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    Relationship between lower extremity sensation, physical activity, cognition, body awareness, and fatigue in people with multiple sclerosis: a cross-sectional study
    (Springer Heidelberg, 2025) Eldemir, Kader; Ozkul, Cagla; Yildirim, Muhammed Seref; Eldemir, Sefa; Saygili, Fettah; Irkec, Ceyla; Guclu-Gunduz, Arzu
    Background Multiple sclerosis (MS) is a chronic autoimmune disease causing sensory and motor impairments due to central nervous system demyelination. Sensory feedback, essential for balance and gait, is often disrupted in people with MS (PwMS). However, its relationship with fatigue, physical activity, cognitive function, and body awareness remains unclear. Aim To investigate the relationship between plantar sensation, knee position sense, and clinical factors in PwMS compared to healthy controls (HC). MethodsThirty-three PwMS and 11 HC participated in this study. Foot sensations including light touch threshold, two-point discrimination, vibration duration, and knee position sense were assessed. In addition, physical activity level, cognitive function, body awareness, and fatigue were assessed as clinical factors. Results No significant differences were found between PwMS and HC in most sensory measures, except for body awareness, which was higher in HC (p:0.029). In PwMS, light touch thresholds correlated with age (r = 0.454, p = 0.008), vibration duration with walking and physical activity levels (r = 0.392-0.396, p < 0.05), two-point discrimination with EDSS score (r = 0.474, p = 0.005), knee position sense with EDSS (r = 0.385, p = 0.027) and cognitive function (r = 0.382, p = 0.028). In HC, vibration duration correlated negatively with age (r=-0.834, p:0.001), and knee position sense correlated with body mass index (r = 0.764, p:0.006) and cognitive function (r = 0.609-0.736, p < 0.05). Conclusion These findings highlight the relationship between sensory function and clinical factors in PwMS, emphasizing the importance of age, disability level, physical activity, and cognitive function in preserving the sensory functions of the lower extremity.
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    Relationship between sensation and balance and gait in multiple sclerosis patients with mild disability
    (Elsevier Sci Ltd, 2024) Ozkul, Cagla; Eldemir, Kader; Yildirim, Muhammed Seref; Cobanoglu, Gamze; Eldemir, Sefa; Guzel, Nevin Atalay; Irkec, Ceyla
    Background: Patients with Multiple Sclerosis (PwMS) often experience sensory, balance, and gait problems. Impairment in any sensation may increase imbalance and gait disorder in PwMS. This study aimed to (1) compare foot plantar sensations, knee position sense, balance, and gait in PwMS compared to Healthy Individuals (HI) and (2) examine the relationship between plantar sensations, knee position sense, balance, and gait in PwMS. Methods: Thirty PwMS with mild disability and 10 HI participated in this study. Light touch threshold, two -point discrimination, vibration duration, and knee position sense were examined on the Dominant Side (DS) and NonDominant Side (NDS). Balance and spatio-temporal gait analysis were evaluated in all participants. Results: PwMS had higher postural sway with eyes closed on the foam surface, longer swing phase of DS, longer single support phase of NDS, and shorter double support phase of DS compared to HI (p < 0.05). The results of regression analysis showed that the light touch thresholds of the 1st and 5th toes of the DS were associated with postural sway in different sensory conditions (p < 0.05). In contrast, the light touch thresholds of the 1st and 5th toes, two-point discrimination of the heel, vibration duration of the 1st metatarsal head and knee position sense of the NDS, and light touch threshold in the medial arch of both sides were associated with the gait parameters (p < 0.05). Conclusion: PwMS, even with mild disabilities needs neurorehabilitation to improve plantar sensation and knee position sense.