Investigation of the Relationship Between Balance, Functional Mobility, and Walking in Patients with Multiple Sclerosis

Introduction: Balance disorders are common in patients with multiple sclerosis (PwMS) and impact functional mobility and walking. Impaired postural stability is also a predisposing factor that increases the risk of falls in this population. Objectives/Aims: This study aimed to investigate which balance parameters are more strongly associated with functional mobility and walking in PwMS. Methods: Sixty-two PwMS, with a mean Expanded Disability Status Scale (EDSS) score of 2.03±1.05 and a mean age of 36.5±12.28 years, were included in the study. Balance was assessed using the Postural Stability Test (PST), the Limits of Stability Test (LOS), and the modified Clinical Test of Sensory Interaction in Balance (m-CTSIB) and Activities-specific Balance Confidence (ABC) Scale. Functional mobility was evaluated with the Timed Up and Go Test (TUG), while walking performance was measured using the Six-Minute Walk Test (6MWT). Results: A significant relationship was found between all balance measurements, functional mobility, and walking distance. Postural stability during double-leg stance demonstrated a strong correlation with mobility (r=0.70-0.89, p<0.05), whereas single-leg stance stability was moderately correlated with both functional mobility and walking distance (r= 0.40-0.69, p<0.05). Furthermore, moderate correlations were observed between limits of stability and mobility, as well as between m-CTSIB scores and mobility (r= 0.40-0.69, p<0.05). Balance confidence exhibited a strong correlation with walking distance (r=0.70-0.89, p<0.05), and a moderate correlation with functional mobility (r= 0.40-0.69, p<0.05). Conclusion: Postural stability and perceived balance confidence are strongly associated with physical performance, walking distance, and walking speed in PwMS. These findings suggest that clinicians may consider the PST and the ABC Scale as practical indicators of mobility in this population. Furthermore, the results emphasize the importance of targeting postural stability in rehabilitation programs to enhance both physical performance and mobility in PwMS.