Local dynamic stability as a responsive index for the evaluation of rehabilitation effect on fall risk in patients with multiple sclerosis: a longitudinal study

BMC Research Notes

Philippe Terrier³  Denise Foinant¹  Cécilia Palaci¹  Anne-Marie Anchisi-Bellwald¹  Véronique Lugon-Moulin²  Olivier Deriaz³  André Meichtry⁴  Brigitte Gattlen¹  Claude Vaney¹  Roger Hilfiker² 

[1]Berner Klinik Montana, Crans-Montana, Switzerland

[2]RéSaR, Réseau d’études appliquées des pratiques de Santé, de Réadaptation/(ré)insertion, HES-SO, Delémont, Switzerland

[3]Clinique romande de réadaptation SUVACare, Sion, Switzerland

[4]ZHAW, Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, Winterthur, 8401, Switzerland

关键词: Dynamic balance;    Accelerometer;    Maximal Lyapunov exponent;    Gait;   

Others  :  1142251
DOI  :  10.1186/1756-0500-6-260

 received in 2012-12-14, accepted in 2013-07-01,  发布年份 2013

【 摘 要 】

Background

Gait and balance problems are common in patients with multiple sclerosis, leading to high risk for falls. Local Dynamic Stability (LDS), a non-linear gait stability index, has been advocated as an early indicator of risk for falls. With this longitudinal study over three weeks, we aimed to assess the responsiveness of Local Dynamic Stability to a rehabilitation program and to compare it to other measures.

Methods

Eighteen patients (mean 54 years, median EDSS score: 5) participated. They were admitted to inpatient rehabilitation and received a three weeks individually tailored program. They performed a 3-minute walking test at the beginning and at the end of the stay, as well as pain, wellbeing, fatigue, and balance assessment. The Local Dynamic Stability was computed from the acceleration signals measured with a 3D-accelerometer.

Results

At the end of the rehabilitation process, patients reported reduced pain (Effect Size: −0.7), fatigue (ES:-0.6), and increased wellbeing (ES: 1.1). A small positive effect on static balance was observed (ES: 0.3). LDS was improved (ES: 0.6), and the effect was higher than walking speed improvement (ES: 0.4).

Conclusions

The Local Dynamic Stability seemed responsive to assess rehabilitation effects in patients with multiple sclerosis. It could constitute a valuable gait quality index, which could evaluate potential effects of rehabilitation on fall risk.

Trial registration

Current Controlled Trials ISRCTN69803702.

【 授权许可】

   
2013 Hilfiker et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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