An investigation of knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis: a pilot study.

Background: Sex hormones have been thought to play an important role in disease progression and inflammatory activity in females with multiple sclerosis. The aim of this study was to investigate knee position sense, balance, and dual task performance in different phases of menstrual cycle in females with multiple sclerosis.

Methods: The study included 14 females diagnosed with MS and 13 healthy females with regular menstrual cycles who did not use oral contraceptives. The disability level was determined using the Expanded Disability Status Scale. The mental state was assessed using the Mini-Mental State Examination. Knee position sense was evaluated with an Acumar dual digital inclinometer (Acu360, Acumar, Lafayette, IN, USA). The balance was measured with the Biodex Balance System (Biodex Medical Systems, Shirley, NY, USA). Time taken to complete the Timed Up and Go test (TUG) under 3 conditions (TUG without task, TUG with counting backward from 100 by 3s or listing the names starting with the letter "A" [TUG], and TUG while carrying three glasses of water on a tray [TUG]) was measured. Measurements were conducted in the early follicular, ovulation, and luteal phases.

Results: As a result, it was found that knee position sense, dynamic balance, and dual task performance decreased in the early follicular phase in both the group of females with multiple sclerosis and the control group (p<0.05). The change of dynamic balance and gait performance in the three phases of the menstrual cycle were different between the groups (p<0.05).

Conclusion: As a result, it was found that knee position sense, dynamic balance, and dual task performance in females with multiple sclerosis changed throughout the menstrual cycle. The change in dynamic balance and gait performance differed from the control group during the menstrual cycle. Therefore, we think that each phase of the menstrual cycle should be taken into consideration in the follow-up of physiotherapy evaluations in females with multiple sclerosis.