Predictors of static balance in ambulatory persons with multiple sclerosis.

People with multiple sclerosis (MS) experience a high rate of falls and have decreased static and dynamic balance. The purpose of this study was to determine best predictors of static standing balance, as measured by a single limb stance (SLS) timed test, in ambulatory persons with MS (PwMS) from among commonly used medical and rehabilitation clinical tests. Ambulatory PwMS participated in a single test session. Medical exam data gathered included the Function System (FS) neurologic exam and Expanded Disability Status Score (EDSS). A variety of commonly administered rehabilitation clinical tests addressing static balance, dynamic balance, gait endurance, functional lower extremity strength, abdominal and respiratory muscle strength were completed. Descriptive statistics, Pearson product moment correlations, and forward step-wise linear regressions were calculated. Twenty-eight ambulatory PwMS completed this study. Mean age was 54.74 years. Mean SLS score was 14.6 s. Pyramidal, sensory, bowel/bladder, and visual FS scores and the EDSS were significantly correlated with SLS. Maximal step length scores were significantly correlated with SLS at P less than 0.05 and the Functional Stair Test (FST) and 6-min walk test were correlated with SLS at P less than 0.10. Medical exam data EDSS and FS sensory explain 72.1% of the variance in SLS scores. Rehabilitation exam data FS sensory and FST explain 68.8% of the variance. The FS sensory, EDSS, and FST together explain 73.3% of the variance.

Core muscle strength and endurance measures in ambulatory persons with multiple sclerosis: validity and reliability.

This study examined the test-retest reliability and validity of three core muscle strength tests in individuals with multiple sclerosis (MS). Twenty-one ambulatory individuals with MS completed the curl-up, flexor endurance, and pelvic tilt stabilization tests of core muscle strength. They were retested 1-2 weeks after the first test. The sit-to-stand (STS) test was also conducted on the first test. Descriptive statistics, intraclass correlation coefficients, SEM, and minimal detectable change (MDC) were calculated for each test. Pearson's correlations were calculated between all variables for the first test date. The curl-up test demonstrated excellent test-retest reliability (intraclass correlation coefficient=0.995), requiring 3.4 additional repetitions in 60 s to demonstrate a detectable change. The curl-up test was moderately correlated with the STS. The flexor endurance and pelvic tilt stabilization tests demonstrated moderate test-retest reliability, with relatively large SEMs and MDCs and only a low correlation with the STS. The curl-up test is recommended as a valid and reliable test of core muscle strength in individuals with MS. The flexor endurance test and the pelvic tilt stabilization test of core muscle strength are not recommended due to large SEM and MDC scores. Further study of core muscle strength and endurance measures is indicated to seek additional tests that are valid and reliable in the MS population.