple sclerosis. Brain : J Neurol, 138(6): 1568-1582. DOI: 10.1093/BRAIN/AWV086.
  • Boes MK, Sosnoff JJ, Socie MJ, Sandroff BM, Pula JH, Motl RW. 2012. Postural control in multiple sclerosis: effects of disability status and dual task. J Neurol Sci, 315(1–2): 44-48. DOI: 10.1016/J.JNS.2011.12.006.
  • Bohannon RW. 1986. Manual muscle test scores and dynamometer test scores of knee extension strength. Arch Physical Medic Rehab, 67(6): 390-392.
  • Bohannon RW. 2005. Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehab, 19(6): 662-667. DOI: 10.1191/0269215505CR873OA.
  • Broekmans T, Roelants M, Feys P, Alders G, Gijbels D, Hanssen I, Stinissen P, Eijnde BO. 2011. Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis. Multiple Sclerosis, 17(4): 468-477. DOI: 10.1177/1352458510391339.
  • Cameron MH, Lord S. 2010. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci Rep, 10(5): 407-412. DOI: 10.1007/S11910-010-0128-0.
  • Cattaneo D, de Nuzzo C, Fascia T, Macalli M, Pisoni I, Cardini R. 2002. Risks of falls in subjects with multiple sclerosis. Arch Physical Medic Rehab, 83(6): 864-867. DOI: 10.1053/APMR.2002.32825.
  • Cattaneo D, Jonsdottir J, Repetti S. 2007. Reliability of four scales on balance disorders in persons with multiple sclerosis. Disabil Rehab, 29(24): 1920-1925. DOI: 10.1080/09638280701191859.
  • Cattaneo D, Jonsdottir J. 2009. Sensory impairments in quiet standing in subjects with multiple sclerosis. Multiple Sclerosis, 15(1): 59-67. DOI: 10.1177/1352458508096874.
  • Cattaneo D, Regola A, Meotti M. 2006. Validity of six balance disorders scales in persons with multiple sclerosis. Disabil Rehab, 28(12): 789-795. DOI: 10.1080/09638280500404289.
  • Chung LH, Remelius JG, van Emmerik REA, Kent-Braun JA. 2008. Leg power asymmetry and postural control in women with multiple sclerosis. Medic Sci Sports Exerc, 40(10): 1717-1724. DOI: 10.1249/MSS.0B013E31817E32A3.
  • Citaker S, Guclu-Gunduz A, Yazici G, Bayraktar D, Nazliel B, Irkec C. 2013. Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis. Neuro Rehab, 33(2): 293-298. DOI: 10.3233/NRE-130958.
  • Claros-Salinas D, Dittmer N, Neumann M, Sehle A, Spiteri S, Willmes K, Schoenfeld MA, Dettmers C. 2013. Induction of cognitive fatigue in MS patients through cognitive and physical load. Neuropsychol Rehab, 23(2): 182-201. DOI: 10.1080/09602011.2012.726925.
  • Daley ML, Swank RL. 1981. Quantitative posturography: use in multiple sclerosis. IEEE Trans Bio-Medic Eng, 28(9): 668-671. DOI: 10.1109/TBME.1981.324761.
  • Dalgas U, Stenager E, Jakobsen J, Petersen T, Overgaard K, Ingemann-Hansen T. 2010. Muscle fiber size increases following resistance training in multiple sclerosis. Multiple Sclerosis, 16(11): 1367-1376. DOI: 10.1177/1352458510377222.
  • DeBolt LS, McCubbin JA. 2004. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Physical Medic Rehab, 85(2): 290-297. DOI: 10.1016/J.APMR.2003.06.003.
  • Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, Mobberley C, Nock A, Sims R, Thain J. 2010. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Multiple Sclerosis, 16(11): 1377-1384. DOI: 10.1177/1352458510378126.
  • Frzovic D, Morris ME, Vowels L. 2000. Clinical tests of standing balance: performance of persons with multiple sclerosis. Arch Physical Medic Rehab, 81(2): 215-221. DOI: 10.1016/S0003-9993(00)90144-8.
  • Heesen C, Böhm J, Reich C, Kasper J, Goebel M, Gold SM. 2008. Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Multiple Sclerosis, 14(7): 988-991. DOI: 10.1177/1352458508088916.
  • López-Rodríguez S, de-las-Peñas CF, Alburquerque-Sendín F, Rodríguez-Blanco C, Palomeque-del-Cerro L. 2007. Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain. J Manipulat Physiol Therap, 30(3): 186-192. DOI: 10.1016/J.JMPT.2007.01.011.
  • Lovett RW, Martin EG. 1916. Certain aspects of infantile paralysis with a description of a method of muscle testing. JAMA, 66: 729-733.
  • Mofateh R, Salehi R, Negahban H, Mehravar M, Tajali S. 2017. Effects of cognitive versus motor dual-task on spatiotemporal gait parameters in healthy controls and multiple sclerosis patients with and without fall history. Multiple Sclerosis Related Disord, 18: 8-14. DOI: 10.1016/J.MSARD.2017.09.002.
  • Önder H. 2018. Nonparametric statistical methods used in biological experiments. BSJ Eng Sci, 1(1): 1-6.
  • Penner IK, Bechtel N, Raselli C, Stöcklin M, Opwis K, Kappos L, Calabrese P. 2007. Fatigue in multiple sclerosis: relation to depression, physical impairment, personality and action control. Multiple Sclerosis, 13(9): 1161-1167. DOI: 10.1177/1352458507079267.
  • Porosińska A, Pierzchała K, Mentel M, Karpe J. 2010. Evaluation of postural balance control in patients with multiple sclerosis - effect of different sensory conditions and arithmetic task execution. A pilot study. Neurologia i Neurochirurgia Polska, 44(1): 35-42. DOI: 10.1016/S0028-3843(14)60405-9.
  • Sabapathy NM, Minahan CL, Turner GT, Broadley SA. 2011. Comparing endurance- and resistance-exercise training in people with multiple sclerosis: a randomized pilot study. Clin Rehab, 25(1): 14-24. DOI: 10.1177/0269215510375908.
  • Sagawa Y, Watelain E, Moulin T, Decavel P. 2021. Physical activity during weekdays and weekends in persons with multiple sclerosis. Sensors, 21(11): 3617. DOI: 10.3390/S21113617
  • Sosnoff JJ, Socie MJ, Boes MK, Sandroff BM, Pula JH, Suh Y, Weikert M, Balantrapu S, Morrison S, Motl RW. 2011. Mobility, balance and falls in persons with multiple sclerosis. PloS ONE, 6(11): e28021. DOI: 10.1371/JOURNAL.PONE.0028021.
  • Wens I, Dalgas U, Vandenabeele F, Krekels M, Grevendonk L, Eijnde BO. 2014. Multiple sclerosis affects skeletal muscle characteristics. PloS ONE, 9(9): e108158. DOI: 10.1371/JOURNAL.PONE.0108158.
  • Yahia A, Ghroubi S, Mhiri C, Elleuch MH. 2011. Relationship between muscular strength, gait and postural parameters in multiple sclerosis. Annals Physical Rehab Medic, 54(3): 144-155. DOI: 10.1016/J.REHAB.2011.02.004.
  • Yamout BI, Alroughani R. 2018. Multiple sclerosis. Seminars in Neurol, 38(2): 212-225. DOI: 10.1055/S-0038-1649502
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Fatma Erdeo 0000-0002-0266-229X

Ali Ulvi Uca 0000-0002-5783-8061

Neslihan Altuntas Yılmaz 0000-0003-0116-9089

Ahmet Furkan Doğan This is me 0000-0001-6452-1559

Ahmet Şimşek 0000-0001-6892-8882

Early Pub Date June 20, 2023
Publication Date July 1, 2023
Submission Date April 29, 2023
Acceptance Date June 13, 2023
Published in Issue Year 2023 Volume: 6 Issue: 3

Cite

APA Erdeo, F., Uca, A. U., Yılmaz, N. A., Doğan, A. F., et al. (2023). Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients. Black Sea Journal of Health Science, 6(3), 457-462. https://doi.org/10.19127/bshealthscience.1252347
AMA Erdeo F, Uca AU, Yılmaz NA, Doğan AF, Şimşek A. Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients. BSJ Health Sci. July 2023;6(3):457-462. doi:10.19127/bshealthscience.1252347
Chicago Erdeo, Fatma, Ali Ulvi Uca, Neslihan Altuntas Yılmaz, Ahmet Furkan Doğan, and Ahmet Şimşek. “Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients”. Black Sea Journal of Health Science 6, no. 3 (July 2023): 457-62. https://doi.org/10.19127/bshealthscience.1252347.
EndNote Erdeo F, Uca AU, Yılmaz NA, Doğan AF, Şimşek A (July 1, 2023) Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients. Black Sea Journal of Health Science 6 3 457–462.
IEEE F. Erdeo, A. U. Uca, N. A. Yılmaz, A. F. Doğan, and A. Şimşek, “Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients”, BSJ Health Sci., vol. 6, no. 3, pp. 457–462, 2023, doi: 10.19127/bshealthscience.1252347.
ISNAD Erdeo, Fatma et al. “Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients”. Black Sea Journal of Health Science 6/3 (July 2023), 457-462. https://doi.org/10.19127/bshealthscience.1252347.
JAMA Erdeo F, Uca AU, Yılmaz NA, Doğan AF, Şimşek A. Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients. BSJ Health Sci. 2023;6:457–462.
MLA Erdeo, Fatma et al. “Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients”. Black Sea Journal of Health Science, vol. 6, no. 3, 2023, pp. 457-62, doi:10.19127/bshealthscience.1252347.
Vancouver Erdeo F, Uca AU, Yılmaz NA, Doğan AF, Şimşek A. Relationship Between Trunk and Lower Extremity Muscles and Balance in Multiple Sclerosis Patients. BSJ Health Sci. 2023;6(3):457-62.
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