title: Longitudinal relationships among posturography and gait measures in multiple sclerosis.
abstract: OBJECTIVE
  Gait and balance dysfunction frequently occurs early in the multiple sclerosis (MS) disease course. Hence, we sought to determine the longitudinal relationships among quantitative measures of gait and balance in individuals with MS.
  
  
  METHODS
  Fifty-seven ambulatory individuals with MS (28 relapsing-remitting, 29 progressive) were evaluated using posturography, quantitative sensorimotor and gait measures, and overall MS disability with the Expanded Disability Status Scale at each session.
  
  
  RESULTS
  Our cohort's age was 45.8 ± 10.4 years (mean ± SD), follow-up time 32.8 ± 15.4 months, median Expanded Disability Status Scale score 3.5, and 56% were women. Poorer performance on balance measures was related to slower walking velocity. Two posturography measures, the anterior-posterior sway and sway during static eyes open, feet apart conditions, were significant contributors to walk velocity over time (approximate R(2) = 0.95), such that poorer performance on the posturography measures was related to slower walking velocity. Similarly, the anterior-posterior sway and sway during static eyes closed, feet together conditions were also significant contributors to the Timed 25-Foot Walk performance over time (approximate R(2) = 0.83).
  
  
  CONCLUSIONS
  This longitudinal cohort study establishes a strong relationship between clinical gait measures and posturography. The data show that increases in static posturography and reductions in dynamic posturography are associated with a decline in walk velocity and Timed 25-Foot Walk performance over time. Furthermore, longitudinal balance measures predict future walking performance. Quantitative walking and balance measures are important additions to clinical testing to explore longitudinal change and understand fall risk in this progressive disease population.
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD. fritzn@kennedykrieger.org.
authors: Nora E
authors: NE
authors: Fritz
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD.
authors: Scott D
authors: SD
authors: Newsome
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD.
authors: Ani
authors: A
authors: Eloyan
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD.
authors: Rhul Evans R
authors: RE
authors: Marasigan
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD.
authors: Peter A
authors: PA
authors: Calabresi
authors: From the Kennedy Krieger Institute (N.E.F., R.E.R.M., K.M.Z.), Baltimore; and Departments of Physical Medicine and Rehabilitation (N.E.F., K.M.Z.), Neurology (S.D.N., P.A.C., K.M.Z.), and Biostatistics (A.E.), Johns Hopkins University, Baltimore, MD.
authors: Kathleen M
authors: KM
authors: Zackowski
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005684:Gait; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology*; D004856:Postural Balance