The Romberg ratio in people with multiple sclerosis

Postural control relies on the integration of inputs from the visual, somatosensory and vestibular systems which are frequently impaired in people with Multiple Sclerosis (PwMS). In this situation, examining the Romberg ratio can be useful. This parameter can be interpreted as a gross indicator of a vestibular and proprioceptive contribution to postural control. Therefore, the primary objective of the current study was to examine whether the Romberg ratio differs between MS fallers, non-fallers and neurological disability levels. In addition, we clarified the association between the Romberg ratio values with validated gait and the balance tests in PwMS. Romberg ratio values were calculated according to the sway rate, total sway area and center of pressure (CoP) path length. The patient group included 542 PwMS (337 women) with a mean age of 42.3 (S.D = 13.8). In terms of fall status, significant differences were observed between the faller (n = 287) and non-faller (n = 255) groups solely in terms of the Romberg ratio-ellipse sway area: 2.76 (S.D = 2.46) vs. 2.24 (S.D = 2.01), P-value = 0.01. A significant increase in the Romberg ratio was found between the severe group (n = 50), the very mild (n = 245), mild (n = 186) and moderate (n = 61) groups for each of the three Romberg ratio quotients. Significant weak correlation scores were found between the Romberg ratio-ellipse sway area and all walking and balance outcome measures; the Pearson's rho ranged from 0.172 to 0.270. The present data suggest that an elevated Romberg ratio quotient, especially according to the sway area, is an indicator of poor walking and balance capabilities in PwMS.