Multipl sklerozlu hastalarda dengenin değerlendirilmesinde Mini-BESTest ve manyetik rezonans görüntülemenin etkinliği

Amaç:Multipl skleroz (MS) santral sinir sisteminin demiyelinizan plaklarla seyreden nörodejeneratif bir hastalığıdır. MS’li hastaların önemli bir kısmı denge bozukluğundan şikayet eder. MS’li hastada denge durumunu değerlendirmede kullanılacak pratik ve kolay uygulanabilir testlere ihtiyaç halen devam etmektedir. Bu çalışmamızda MS’de dengeyi değerlendirmede Mini-BESTest’in ve manyetik rezonans görüntüleme (MRG) bulgularının etkinliğini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya toplam 80 MS hastası dahil edildi. Hastalar ilk olarak EDSS skoru 2’nin altında (Grup 1), 2-2.5 (Grup 2) ve 3-3.5 olanlar (Grup 3) olmak üzere üç gruba ayrıldı. Ayrıca hastalar MRG bulgularına göre 1 Bölge, 2 Bölge ve 3 Bölge tutulumu olanlar olmak üzere ikinci kez gruplandırıldı. Hastalara Mini-BESTest ve 6-metre yürüme hızı testi uygulandı. Hastaların demografik ve klinik verileri kaydedildi. Bulgular: EDSS skoruna göre gruplandırıldığında, Mini-BESTest skoru Grup3’de Grup 1 ve Grup 2’den anlamlı derecede daha düşüktü (p=0,001 ve p=0,001). Aynı zamanda Mini-BESTest Grup 2’de Grup 1’den anlamlı olarak düşüktü (p=:0,018). Yürüme hızı Grup 3’de Grup 1 ve Grup 2’den anlamlı derecede yavaştı (p=0,001 ve p=0,001). MRG bulgularına göre Mini-BESTest skoru 3 Bölge tutulumunda 1 Bölge ve 2 Bölge tutulumu olanlardan daha düşüktü (p=0,001 ve p=0,026). Ancak 1 Bölge ve 2 Bölge tutulumu olanlar arasında Mini-BESTest açısından farklılık yoktu. 3 Bölge tutulumu olanlarda yürüme hızı 1 Bölge tutulumu olanlardan daha yavaştı (p=0.004). Mini-BESTest ile EDSS arasında ters yönlü korelasyon (r:-0,621, p=0,001) varken Mini-BESTest ile yürüme hızı arasında doğru yönlü korelasyon saptandı (r:0,774, p=0,001). Sonuç: Mini-BESTest MS’li hastalarda denge durumunun belirlenmesini sağlayan basit ve kolay uygulanabilir bir testtir. Mini-BESTest skoru ve MSS lezyon yaygınlığının basit bir MRG bölge sınıflaması sonuçları ile birleştirildiğinde, hastalarda hareket ve denge bozukluklarının erken saptanmasına olanak sağlayabilir.

Anahtar Kelimeler:

Multipl skleroz, Denge bozukluğu, Mini-BESTest, Manyetik Rezonans Görüntüleme

The effectiveness of Mini-BESTest and magnetic resonance ımaging in the evaluation of balance in patients with multiple sclerosis

Aim:Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. Most MS patients have balance disorders. Simple and easily applicable tests are needed to evaluate balance in patients with MS. In this study, we aimed to investigate the effectiveness of Mini-BESTest and magnetic resonance imaging (MRI) findings in evaluating balance in MS. Material and Methods:Eighty MS patients were included in the study. The patients were divided into three groups as those with an EDSS score below 2 (Group 1), 2-2.5 (Group 2), and 3-3.5 (Group 3). Additionally, patients were grouped according to MRI findings as those with 1 Region, 2 Region and 3 Region involvement. Mini-BESTest and 6-meter gait speed were applied to the patients. Results:The Mini-BESTest score was lower in Group 3 than in Group 1 and Group 2 (p=0.001 and p:0.001). Mini-BESTest in Group 2 was lower than Group 1 (p=0.018). Gait speed was slower in Group 3 than Group 1 and Group 2 (p=0.001 and p=0.001). According to MRI findings, the Mini-BESTest score was lower in 3 Region involvement than in 1 Region and 2 Region involvement (p=0.001 and p=0.026). Gait speed was slower in those with 3 Region involvement than in 1 Region involvement (p=0.004). While the Mini-BESTest score was negatively correlated with the EDSS score (r:-0.621, p=0,.001), it was positively correlated with gait speed (r:0.774, p=0.001). Conclusion:Mini-BESTest is a simple and easily applicable test that enables the determination of balance status in patients with MS. Combined with the results of the mini-BESTest score and a simple MRI region classification of CNS lesions, it may allow early detection of gait and balance disorders in MS patients.

Keywords:

Multiple sclerosis, balance disorder, Mini-BESTest, magnetic resonance imaging,

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