The virtual time to contact in the evaluation of balance disorders and prediction of falls in people with multiple sclerosis

Abstract

Purpose: The purpose of the study was to compute Virtual Time to Contact (VTC) from stabilometric assessment to study balance impairments in people with multiple sclerosis (PwMS). To this purpose we assessed the ability of VTC to discriminate between balance skills of PwMS and healthy subjects (HS), among sensory conditions and between fallers and non fallers. Methods: VTC was calculated to characterize balance performance in 47 PwMS and 13 HS in four different sensory conditions during quiet standing. Main Outcome Measures were VTC, Number of falls, Berg Balance Scale and Dynamic Gait Index. Results: The results showed that VTC was able to discriminate between PwMS and HS (p < 0.0001) and between challenging sensory conditions (p < 0.0001), no relevant information was added by VTC in the detection of subjects prone to falls. Conclusion: VTC provides unique information with respect to balance control because it takes into account the relationship between centre of mass (CoM) and the borders of base of support (BoS). VTC proved to be a valid descriptor of balance performance in PwMS highlighting balance disorders in this population of subjects, however models for falls prediction have to be improved.

Implications for Rehabilitation

• Given the high prevalence of balance disorders in MS balance control and fall frequency should be routinely assessed.

• VTC appears to be useful in assessing upright balance in different sensory conditions.

• The adjunction of stabilometric evaluation did not improve ability of clinical scales to detect subjects prone to fall.

Keywords::

• Falls
• neurological disorders
• balance
• multiple sclerosis

Declaration of interest: Supported by the Italian Institutes of Health.