Straighten your back! Self-correction posture and postural balance in “non rehabilitative instructed” multiple sclerosis patients

Article type: Research Article

Authors: Paolucci, Teresa^a | Bernetti, Andrea^b | Sbardella, Silvia^b | La Russa, Chiara^b | Murgia, Massimiliano^b | Salomè, Angela^b | Villani, Ciro^b | Altieri, Marta^c | Santilli, Valter^b | Paoloni, Marco^b | Agostini, Francesco^{b; *} | Mangone, Massimiliano^b

Affiliations: [a] Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy | [b] Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy | [c] Multiple Sclerosis Center, Sapienza University of Rome, Rome, Italy

Correspondence: [*] Address for correspondence: Francesco Agostini, MD, Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Piazzale Aldo Moro, 5, Rome, 00185, Italy. Tel.: +39 3404751090; E-mail: francescoagostini.ff@gmail.com.

Abstract: BACKGROUD:Patients with MS, regardless of the complexity of the activity or sensory conditions, commonly present a significant postural control deficit compared to healthy subjects. OBJECTIVE:To investigate which postural self-correction strategies are adopted by patients with Multiple Sclerosis versus a group of healthy-subjects and how self-correction can influence the control of postural balance. METHODS:A case-control prospective observational study was conducted. Person with Multiple Sclerosis and a group of healthy volunteers were enrolled. Patients included were instructed with vocal commands, to reach a self-correction posture, and they were compared to healthy subjects. Clinical assessments including Balance, Stabilometry and Postural evaluation of the spine were performed. RESULTS:Sixty patients (30: control-group; 30: treatment-group) were enrolled. In the treatment group, the analysis reported a significant statistical difference between path length and center of pressure speed in self-correction posture with closed-eyes (p = 0,049; 0,047) and an improvement in C7 and L3 levels in self-correction posture (p < 0,01–C7; p < 0,01–L3). There are significant statistical differences about path length between the two groups in all examined conditions (p = 0,0001). At sagittal plane evaluation, results show an increase of all measurements in both posture (C7-neutral posture p = 0,0001; L3-neutral posture p = 0,0001; C7-self-correction posture p = 0,0001; L3-self-correction posture p = 0,0001). CONCLUSION:Further study should investigate dynamic situations and different Multiple Sclerosis forms to complete balance analysis and to establish a correct rehabilitative program with self-correction exercise as powerful focus.

Keywords: Self-correction, postural balance, spine, multiple sclerosis, gait analysis, rehabilitation, proprioceptions

DOI: 10.3233/NRE-192987

Journal: NeuroRehabilitation, vol. 46, no. 3, pp. 333-341, 2020