Relationship between subjective visual vertical and balance in individuals with multiple sclerosis.
Brooke N Klatt, Patrick J Sparto, Lauren Terhorst and 3 others
PMID 30403321WHAT IT FOUND
With the rod alone, no balance score correlated with perceived vertical errors.
With a tilted frame, larger errors correlated with worse balance scores in 20 people with MS and cerebellar signs.
Key findings
01SVV deviations were within normal limits with the rod alone but exceeded normal limits when a tilted frame was used.
02No functional outcome measure correlated with SVV deviations in the rod-only condition.
03When the frame was tilted counterclockwise, larger SVV deviations had significant moderate correlations with all six balance and function scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Twenty participants is a small sample, so the correlations may not apply to all people with MS. The study was cross-sectional, so it cannot show that abnormal SVV caused worse balance or that changing SVV would improve balance. Participants had to be able to walk 10 meters without physical help, so people unable to ambulate or with more severe balance impairment were not represented. No medical imaging was used to locate lesions, and MS disease course was not characterized, so differences in SVV direction could not be linked to specific brainstem or cerebellar damage. The rod-and-frame SVV findings were condition-specific: no relationship appeared in the rod-only condition, and only the counterclockwise frame tilt showed significant correlations with all outcomes.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not read the correlations as evidence that SVV testing or vestibular training will improve balance. This was a cross-sectional association in 20 people, and rod-only SVV was not related to balance.