Open Access
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

Flavia Salvaterra Cusin 
1   Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
,
Andreza Tomaz 
1   Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
,
Maurício Malavasi Ganança 
1   Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
,
Enedina Maria Oliveira 
2   Department of Neurology and Neurosurgery, Demyelinating Diseases Outpatient Clinic, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
,
Alessandra Billi Falcão Gonçalves 
2   Department of Neurology and Neurosurgery, Demyelinating Diseases Outpatient Clinic, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
,
Heloisa Helena Caovilla 
1   Department of Otolaryngology and Head and Neck Surgery, Otology and Neurotology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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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


Publikationsverlauf

Eingereicht: 28. Juni 2021

Angenommen: 11. November 2021

Artikel online veröffentlicht:
09. Februar 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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