Multiple Sclerosis Clinical Trial
Official title:
An Investigation of Knee Position Sense, Balance, and Dual Task Performance in Different Phases of Menstrual Cycle in Females With Multiple Sclerosis
The aim of this study was to investigation of knee position sense, balance, and dual task
performance in different phases of menstrual cycle in females with multiple sclerosis.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS)
affecting young people and leading to demyelination and neurodegeneration. MS affects females
more than males with a ratio approximately of 3:1. Important gender differences in
progression and inflammatory activity of disease have been observed. Sex hormones have been
thought to play an important role in this condition. It is worth noting however that sex
hormones not only affect reproduction (menses/pregnancy), they also have direct effects on
the nervous and immune system. In the neurologic group, especially in MS patients, it is well
known that disease activity, course, and symptoms can be influenced by hormonal fluctuations
in different phases of the menstrual cycle. Previous studies have reported that the variation
of estrogen and progesterone during the menstrual cycle may have an effect on several
neurological functions. However, these studies are mostly subjective, in the form of patient
reports and in limited numbers. Smith and Studd reported that there was a premenstrual
increase in disease severity as changes in the Th-1 / Th-2 balance occurred in association
with decreased circulating estrogen. Withdrawal of hormones from damaged tissues that affect
axonal conduction can explain the change in disease activity, course symptoms during the
menstrual cycle in female with MS.
For all these reasons,investigators think that different phases of menstrual cycle change
position sense, balance, and dual task performance in females with MS. Considering hormonal
fluctuations occurring in the menstrual cycle, is an important criterion for organizing the
rehabilitation program and evaluation in terms of physiotherapy.
The purpose of this study was to determine the effect of hormonal changes on knee position
sense, balance and dual task performance throughout the menstrual cycle in females with MS.
14 females with MS and 13 healthy females with matching ages and genders were included the
study. A neurologic examination was performed using the EDSS by a neurologist.
Position sense was measured with Acumar dual digital inclinometer (Acu360, Acumar, Lafayette,
USA). Balance was measured with Biodex Balance System (Biodex Medical Systems, Shirley, NY,
USA). Dual task performance was evaluated with Time Up and Go test.
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