Investigation of the relationship between disability level and core stability in patients with Multiple Sclerosis

Yıl 2021, Cilt: 8 Sayı: 3, 655 - 669, 31.12.2021

Taşkın Özkan Arzu Güçlü Gündüz Fatih Soke Çağla Özkul Ceyla İrkeç

Öz

Objectives: Optimal core stability relies on somatosensory, motor and musculoskeletal systems that are often compromised with the progression of the disability level in the Multiple Sclerosis (MS) population. The aim of this study was to investigate the relationship between disability level and core stability in patients with MS. Materials and Methods: Thirty-seven MS patients (26 female and 11 male) with mild to moderate disability were included in the study. Kurtzke Expanded Disability Status Scale (EDSS) was used to evaluate the level of disability of patients with MS. Core endurance tests including the flexion endurance test, extension endurance test, right and left side bridge tests and core power tests including the sit-ups test and modified push-ups test were evaluated. Results: When the relationship between disability level and core stability was examined in patients with MS, it was seen that the EDSS was associated with flexion endurance test, extension endurance test, right and left side bridge tests, sit-ups test and modified push-ups test (r= -0.572, r= -0.445, r= -0.585, r= -0.653, r= -0.571, r= -0.532 respectively; p<0.05). Conclusion: Disability level was associated with core endurance and core power, which are the sub-parameters of core stability in patients with MS. These results suggest that core stability may also lead to increase neurological impairment and disability level; therefore it should be evaluated from the early stage of the disease.

Anahtar Kelimeler

Multiple Sclerosis, disability, core endurance, core power

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

• Abdel-Aziz, K., Schneider, T., Solanky, B. S., Yiannakas, M. C., Altmann, D. R., Wheeler-Kingshott, C. A., ... & Ciccarelli, O. (2015). Evidence for early neurodegeneration in the cervical cord of patients with primary progressive multiple sclerosis. Brain, 138(6), 1568-1582.
• Altman, D., Machin, D., Bryant, T., & Gardner, M. (Eds.). (2013). Statistics with confidence: confidence intervals and statistical guidelines. John Wiley & Sons.
• Amiri, B., Sahebozamani, M., & Sedighi, B. (2019). The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: a single-blinded randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, 55(2), 199-208.
• Arntzen, E. C., Straume, B. K., Odeh, F., Feys, P., Zanaboni, P., & Normann, B. (2019). Group-based individualized comprehensive core stability intervention improves balance in persons with multiple sclerosis: A randomized controlled trial. Physical Therapy, 99(8), 1027-1038.
• Arntzen, E. C., Straume, B., Odeh, F., Feys, P., & Normann, B. (2020). Group‐based, individualized, comprehensive core stability and balance intervention provides immediate and long‐term improvements in walking in individuals with multiple sclerosis: A randomized controlled trial. Physiotherapy Research International, 25(1), e1798.
• Baltacı, G., Tunay, V. B., Tuncer, A., & Ergun, N. (Eds.). (2016). Spor yaralanmalarında egzersiz tedavi. Hipokrat Kitabevi.
• Bertoni, R., Lamers, I., Chen, C. C., Feys, P., & Cattaneo, D. (2015). Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis. Multiple Sclerosis Journal, 21(12), 1566-1574.
• Borghuis, J., Hof, A. L., & Lemmink, K. A. (2008). The importance of sensory-motor control in providing core stability. Sports Medicine, 38(11), 893-916.
• Cameron, M. H., & Lord, S. (2010). Postural control in multiple sclerosis: implications for fall prevention. Current Neurology and Neuroscience Reports, 10(5), 407-412.
• Cameron, M. H., & Nilsagard, Y. (2018). Balance, gait, and falls in multiple sclerosis. Handbook of Clinical Neurology, 159, 237-250.
• Chung, L. H., Remelius, J. G., Van Emmerik, R. E., & Kent-Braun, J. A. (2008). Leg power asymmetry and postural control in women with multiple sclerosis. Medicine and Science in Sports and Exercise, 40(10), 1717-1724.
• Confavreux, C., Vukusic, S., Moreau, T., & Adeleine, P. (2000). Relapses and progression of disability in multiple sclerosis. New England Journal of Medicine, 343(20), 1430-1438.
• Corporaal, S. H., Gensicke, H., Kuhle, J., Kappos, L., Allum, J. H., & Yaldizli, Ö. (2013). Balance control in multiple sclerosis: correlations of trunk sway during stance and gait tests with disease severity. Gait & posture, 37(1), 55-60.
• Citaker, S., Guclu-Gunduz, A., Yazici, G., Bayraktar, D., Nazliel, B., & Irkec, C. (2013). Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis. NeuroRehabilitation, 33(2), 293-298.
• Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.
• Fjeldstad, C., Pardo, G., Bemben, D., & Bemben, M. (2011). Decreased postural balance in multiple sclerosis patients with low disability. International Journal of Rehabilitation Research, 34(1), 53-58.
• Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198.
• Freund, J. E., Stetts, D. M., & Vallabhajosula, S. (2016). Relationships between trunk performance, gait and postural control in persons with multiple sclerosis. NeuroRehabilitation, 39(2), 305-317.
• Genthon, N., Vuillerme, N., Monnet, J. P., Petit, C., & Rougier, P. (2007). Biomechanical assessment of the sitting posture maintenance in patients with stroke. Clinical biomechanics, 22(9), 1024-1029.
• Guclu-Gunduz, A., Citaker, S., Irkec, C., Nazliel, B., & Batur-Caglayan, H. Z. (2014). The effects of pilates on balance, mobility and strength in patients with multiple sclerosis. NeuroRehabilitation, 34(2), 337-342.
• Hodges, P. W., & Richardson, C. A. (1997a). Contraction of the abdominal muscles associated with movement of the lower limb. Physical Therapy, 77(2), 132-142.
• Hodges, P. W., & Richardson, C. A. (1997b). Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Experimental Brain Research, 114(2), 362-370.
• Ketelhut, N. B., Kindred, J. H., & Manago, M. M. (2015). Core muscle characteristics during walking of patients with multiple sclerosis. Journal of Rehabilitation Research and Development, 52(6), 713-724.
• Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine, 36(3), 189-198.
• Krishnan, V., Kanekar, N., & Aruin, A. S. (2012). Anticipatory postural adjustments in individuals with multiple sclerosis. Neuroscience Letters, 506(2), 256-260.
• Krishnan, V., Kanekar, N., & Aruin, A. S. (2012). Feedforward postural control in individuals with multiple sclerosis during load release. Gait & Posture, 36(2), 225-230.
• Kurtzke, J. F. (1983). Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology, 33(11), 1444-1444.
• Lanzetta, D., Cattaneo, D., Pellegatta, D., & Cardini, R. (2004). Trunk control in unstable sitting posture during functional activities in healthy subjects and patients with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 85(2), 279-283.
• McGill, S. M., Childs, A., & Liebenson, C. (1999). Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Archives of Physical Medicine and Rehabilitation, 80(8), 941-944.
• Moreno-Navarro, P., Gomez-Illán, R., Carpena-Juan, C., P Sempere, Á., Vera-Garcia, F. J., & Barbado, D. (2020). Understanding the Deterioration of Gait, Postural Control, Lower Limb Strength and Perceived Fatigue Across the Disability Spectrum of People with Multiple Sclerosis. Journal of Clinical Medicine, 9(5), 1385.
• Preuss, R., & Fung, J. (2008). Musculature and biomechanics of the trunk in the maintenance of upright posture. Journal of Electromyography and Kinesiology, 18(5), 815-828.
• Ramari, C., Hvid, L. G., de David, A. C., & Dalgas, U. (2020). The importance of lower-extremity muscle strength for lower-limb functional capacity in multiple sclerosis: Systematic review. Annals of Physical and Rehabilitation Medicine, 63(2), 123-137.
• Sosnoff, J. J., Socie, M. J., Boes, M. K., Sandroff, B. M., Pula, J. H., Suh, Y., ... & Motl, R. W. (2011). Mobility, balance and falls in persons with multiple sclerosis. PloS One, 6(11), e28021.
• Yoosefinejad, A. K., Motealleh, A., Khademi, S., & Hosseini, S. F. (2017). Lower endurance and strength of core muscles in patients with multiple sclerosis. International Journal of MS Care, 19(2), 100-104.