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Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği

Yıl 2022, , 110 - 115, 26.03.2022
https://doi.org/10.18663/tjcl.1069550

Öz

Amaç:Multipl skleroz (MS) santral sinir sisteminin demiyelinizan plaklarla seyreden nörodejeneratif bir hastalığıdır. MS’li hastaların önemli bir kısmı denge bozukluğundan şikayet eder. MS’li hastada denge durumunu değerlendirmede kullanılacak pratik ve kolay uygulanabilir testlere ihtiyaç halen devam etmektedir. Bu çalışmamızda MS’de dengeyi değerlendirmede Mini-BESTest’in ve manyetik rezonans görüntüleme (MRG) bulgularının etkinliğini araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmaya toplam 80 MS hastası dahil edildi. Hastalar ilk olarak EDSS skoru 2’nin altında (Grup 1), 2-2.5 (Grup 2) ve 3-3.5 olanlar (Grup 3) olmak üzere üç gruba ayrıldı. Ayrıca hastalar MRG bulgularına göre 1 Bölge, 2 Bölge ve 3 Bölge tutulumu olanlar olmak üzere ikinci kez gruplandırıldı. Hastalara Mini-BESTest ve 6-metre yürüme hızı testi uygulandı. Hastaların demografik ve klinik verileri kaydedildi.
Bulgular: EDSS skoruna göre gruplandırıldığında, Mini-BESTest skoru Grup3’de Grup 1 ve Grup 2’den anlamlı derecede daha düşüktü (p=0,001 ve p=0,001). Aynı zamanda Mini-BESTest Grup 2’de Grup 1’den anlamlı olarak düşüktü (p=:0,018). Yürüme hızı Grup 3’de Grup 1 ve Grup 2’den anlamlı derecede yavaştı (p=0,001 ve p=0,001). MRG bulgularına göre Mini-BESTest skoru 3 Bölge tutulumunda 1 Bölge ve 2 Bölge tutulumu olanlardan daha düşüktü (p=0,001 ve p=0,026). Ancak 1 Bölge ve 2 Bölge tutulumu olanlar arasında Mini-BESTest açısından farklılık yoktu. 3 Bölge tutulumu olanlarda yürüme hızı 1 Bölge tutulumu olanlardan daha yavaştı (p=0.004). Mini-BESTest ile EDSS arasında ters yönlü korelasyon (r:-0,621, p=0,001) varken Mini-BESTest ile yürüme hızı arasında doğru yönlü korelasyon saptandı (r:0,774, p=0,001).
Sonuç: Mini-BESTest MS’li hastalarda denge durumunun belirlenmesini sağlayan basit ve kolay uygulanabilir bir testtir. Mini-BESTest skoru ve MSS lezyon yaygınlığının basit bir MRG bölge sınıflaması sonuçları ile birleştirildiğinde, hastalarda hareket ve denge bozukluklarının erken saptanmasına olanak sağlayabilir.

Kaynakça

  • 1. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med 2018; 378: 169–80.
  • 2. Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol 2018; 159: 237–50.
  • 3. Doty RL, MacGillivray MR, Talab H et al. Balance in multiple sclerosis: relationship to central brain regions. Exp Brain Res 2018; 236: 2739–50.
  • 4. Prosperini L, Kouleridou A, Petsas N et al. The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. Journal of the Neurological Sciences 2011; 304: 55–60.
  • 5. Ross E, Purtill H, Uszynski M et al. Cohort Study Comparing the Berg Balance Scale and the Mini-BESTest in People Who Have Multiple Sclerosis and Are Ambulatory. Phys Ther 2016; 96: 1448-55
  • 6. Cattaneo D, Coote S, Rasova K et al. Factors influencing balance improvement in multiple sclerosis rehabilitation: A pragmatic multicentric trial. Annals of Physical and Rehabilitation Medicine 2020; 63: 93–8.
  • 7. Gunn H, Markevics S, Haas B, Marsden J, Freeman J. Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation 2015; 96: 1898–912.
  • 8. D’Orio VL, Foley FW, Armentano F, Picone MA, Kim S, Holtzer R. Cognitive and motor functioning in patients with multiple sclerosis: neuropsychological predictors of walking speed and falls. J Neurol Sci 2012; 316: 42–6.
  • 9. Martino Cinnera A, Bisirri A, Leone E, Morone G, Gaeta A. Effect of dual-task training on balance in patients with multiple sclerosis: A systematic review and meta-analysis. Clin Rehabil 2021; 35: 1399–412.
  • 10. Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis. Neurorehabil Neural Repair 2013; 27: 45–52.
  • 11. Göktaş A, Çolak FD, Kar İ, Ekici G. Reliability and Validity of the Turkish Version of the Mini-BESTest Balance Scale in Patients with Stroke. Turk J Neurol 2020; 26: 303-10.
  • 12. Leddy AL, Crowner BE, Earhart GM. Utility of the Mini-BESTest, BESTest, and BESTest Sections for Balance Assessments in Individuals With Parkinson Disease. Journal of Neurologic Physical Therapy 2011; 35: 90–7.
  • 13. Potter K, Brandfass K. The Mini-Balance Evaluation Systems Test (Mini-BESTest). Journal of Physiotherapy 2015; 61: 225.
  • 14. Tsang CSL, Liao L-R, Chung RCK, Pang MYC. Psychometric Properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in Community-Dwelling Individuals With Chronic Stroke. Physical Therapy 2013; 93: 1102–15.
  • 15. Loyd BJ, Fangman A, Peterson DS et al. Rehabilitation to improve gaze and postural stability in people with multiple sclerosis: study protocol for a prospective randomized clinical trial. BMC Neurol 2019; 1: 119.
  • 16. Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord 2017; 10: 247–61.
  • 17. Anderson V, Wheeler-Kingshott C, Abdel-Aziz K et al. A comprehensive assessment of cerebellar damage in multiple sclerosis using diffusion tractography and volumetric analysis. Mult Scler 2011; 17: 1079–87.
  • 18. Calabrese M, Reynolds R, Magliozzi R et al. Regional Distribution and Evolution of Gray Matter Damage in Different Populations of Multiple Sclerosis Patients. PLoS ONE 2015; 10: 0135428.
  • 19. Commowick O, Kain M, Casey R et al. Multiple sclerosis lesions segmentation from multiple experts: The MICCAI 2016 challenge dataset. NeuroImage 2021; 244: 118589.
  • 20. Prosperini L, Sbardella E, Raz E et al. Multiple Sclerosis: White and Gray Matter Damage Associated with Balance Deficit Detected at Static Posturography. Radiology 2013; 268: 181–9.
  • 21. Thompson AJ, Banwell BL, Barkhof F et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17: 162-73.
  • 22. Motl RW, Pekmezi D, Wingo BC. Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Multiple Sclerosis Journal - Experimental, Translational and Clinical 2018; 4: 205521731878674.
  • 23. Abasıyanık Z, Özdoğar AT, Sağıcı Ö et al. Explanatory factors of balance confidence in persons with multiple sclerosis: Beyond the physical functions. Multiple Sclerosis and Related Disorders 2020; 43: 102239.
  • 24. Grasso MG, Pace L, Troisi E, Tonini A, Paolucci S. Prognostic factors in multiple sclerosis rehabilitation. Eur J Phys Rehabil Med 2009; 45: 47–51.
  • 25. Prosperini L, Petsas N, Raz E et al. Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis. Mult Scler 2014; 20: 81–90.
  • 26. Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of Risk Factors for Falls in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Physical Therapy 2013; 93: 504–13.
  • 27. Yuksel H, Balaban M, Tan OO, Mungan S. Sarcopenia in patients with multiple sclerosis. Multiple Sclerosis and Related Disorders 2022; 58: 103471.
  • 28. Nogueira LAC, dos Santos LT, Sabino PG, Alvarenga RMP, Santos Thuler. Factors for Lower Walking Speed in Persons with Multiple Sclerosis. Multiple Sclerosis International 2013; 2013: 1–8.
  • 29. Sacco R, Bussman R, Oesch P, Kesselring J, Beer S. Assessment of gait parameters and fatigue in MS patients during inpatient rehabilitation: a pilot trial. J Neurol 2011; 258: 889–94.

The effectiveness of Mini-BESTest and magnetic resonance ımaging in the evaluation of balance in patients with multiple sclerosis

Yıl 2022, , 110 - 115, 26.03.2022
https://doi.org/10.18663/tjcl.1069550

Öz

Aim:Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. Most MS patients have balance disorders. Simple and easily applicable tests are needed to evaluate balance in patients with MS. In this study, we aimed to investigate the effectiveness of Mini-BESTest and magnetic resonance imaging (MRI) findings in evaluating balance in MS.
Material and Methods:Eighty MS patients were included in the study. The patients were divided into three groups as those with an EDSS score below 2 (Group 1), 2-2.5 (Group 2), and 3-3.5 (Group 3). Additionally, patients were grouped according to MRI findings as those with 1 Region, 2 Region and 3 Region involvement. Mini-BESTest and 6-meter gait speed were applied to the patients.
Results:The Mini-BESTest score was lower in Group 3 than in Group 1 and Group 2 (p=0.001 and p:0.001). Mini-BESTest in Group 2 was lower than Group 1 (p=0.018). Gait speed was slower in Group 3 than Group 1 and Group 2 (p=0.001 and p=0.001). According to MRI findings, the Mini-BESTest score was lower in 3 Region involvement than in 1 Region and 2 Region involvement (p=0.001 and p=0.026). Gait speed was slower in those with 3 Region involvement than in 1 Region involvement (p=0.004). While the Mini-BESTest score was negatively correlated with the EDSS score (r:-0.621, p=0,.001), it was positively correlated with gait speed (r:0.774, p=0.001).
Conclusion:Mini-BESTest is a simple and easily applicable test that enables the determination of balance status in patients with MS. Combined with the results of the mini-BESTest score and a simple MRI region classification of CNS lesions, it may allow early detection of gait and balance disorders in MS patients.

Kaynakça

  • 1. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med 2018; 378: 169–80.
  • 2. Cameron MH, Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol 2018; 159: 237–50.
  • 3. Doty RL, MacGillivray MR, Talab H et al. Balance in multiple sclerosis: relationship to central brain regions. Exp Brain Res 2018; 236: 2739–50.
  • 4. Prosperini L, Kouleridou A, Petsas N et al. The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. Journal of the Neurological Sciences 2011; 304: 55–60.
  • 5. Ross E, Purtill H, Uszynski M et al. Cohort Study Comparing the Berg Balance Scale and the Mini-BESTest in People Who Have Multiple Sclerosis and Are Ambulatory. Phys Ther 2016; 96: 1448-55
  • 6. Cattaneo D, Coote S, Rasova K et al. Factors influencing balance improvement in multiple sclerosis rehabilitation: A pragmatic multicentric trial. Annals of Physical and Rehabilitation Medicine 2020; 63: 93–8.
  • 7. Gunn H, Markevics S, Haas B, Marsden J, Freeman J. Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation 2015; 96: 1898–912.
  • 8. D’Orio VL, Foley FW, Armentano F, Picone MA, Kim S, Holtzer R. Cognitive and motor functioning in patients with multiple sclerosis: neuropsychological predictors of walking speed and falls. J Neurol Sci 2012; 316: 42–6.
  • 9. Martino Cinnera A, Bisirri A, Leone E, Morone G, Gaeta A. Effect of dual-task training on balance in patients with multiple sclerosis: A systematic review and meta-analysis. Clin Rehabil 2021; 35: 1399–412.
  • 10. Prosperini L, Fortuna D, Giannì C, Leonardi L, Pozzilli C. The Diagnostic Accuracy of Static Posturography in Predicting Accidental Falls in People With Multiple Sclerosis. Neurorehabil Neural Repair 2013; 27: 45–52.
  • 11. Göktaş A, Çolak FD, Kar İ, Ekici G. Reliability and Validity of the Turkish Version of the Mini-BESTest Balance Scale in Patients with Stroke. Turk J Neurol 2020; 26: 303-10.
  • 12. Leddy AL, Crowner BE, Earhart GM. Utility of the Mini-BESTest, BESTest, and BESTest Sections for Balance Assessments in Individuals With Parkinson Disease. Journal of Neurologic Physical Therapy 2011; 35: 90–7.
  • 13. Potter K, Brandfass K. The Mini-Balance Evaluation Systems Test (Mini-BESTest). Journal of Physiotherapy 2015; 61: 225.
  • 14. Tsang CSL, Liao L-R, Chung RCK, Pang MYC. Psychometric Properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in Community-Dwelling Individuals With Chronic Stroke. Physical Therapy 2013; 93: 1102–15.
  • 15. Loyd BJ, Fangman A, Peterson DS et al. Rehabilitation to improve gaze and postural stability in people with multiple sclerosis: study protocol for a prospective randomized clinical trial. BMC Neurol 2019; 1: 119.
  • 16. Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord 2017; 10: 247–61.
  • 17. Anderson V, Wheeler-Kingshott C, Abdel-Aziz K et al. A comprehensive assessment of cerebellar damage in multiple sclerosis using diffusion tractography and volumetric analysis. Mult Scler 2011; 17: 1079–87.
  • 18. Calabrese M, Reynolds R, Magliozzi R et al. Regional Distribution and Evolution of Gray Matter Damage in Different Populations of Multiple Sclerosis Patients. PLoS ONE 2015; 10: 0135428.
  • 19. Commowick O, Kain M, Casey R et al. Multiple sclerosis lesions segmentation from multiple experts: The MICCAI 2016 challenge dataset. NeuroImage 2021; 244: 118589.
  • 20. Prosperini L, Sbardella E, Raz E et al. Multiple Sclerosis: White and Gray Matter Damage Associated with Balance Deficit Detected at Static Posturography. Radiology 2013; 268: 181–9.
  • 21. Thompson AJ, Banwell BL, Barkhof F et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17: 162-73.
  • 22. Motl RW, Pekmezi D, Wingo BC. Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Multiple Sclerosis Journal - Experimental, Translational and Clinical 2018; 4: 205521731878674.
  • 23. Abasıyanık Z, Özdoğar AT, Sağıcı Ö et al. Explanatory factors of balance confidence in persons with multiple sclerosis: Beyond the physical functions. Multiple Sclerosis and Related Disorders 2020; 43: 102239.
  • 24. Grasso MG, Pace L, Troisi E, Tonini A, Paolucci S. Prognostic factors in multiple sclerosis rehabilitation. Eur J Phys Rehabil Med 2009; 45: 47–51.
  • 25. Prosperini L, Petsas N, Raz E et al. Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis. Mult Scler 2014; 20: 81–90.
  • 26. Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of Risk Factors for Falls in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Physical Therapy 2013; 93: 504–13.
  • 27. Yuksel H, Balaban M, Tan OO, Mungan S. Sarcopenia in patients with multiple sclerosis. Multiple Sclerosis and Related Disorders 2022; 58: 103471.
  • 28. Nogueira LAC, dos Santos LT, Sabino PG, Alvarenga RMP, Santos Thuler. Factors for Lower Walking Speed in Persons with Multiple Sclerosis. Multiple Sclerosis International 2013; 2013: 1–8.
  • 29. Sacco R, Bussman R, Oesch P, Kesselring J, Beer S. Assessment of gait parameters and fatigue in MS patients during inpatient rehabilitation: a pilot trial. J Neurol 2011; 258: 889–94.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Hatice Yüksel

Semra Mungan 0000-0002-6469-5185

Yayımlanma Tarihi 26 Mart 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

APA Yüksel, H., & Mungan, S. (2022). Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği. Turkish Journal of Clinics and Laboratory, 13(1), 110-115. https://doi.org/10.18663/tjcl.1069550
AMA Yüksel H, Mungan S. Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği. TJCL. Mart 2022;13(1):110-115. doi:10.18663/tjcl.1069550
Chicago Yüksel, Hatice, ve Semra Mungan. “Multipl Sklerozlu Hastalarda Dengenin değerlendirilmesinde Mini-BESTest Ve Manyetik Rezonans görüntülemenin etkinliği”. Turkish Journal of Clinics and Laboratory 13, sy. 1 (Mart 2022): 110-15. https://doi.org/10.18663/tjcl.1069550.
EndNote Yüksel H, Mungan S (01 Mart 2022) Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği. Turkish Journal of Clinics and Laboratory 13 1 110–115.
IEEE H. Yüksel ve S. Mungan, “Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği”, TJCL, c. 13, sy. 1, ss. 110–115, 2022, doi: 10.18663/tjcl.1069550.
ISNAD Yüksel, Hatice - Mungan, Semra. “Multipl Sklerozlu Hastalarda Dengenin değerlendirilmesinde Mini-BESTest Ve Manyetik Rezonans görüntülemenin etkinliği”. Turkish Journal of Clinics and Laboratory 13/1 (Mart 2022), 110-115. https://doi.org/10.18663/tjcl.1069550.
JAMA Yüksel H, Mungan S. Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği. TJCL. 2022;13:110–115.
MLA Yüksel, Hatice ve Semra Mungan. “Multipl Sklerozlu Hastalarda Dengenin değerlendirilmesinde Mini-BESTest Ve Manyetik Rezonans görüntülemenin etkinliği”. Turkish Journal of Clinics and Laboratory, c. 13, sy. 1, 2022, ss. 110-5, doi:10.18663/tjcl.1069550.
Vancouver Yüksel H, Mungan S. Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği. TJCL. 2022;13(1):110-5.


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