Balance issues are often a difficult symptom to detect and track in those with multiple sclerosis. It is important that these problems are addressed by doctors, as they can lead to falls and injuries. To address this issue, researchers at the University of North Carolina at Chapel Hill and North Carolina State University have created a test that can identify the balance issues and falling risk in MS patients, even if they are unaware of that risk themselves.

About Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a neurological disorder that affects the sending of signals from the brain to the body. When one has this disorder, their immune systems attack myelin, which is the protective covering of nerve cells.  In severe cases, these nerves can be damaged permanently.

There are two types of MS, relapsing/remitting or progressive. The former is characterized by long periods without symptoms followed by episodes of intense symptoms. Progressive MS does not include periods without symptoms, instead people with this type constantly feel the effects of the disorder. It can result in the loss of daily function. It is difficult to know the number of people who are affected by MS, as many often go without a diagnosis or are misdiagnosed. It is thought that 2.3 million people have this disorder worldwide, with 400,000 of those people living in the United States.

There is no known cause for MS. It is an autoimmune disease, which occurs when the immune system attacks parts of the body, in this case myelin. These attacks result in the slowing or blockage of neuro messages. It is suspected that there is a hereditary element, but a combination of genetics and environmental factors are most likely the cause. What is known is that this disorder can occur at any age, but is most common from the ages of 15 to 60, and women are twice as likely to have it.

Symptoms of multiple sclerosis can vary from patient to patient; all parts of the body can be affected. Muscles in the extremities and the eyes are most commonly affected. The first symptoms often appear between the ages of 20 to 40, which could be weakness, numbness, loss of coordination and balance, or problems with speech, vision, and bladder control. While there is currently no cure for MS, specific symptoms can be treated.

About the Balance Test

Studies have shown that 56% of those with MS will experience a fall, and 37% will fall frequently. As falls have the potential to cause lasting injuries, balance issues need to be studied and identified more frequently than they are currently.

In order to create a viable balance test, researchers enrolled 14 people with relapsed MS and 14 people without the condition as a control group. Both groups were tested with virtual reality, which simulated walking down a hallway while they were on a treadmill. Researchers could simulate falling, with allowed them to measure participants’ response. They studied gait variability, kinematics, and margin of stability.

Results proved that both groups of participants walked similarly without any simulated falling, but after researchers implemented “wobbles” there was a clear difference. Those with MS showed a higher variability in stability, step width, and position.

A standing sensory organization test was also performed, which assesses one’s ability to use visual cues to maintain stability. Like the previous test, MS patients performed worse.

The results of both tests are allowing for researchers to better understand multiple sclerosis. They hope to implement this test so that balance issues will be better diagnosed, allowing for medical professionals to prevent falls. The goal is to create technology to be used in physical therapy to help reduce falls as well.

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