Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis

Background: Multiple sclerosis (MS) is a neurological condition that can affect the postural stability of the individual and predispose falls in this population. Methods: A systematic literature search identified case-control studies investigating differences in postural control across a diversity of task conditions, with the exception of gait, between people with MS and healthy controls. Meta-analysis was conducted where a variable was presented by four or more studies. Results: Forty-three studies of people with a mean Expanded Disability Status Scale (EDSS) of 1.0 to 6.0 were included. Seven conditions of assessment and 105 individual measurement variables relating to postural control were included. Quiet stance was the only condition (11 studies) possessing sufficient data to contribute to meta-analysis in terms of centre of pressure path length (SMD= 1.04, 95% CI {0.86-1.22}, p < 0.001), medio-lateral velocity (SMD= 1.35, 95% CI {0.77-1.92}, p < 0.001) and 95% confidence ellipse (SMD= 0.83 95% CI {0.59-1.08}, p < 0.001). Results: indicate that regardless of task complexity or sensory condition, people with MS display considerable deficits in postural control in comparison to healthy controls. Conclusions: The large number of variables and lack of standardisation of reporting makes data synthesis challenging, however, people with MS display considerable deficits in postural control compared to healthy controls regardless of task condition or complexity.