Distinct correlations between clinical and laboratory-based instrumented balance measures in individuals with multiple sclerosis: a cross-sectional study

Abstract

Abstract Multiple sclerosis (MS) frequently leads to balance impairments and an increased risk of falls. Because laboratory-derived stability metrics are rarely feasible in clinical routine, clinicians commonly rely on functional balance assessments. This exploratory cross-sectional study examined associations between six clinical balance tests (DGI, BBS, TUG, Mini-BESTest, SSST, CTSIB) and laboratory-derived measures of static and dynamic balance, including margin of stability (MoS), whole-body angular momentum (WBAM), and center of pressure (CoP) in 30 people with MS (EDSS 3.6 ± 1.1). Patients completed 3D gait analysis, force-plate posturography, and clinical tests. Spearman correlations and nonparametric bootstrapping were used to estimate associations and 95% confidence intervals. Clinical test scores generally showed moderate-to-strong correlations with CoP measures, with the strongest association observed for the BBS ( r  = 0.76). For dynamic outcomes, larger MoS values were associated with poorer clinical test performance, most prominently for the TUG, suggesting that MoS may partly reflect compensatory gait strategies rather than superior balance capacity. Frontal-plane WBAM showed its strongest correlation with the TUG ( r  = 0.67). In conclusion, the BBS was most closely associated with static balance, whereas the TUG showed the most consistent associations across selected static and dynamic laboratory-derived balance measures.