Comparison of the effects of trunk and lower extremity ataxia on gait and balance parameters in individuals with multiple sclerosis

The aim of this study was to investigate the effects of lower extremity and trunk ataxia on walking, plantar pressure and balance in ataxic Multiple Sclerosis (MS) patients and determine their differences with truncal ataxia. 60 MS patients who could walk independently between 3 and 5 in the EDSS (Expanded Disability Status Scale) score were included in the study. In patients, it was decided by EDSS which of the trunk and extremity ataxia was predominant. According to EDSS, 36 subjects with predominant trunk ataxia and 24 patients with extremity ataxia (limb ataxia) were included. 32 healthy subjects were included in the control group. Functional Reach Test (FUT), International Cooperative Rating Scale (ICARS), Dynamic Gait Index (DGI), Pedobarography (PBG) and Stabilometer were used to evaluate balance and gait. Pedobarography (PBG) and stabilometer were applied to the subjects in the control group. Spatiotemporal parameters of MS patients with ekstremty ataxia and trunk ataxia and healthy individuals showed statistically significant differences (p <0.05). Patients with lower extremity ataxia had lower velocity and cadence than the group with ataxia (p <0.05). Foot angle and step length were lower than the control group and no significant difference was found between the groups. There was no significant difference between the groups when the duration time of stance was examined (p> 0.05). Statistically significant differences were observed in the static and dynamic plantar pressure distribution of MS patients with ekstremty ataxia and trunk ataxia (p <0.05). When the static plantar pressure distribution was examined, the pressure in the lateral of back foot of the extremity ataxia group was significantly higher than the trunk ataxia and the control group (p <0.05). Dynamic plantar pressure was found to be lower in the forefoot and middle foot lateral to healthy individuals. Dynamic plantar pressure was found to be lower in the middle and lateral hind of foot compared to healthy individuals (p <0.05). Stabilometric evaluation of the trunk ataxia individuals eyes open and eyes closed swing length, was found to be higher than the extremity ataxia. Lower extremity ataxia was found to be more effective than the body ataxia. Trunk ataxia was shown to affect the balance more than the lower extremity ataxia.The importance of determining the type of ataxia that predominates in the person with MS, taking into account the treatment approaches to increase the plantar pressure and balance activities was emphasized. Key Words : Multiple sclerosis, extremity ataxia, plantar pressure, gait