title: Stabilometric assessment of context dependent balance recovery in persons with multiple sclerosis: a randomized controlled study.
abstract: BACKGROUND
  Balance control relies on accurate perception of visual, somatosensory and vestibular cues. Sensory flow is impaired in Multiple Sclerosis (MS) and little is known about the ability of the sensory systems to adapt after neurological lesions reducing sensory impairment. The aims of the present study were to verify whether: 1. Balance rehabilitation administered in a challenging sensory conditions would improve stability in upright posture. 2. The improvement in a treated sensory condition would transfer to a non treated sensory condition.
  
  
  METHODS
  Fifty three persons with MS, median (min-max) EDSS score of 5 (2.5-6.5), participated in a RCT and were randomly assigned to two groups. The Experimental group received balance rehabilitation aimed at improving motor and sensory strategies. The Control group received rehabilitation treatment which did not include training of sensory strategies. Persons with MS were blindly assessed by means of a stabilometric platform with eyes open, eyes closed and dome, on both firm surface and foam. Anterior-posterior and medio-lateral sway, velocity of sway and the length of Center of Pressure (CoP) trajectory were calculated in the six sensory conditions.
  
  
  RESULTS
  Experimental group showed statistically significant improvement (P < 0.05) in stability in upright posture in eyes closed condition on firm surface, and in eyes open, closed, and dome conditions on foam. No differences were observed between groups in the eyes open condition on firm surface nor in the sensory condition not addressed during the treatment.
  
  
  CONCLUSIONS
  After rehabilitation people with MS can recover from sensory impairments thus improving upright balance. Further, the improvement seems to be context-dependent and present just in the treated sensory conditions.
  
  
  BACKGROUND
  ClinicalTrials NCT02131285.
authors.affiliation: Fondazione Don Gnocchi, Via Capecelatro, 66-20148 Milan, Italy. dcattaneo@dongnocchi.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Cattaneo
authors.forename: Johanna
authors.initials: J
authors.lastname: Jonsdottir
authors.forename: Alberto
authors.initials: A
authors.lastname: Regola
authors.forename: Roberta
authors.initials: R
authors.lastname: Carabalona
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation; D004856:Postural Balance / Q000502:physiology*; D020127:Recovery of Function; D012678:Sensation Disorders / Q000209:etiology / Q000534:rehabilitation*