Biomedical Engineering Reference
In-Depth Information
than registered in right foot. Another interesting finding is the result of CT value
in MS group, is equal in both foot and superior to healthy group, more 31% in
right foot and 33% in left foot. The disease duration has a positive correlation
and moderate intensity with CT in both feet (rs
0.472), indicating that the higher
disease duration tend to be associated with higher CT. The BBS has a negative
correlation and moderate intensity with the TD (rs
D
D
0.585) indicating that high
values of BBS tend to be related to low values of DT.
4
Discussion
The main aim of this study was to study if patients with multiple sclerosis, when
in upright standing position and in the stance phase of gait, do have kinematics
changes associated to COP when compared with a healthy group. To perform this
study we compare plantar pressure assessment with a clinical test. The primary
limitation of the investigation is related to the disease itself. Multiple sclerosis is
a chronic, inflammatory autoimmune central nervous system, causing motor and
sensory changes. The disease course is variable and is related to changes in the
inflammatory process, causing changes in symptoms over time [
27
]. So it's very
difficult to recruit subjects with the same characteristics and the same evolutionary
stage of the disease. In this sense and in order to achieve the greatest number of
subjects, we considered all patients with MS which satisfied the inclusion criteria,
regardless the type and stage of MS evolution. Also, the study did not compare
balance performance between subcategories of people with MS, such as those with
spasticity, ataxia or sensory loss. These factors increased the group variability in the
MS sample.
An important factor in data collection of plantar pressure is the test time. Test
periods with short time may lead to results that aren't representative of postural
stability. On the other hand long periods, in certain clinical situations, might
influence the results due to increased fatigue. However it's necessary to establish
what the optimum testing time, allowing the collection of data with confidence,
without developing factors that may influence the results. A study with MS patients,
to obtain the offset AP with eyes open and closed in upright standing position, used
three trials with time 10 s [
100
]. The validity and confidence in gait assessment with
plantar pressure in this population is unknown. There are however studies on plantar
pressure in subjects with MS, who used a first step protocol [
98
,
101
]. In our study,
we used the same protocol based on the subject safety and to minimize any effects of
fatigue. The analysis of test results in MS group shows that the variables are higher
when compared to control group. In standing position an increase of ML is strongly
correlated with increased AP, TD, and EA. In our study the statistical correlation
between BBS and data obtained in the plate are not linear, showing large variations.
BBS maintains the relationship with ML, AP and TD. A high value on BBS tends
to be related to reduce values of ML, AP and TD. In 1-step protocol the correlation
shows that a high value of BBS tends to be associated with a reduced value of
