Combined effect of gender differences and fatiguing task on postural balance, functional mobility and fall risk in adults with multiple sclerosis: A preliminary study

ABSTRACT

Aim

To investigate the gender difference effect on postural balance, functional mobility, and fall risk after performing a fatiguing task in adults with multiple sclerosis (MS).

Methods

Eleven women (30.91 ± 8.19 years) and seven men (30.29 ± 7.99 years) with relapsing-remitting MS performed a fatiguing task: three sets of the Five-repetition Sit-To-Stand Test (5-STST) were performed before and after the six-minute WalkTest (6MWT). Bipedal postural balance in eyes open and eyes closed conditions were assessed prefatigue (T0) and postfatigue (T3) using a force platform. Unipedal balance, functional mobility (Timed Up and Go Test), fall risk (Four Square Step Test) and fatigue [Visual Analogue Scale of Fatigue (VASF)] were assessed at T0 and T3. Heart rate (HR) and Rating of Perceived Exertion (RPE) were recorded before (only for HR), during and after the fatiguing task.

Results

Compared to women, men showed an impairment of posturographic parameters [mean center of pressure (CoP) velocity (CoPVm) in both conditions (p < 0.05); CoP sway area (CoPAr) in both conditions (p < 0.01)], unipedal balance on the dominant leg (p <0.001), mobility (p<0.001) and an increased fall risk (p < 0.05). No gender differences were observed in 6MWT, 5-STST, HR, RPE, and VASF.

Conclusion

This preliminary study showed that fatiguing task negatively affected postural control, mobility and fall risk only in men. These gender differences were inconclusive but could be taken into account in postural balance rehabilitation programs for MS persons.

KEYWORDS:

• Multiple sclerosis
• neurodegenerative disease
• posturography
• functional mobility
• fall risk
• fatiguing exercises
• sex differences

Abbreviations

CoP, center of pressure; CoPL, CoP path length; CoPAr, CoP sway area; CoPVm: mean CoP velocity, d, Cohen’s d; EO, eyes open; EC, eyes closed; ES, effect size; FSST, Four Square Step Test; FMS, faculty of Medicine; HR, heart rate; MS, multiple sclerosis; MS-RR, relapsing-remitting MS; M, mean; 6MWT, Six-Minute Walk test; MD-Phd, Doctorate of Medicine and Philosophy; RPE, Rating of Perceived Exertion; SD, standard deviation; 5-STST, Five-repetition Sit-To-Stand Test; TUGT, Timed Up and Go test; T0, prefatigue; T1, after the first 5-STST; T2, after the 6 MWT; T3, immediately postfatigue; VASF, visual Analogue Scale of Fatigue.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Omar Hammouda

All authors contributed to the study conception and design. SJ and IBD performed the study experimentation. Data analysis and interpretation as well as writing of the first draft of the manuscript were realized by SJ. IBD and OH revised critically the first version of this paper. OH, SG and MHE provided the equipment needed to perform the experimental protocol. SS and CM participated in the selection and the recruitment of patients as well as the collection of their clinical data. All authors read and approved the final version of the present paper.