ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Brain Health and Clinical Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1624969
This article is part of the Research TopicFatigue and Neuroplasticity in Neurological and Psychiatric Disorders: Mechanistic Insights and Biomarkers DiscoveryView all 3 articles
Postural sway in multiple sclerosis patients: interaction of vision, surface and fatigue effects
Provisionally accepted
- 1Faculty of Health Sciences, University of Primorska, Koper, Slovenia
- 2University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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Postural control impairments are common in individuals patients with multiple sclerosis (MS), resulting in postural instability and increased fall risk. Sensory inputs are crucial to maintain balance adequately. Additionally, fatigue is one of the common and most disabling symptoms of MS possibly contributing to postural deficits. Previous studies have examined the effects of fatigue and altered sensory conditions on postural control in patients with multiple sclerosis (MS). The present study aimed to extend this knowledge by jointly assessing these factors within the same experimental framework, providing additional insight into how fatigue modulates sensory contributions to balance. Twenty-one patients with MS (age = 41.1 ±10.1 years; EDSS = 1.9 ±1.0; disease duration = 6.8 ± 4.9 years) completed balance assessments on firm and compliant surfaces with both eyes open and eyes closed, before and after a 6-minute walk test used to induce fatigue. Postural sway was quantified using sway velocity and root mean square (RMS). There was a significant effect of surface on sway velocity (p < 0.001, η² = 0.60), with greater sway on compliant surface compared to firm surface. Fatigue significantly increased sway RMS (p = 0.023, η² = 0.23), but did not affect sway velocity (p > 0.05). Absence of visual input (eyes closed) also significantly increased sway RMS (p = 0.001, η² = 0.46). There was a significant interaction between surface and vision for sway RMS (p < 0.001, η² = 0.54), with a larger effect of surface instability in the eyes-closed condition. Patients with MS face increased challenges in maintaining postural control under conditions of fatigue, surface instability, and lack of visual input. Sway RMS may be more sensitive to these effects than sway velocity.
Keywords: Balance control, sensory integration, Proprioception, motor impairments, Fall prevention, neurological disorders, physical fatigue
Received: 08 May 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Kozinc, Žura and Brecl Jakob. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Žiga Kozinc, ziga.kozinc@fvz.upr.si
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