The effect of visual field manipulations on standing balance control in people with multiple sclerosis

Background: Multiple sclerosis (MS) is associated with an increased risk of falls, degeneration of sensory organization, and possible increased reliance on vision for balance control. Research question: The aim of this study was to assess differences in standing postural control between people with MS and age and sex matched controls during medial-lateral (ML) oscillations of the visual field, with and without blinders to the lower periphery. Methods: Ten persons with MS (mean age 54.0 +/- 5.3 years) and ten age and sex matched controls (mean age: 56.3 +/- 6.0 years) participated in this study. Balance control was assessed while participants stood in a Christie Cave system while wearing stereoscopic glasses that projected an immersive forest scene. Visual conditions consisted of 2 m ML visual oscillations of the scene at five frequencies (0.0, 0.3, 0.6, 0.7 and 0.8 Hz) with and without blinders to block the lower periphery. Results and significance: The results demonstrated that, in comparison to controls, participants with MS had a significantly larger center of pressure sway in both the ML and AP direction to ML visual oscillations. Additionally, participants with MS and controls both increased center of pressure frequency content to the visual oscillation frequency, while participants with MS also increased relative power at the visual oscillation frequency in the AP direction. Blinders of lower periphery reduced the percent power at the visual oscillation frequency in both groups and reduced overall sway in participants with MS during visual oscillations. Overall, results indicate that postural balance is sensitive to visual feedback in people with MS. The elicited AP sway to ML visual oscillation could reflect errors in visual processing for the control of balance, and decreased sway in response to blocking vision of the lower peripheral field could indicate an increased reliance on visual cues to maintain balance.

Automated summary

Individuals with MS show poorer standing postural control during ML visual oscillations compared to controls, and blocking vision of the lower peripheral field can reduce overall sway in individuals with MS.