An investigation of knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis

This study was carried out to investigate knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with MS and how these changes related to pain, anxiety and fatigue. The study included 14 females diagnosed with MS and 13 healthy females with regular menstrual cycles who did not use oral contraceptives. The individuals' knee position sense, balance, and dual task performance were evaluated with a digital inclinometer, Biodex Balance System, and the Time Up and Go Test, respectively. Pain, anxiety, and fatigue were assessed with the Visual Analog Scale, State-Trait Anxiety Inventory, and Fatigue Severity Scale, respectively. Measurements were repeated in the early follicular, ovulation, and luteal phases. As a result of the study, it was found that knee position sense, dynamic balance and dual task performance decreased, and fatigue increased in the early follicular phase in females with MS female (p<0.05). Associations between pain and sense of position, balance and dual task performance, anxiety and sense of position and balance, and fatigue and sense of position and balance were observed (p<0.05). It was found that knee position sense, dynamic balance, dual task performance and anxiety decreased, pain and fatigue increased in the early follicular phase in with healthy females (p<0.05). As a result, it was found that females with MS may have increased neurological symptoms in early follicular phase. Considering these changes occurring in different phases of the menstrual cycle, menstrual cycle is an important criterion for organizing the rehabilitation program and evaluation in terms of physiotherapy. In addition, informing patients during phase/s in which the risk of injury increases is very important for taking necessary precautions.