Clinical Edge

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Nature of Instability in Persons with MS Examined

Arch Phys Med Rehab; 2018 Oct; Peebles, et al

A recent study highlights the multifactorial nature of instability in persons with multiple sclerosis (MS). Therefore, a better understanding of the physiological mechanisms of dynamic instability in persons with MS can be used to improve methods of monitoring disease progression, identifying which impairments to target through interventions, and appropriately evaluating intervention efficacy. In order to compare physiological impairments between persons with MS with a history of falls and persons with MS without a history of falls, and to investigate the association between physiological impairments and dynamic balance, researchers conducted a cross-sectional study in a university motion analysis laboratory. Persons with MS (n=55; 27 recurrent fallers and 28 non-fallers) were classified as fallers if they self-reported ≥2 falls in the previous 6 months. They found:

  • Compared with non-fallers, fallers had lower plantar sensation, longer sensorimotor delays, more spasticity, and more impairment in the pyramidal and cerebellar subscales of the Expanded Disability Status Scale (EDSS).
  • Additionally, these impairments were all moderately to strongly correlated with worse dynamic balance.


Peebles AT, Bruetsch AP, Lynch SG, Huisinga JM. Dynamic balance is related to physiological impairments in persons with multiple sclerosis. Arch Phys Med Rehab. 2018;99(10):2030-2037. doi:10.1016/j.apmr.2017.11.010.