Dysequilibrioception (Imbalance) in Multiple Sclerosis: Can Dynavision D2 Visuomotor Training System be an Effective Tool for the Measurement of Balance?

Background: :  Imbalance is a common clinical finding in multiple sclerosis, which can be caused by visual, perceptual, vestibular and/or proprioceptive deficits.  It is one of the major sources of physical   disability.  One of the major tools used to measure balance is The Berg Balance test (BBT) Dynavision D2 is a computerized tool, which systematically records responses to variable visual stimuli.  However, its value in indirectly measuring balance and correlation with BBT is not described in a MS population.

Objectives: To determine the relationship between Berg Balance Scores (BBS) and Dynavision D2 as related to the assessment of balance in a MS outpatient population.

Methods: Twenty-nine patients were selected from an outpatient MS clinic population.  They underwent BBS testing and thereafter, a Dynavision D2 assessment.  They were separated into two groups, with the first group (15 patients) performing two trials, one with each hand, and the second group (14 patients) performing one trial using both hands. The goal was to turn off as many lights as possible during a 60 second timed period.

Results: The results show a significant correlation between BBS and Dynavision D2 only when using the right hand (P value 0.0279) to turn off the lights. There was no significant correlation between the BBS and Dynavision D2 for the left hand (P score 0.132) and using both hands (P score 0.666). The majority of the patients tested were right handed (21), 2 were left-handed and 5 were unknown.

Conclusions: The Dynavision D2 may be a useful objective computerized tool to indirectly measure equilibrioception in a MS population, especially when using the right (dominant) hand.  More research in needed to determine the full utility of Dynavision D2 as a measurement of balance.