1
|
Kaddoura R, Faraji H, Othman M, Abu Hijleh A, Loney T, Goswami N, Benamer HTS. Exploring Factors Associated with Falls in Multiple Sclerosis: Insights from a Scoping Review. Clin Interv Aging 2024; 19:923-938. [PMID: 38803468 PMCID: PMC11129740 DOI: 10.2147/cia.s460475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic inflammatory condition that causes demyelination of the central nervous system accompanied by a wide range of symptoms. The high prevalence of falls among patients diagnosed with MS within the initial six months highlights the importance of this issue. The objective of this study is to identify factors associated with falls in MS patients in order to increase awareness and reduce the risk of falls. This scoping review used specific Mesh terms to formulate the literature search around falls and MS using Medline, Google Scholar, Scopus, and Embase search engines. English papers published between 2012 and 2022, studies with a clear definition of falls, McDonald's diagnostic criteria for MS, and those with Expanded Disability Status Scale (EDSS) or Patient Determined Disease Steps (PDDS) scores were included. Critical data from the selected articles were extracted and classified according to the different factors associated with falls in MS patients. Eighteen articles were included in this review. The most important factors associated with falls in MS patients identified were the severity and progression of the disease, mobility and balance problems, bladder dysfunction, fear of falling, fatigue, and cognitive dysfunction. In conclusion, this scoping review yielded the most common factors associated with falls in patients with MS. Study findings can be used to develop future interventions focusing on improving mobility, proprioception, and balance to decrease fall risk and injury amongst MS patients.
Collapse
Affiliation(s)
- Rachid Kaddoura
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hanan Faraji
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Malek Othman
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amin Abu Hijleh
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Tom Loney
- Department of Basic Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Nandu Goswami
- Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
- Center for Space and Aviation Health, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hani T S Benamer
- Department of Clinical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| |
Collapse
|
2
|
de Mongeot LB, Galofaro E, Ramadan F, D'Antonio E, Missiroli F, Lotti N, Casadio M, Masia L. Combining FES and Exoskeletons in a Hybrid Haptic System for Enhancing VR Experience. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4812-4820. [PMID: 37971913 DOI: 10.1109/tnsre.2023.3334190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Robotic technology and functional electrical stimulation (FES) have emerged as highly effective rehabilitative techniques for individuals with neuromuscular diseases, showcasting their ability to restore motor functions. Within the proposed study, we developed and tested a new hybrid controller combining an upper-limb exoskeleton with FES to enhance haptic feedback when performing task-oriented and bimanual movement, like pick-and-place, in a virtual environment. We investigated the performance of the proposed approach on eight unimpaired participants providing haptic feedback either only by the exoskeleton or by the hybrid system. The hybrid control presents two different modalities, assistive and resistive, to modulate the perception of the load. FES intensity is calibrated to the subjects' biomechanical properties and it is adjusted in real-time according to the real-time motion of the upper limbs. Experimental results highlighted the ability of the hybrid control to improve kinematic performance: in both hybrid modalities subjects reduced the target matching error(values between 0.048±0.007 m and 0.06±0.006 m) without affecting the normal motion smoothness (SPARC values in the hybrid conditions range from -2.58±0.12 to -3.30±0.13). Moreover, the resistive approach resulted in greater metabolic consumption (1.04±0.03 W/kg), indicating a more realistic experience of lifting a virtual object through FES that increased the perceived weight. The innovation in our hybrid control relies on the modulation of muscular activation during manipulation tasks, which could be a promising approach in the clinical treatment of neuromuscular diseases.
Collapse
|
3
|
Kostenko EV. [The use of botulinum toxin type A in symptomatic therapy and medical rehabilitation of patients with multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:17-25. [PMID: 37966435 DOI: 10.17116/jnevro202312310117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The review of the current state of the problem of symptomatic therapy and medical rehabilitation (MR) of patients with multiple sclerosis (MS) is presented. The search was conducted in the databases Medline, Web of Science, PubMed and Scopus. Information is given about the most common symptoms of MS, among which sensory and motor disorders, bladder dysfunction, and pain have the greatest impact on the quality of life of patients, their functioning and independence in everyday life. The clinical characteristics of spasticity syndrome in MS and its relationship with quality of life indicators are considered. The features of the use of botulinum therapy (BT) in MS are considered. A high level of effectiveness of the use of BT in the treatment of neurogenic hyperactivity of detrusor and neurogenic bladder (the level of persuasiveness of recommendation A) and spasticity (the level of persuasiveness of recommendation B) is shown. Symptomatic treatment of MS and MR with the use of multidisciplinary programs helps to reduce disability, improve the quality of life of patients. When choosing symptomatic treatment and MR methods, it is customary to focus on the needs of patients.
Collapse
Affiliation(s)
- E V Kostenko
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
4
|
Goldlist S, Wijeyaratnam DO, Edwards T, Pilutti LA, Cressman EK. Assessing proprioceptive acuity in people with multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173221111761. [PMID: 35837242 PMCID: PMC9274812 DOI: 10.1177/20552173221111761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Proprioceptive acuity and impairments in proprioceptively guided reaches have not been comprehensively examined in people with multiple sclerosis (MS). Objective To examine proprioceptive acuity in people with MS who self-report and who do not self-report upper limb (UL) impairment, and to determine how people with MS reach proprioceptive targets. Methods Twenty-four participants with MS were recruited into two groups based on self-reported UL impairment: MS-R (i.e. report UL impairment; n = 12) vs. MS-NR (i.e. do not report UL impairment; n = 12). Proprioception was assessed using ipsilateral and contralateral robotic proprioceptive matching tasks. Results Participants in the MS-R group demonstrated worse proprioceptive acuity compared to the MS-NR group on the ipsilateral and contralateral robotic matching tasks. Analyses of reaches to proprioceptive targets further revealed that participants in the MS-R group exhibited deficits in movement planning, as demonstrated by greater errors at peak velocity in the contralateral matching task in comparison to the MS-NR group. Conclusion Our findings suggest that people with MS who self-report UL impairment demonstrate worse proprioceptive acuity, as well as poorer movement planning in comparison to people with MS who do not report UL impairment.
Collapse
Affiliation(s)
| | | | - Thomas Edwards
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Erin K Cressman
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
5
|
Pearse DD, Hefley AB, Morales AA, Ghosh M. Comparative Profiling of TG2 and Its Effectors in Human Relapsing Remitting and Progressive Multiple Sclerosis. Biomedicines 2022; 10:biomedicines10061241. [PMID: 35740263 PMCID: PMC9220003 DOI: 10.3390/biomedicines10061241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 02/05/2023] Open
Abstract
Multiple Sclerosis (MS) is a chronic CNS autoimmune disease characterized by immune-mediated demyelination, axon loss, and disability. Dysregulation of transglutaminase-2 (TG2) has been implicated in disease initiation and progression. Herein, TG2 expression in post-mortem human brain tissue from Relapsing Remitting MS (RRMS) or Progressive MS (PMS) individuals were examined and correlated with the presence of TG2 binding partners and effectors implicated in the processes of inflammation, scar formation, and the antagonism of repair. Tissues from Relapsing-Remitting Multiple Sclerosis (RRMS; n = 6), Progressive Multiple Sclerosis (PMS; n = 5), and non-MS control (n = 6) patients underwent immunohistochemistry for TG2, PLA2, COX-2, FN, CSPG, and HSPG. TG2 was strongly upregulated in active RRMS and PMS lesions, within blood vessels and the perivascular tissue of sclerotic plaques. TG2 colocalization was observed with GFAP+ astrocytes and ECM, including FN, HSPG, and CSPG, which also increased in either RRMS or PMS lesions. Although TG2 was not colocalized with inflammatory mediators COX-2 and PLA2, or the macrophage-microglia marker Iba1, its increased expression correlated with their elevation in active RRMS and PMS lesions. In summary, the correlation of strong TG2 induction in either RRMS or PMS with some of its binding partners but not others implicates potentially different roles for TG2 in disparate MS forms that may warrant further investigation.
Collapse
Affiliation(s)
- Damien D. Pearse
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (D.D.P.); (A.B.H.); (A.A.M.)
- The Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Veterans Affairs, Veterans Affairs Medical Center, Miami, FL 33136, USA
| | - Andrew B. Hefley
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (D.D.P.); (A.B.H.); (A.A.M.)
| | - Alejo A. Morales
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (D.D.P.); (A.B.H.); (A.A.M.)
| | - Mousumi Ghosh
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (D.D.P.); (A.B.H.); (A.A.M.)
- The Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Veterans Affairs, Veterans Affairs Medical Center, Miami, FL 33136, USA
- Correspondence: ; Tel.: +1-305-243-9968; Fax: +1-305-243-3923
| |
Collapse
|