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Enhancing Postural Stability and Adaptability in Multiple Sclerosis

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Progress in Motor Control

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 826))

Abstract

People living with multiple sclerosis (MS) consistently rate balance and gait impairments as having the greatest negative impacts on their quality of life. Our research aims to understand the sensorimotor contributions to balance dysfunction and difficulty with walking in people with MS, with specific attention paid to how fatigue, muscle weakness, and sensory loss interact to limit physical function and mobility. Here, we relate aspects of somatosensory loss and symptomatic fatigue to balance function, and provide new insights in our understanding of the mechanisms of balance and gait dysfunction in MS through the use of novel analytical methods and experimental paradigms. We first review the existing methods and paradigms to assess postural and gait stability in research on MS. Next, we introduce novel measures to assess the stability and adaptability of posture and gait in people with MS that are based on nonlinear and complex systems methods. These novel methods include (1) boundary-relevant measures of postural stability and control (postural “time to contact”), and (2) entropy measures for assessing postural and gait adaptability. These novel methods allow us to differentiate between postural and gait variability caused by dysfunction that may interfere with movement control, and variability that is functional and provides stable and adaptable movement patterns. Finally, we discuss how these methods and paradigms could help to develop innovative treatments for balance and gait dysfunction in people with MS.

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Acknowledgements

The research presented here was supported by a Grant from the National Multiple Sclerosis Society (NMSS; RG3974A2)

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Authors and Affiliations

  1. Department of Kinesiology, University of Massachusetts, 30 Eastman Lane, Amherst, MA, USA

    Richard E. A. van Emmerik, Stephanie L. Jones, Michael A. Busa, Jebb G. Remelius & Julianna L. Averill

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  1. Richard E. A. van Emmerik
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  2. Stephanie L. Jones
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  3. Michael A. Busa
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  4. Jebb G. Remelius
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  5. Julianna L. Averill
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Correspondence to Richard E. A. van Emmerik .

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Editors and Affiliations

  1. School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada

    Mindy F. Levin

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van Emmerik, R., Jones, S., Busa, M., Remelius, J., Averill, J. (2014). Enhancing Postural Stability and Adaptability in Multiple Sclerosis. In: Levin, M. (eds) Progress in Motor Control. Advances in Experimental Medicine and Biology, vol 826. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1338-1_15

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