{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:21:05Z","timestamp":1786123265717,"version":"build-2736575974"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-57507-0","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T07:07:00Z","timestamp":1781680020000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Eyes closed single-leg stance test detects subtle sensorimotor decline in early multiple sclerosis"],"prefix":"10.1038","volume":"16","author":[{"given":"Kardelen","family":"Akar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furkan","family":"Akko\u00e7","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eser","family":"Bulu\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sena Destan","family":"B\u00fcn\u00fcl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcsn\u00fc","family":"Efendi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"Alt\u0131nta\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atay","family":"Vural","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"57507_CR1","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1002\/ana.24747","volume":"80","author":"BAC Cree","year":"2016","unstructured":"Cree, B. A. C. et al. Long-term evolution of multiple sclerosis disability in the treatment era. Ann. Neurol. 80, 499\u2013510 (2016).","journal-title":"Ann. Neurol."},{"key":"57507_CR2","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/S1474-4422(20)30067-3","volume":"19","author":"A He","year":"2020","unstructured":"He, A. et al. Timing of high-efficacy therapy for multiple sclerosis: a retrospective observational cohort study. Lancet Neurol. 19, 307\u2013316 (2020).","journal-title":"Lancet Neurol."},{"key":"57507_CR3","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1001\/jamaneurol.2019.0330","volume":"76","author":"O Beiki","year":"2019","unstructured":"Beiki, O., Frumento, P., Bottai, M., Manouchehrinia, A. & Hillert, J. Changes in the risk of reaching multiple sclerosis disability milestones in recent decades: A nationwide population-based cohort study in sweden. JAMA Neurol. 76, 665\u2013671 (2019).","journal-title":"JAMA Neurol."},{"key":"57507_CR4","doi-asserted-by":"publisher","unstructured":"Goldman, M. D., Motl, R. W. & Rudick, R. A. Possible clinical outcome measures for clinical trials in patients with multiple sclerosis. Ther. Adv. Neurol. Disord. 3, 229\u2013239. https:\/\/doi.org\/10.1177\/1756285610374117 (2010).","DOI":"10.1177\/1756285610374117"},{"key":"57507_CR5","doi-asserted-by":"publisher","unstructured":"Tur, C. et al. Assessing treatment outcomes in multiple sclerosis trials and in the clinical setting. Nat. Rev. Neurol. 14, 75\u201393. https:\/\/doi.org\/10.1038\/nrneurol.2017.171 (2018).","DOI":"10.1038\/nrneurol.2017.171"},{"key":"57507_CR6","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1177\/1352458506070658","volume":"12","author":"CL Martin","year":"2006","unstructured":"Martin, C. L. et al. Gait and balance impairment in early multiple sclerosis in the absence of clinical disability. Mult. Scler. 12, 620\u2013628 (2006).","journal-title":"Mult. Scler."},{"key":"57507_CR7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1097\/MRR.0b013e32833d6ccb","volume":"34","author":"C Fjeldstad","year":"2011","unstructured":"Fjeldstad, C., Pardo, G., Bemben, D. & Bemben, M. Decreased postural balance in multiple sclerosis patients with low disability. Int. J. Rehabil. Res. 34, 53\u201358 (2011).","journal-title":"Int. J. Rehabil. Res."},{"key":"57507_CR8","doi-asserted-by":"publisher","unstructured":"Kurtzke, J. F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1444\u20131452. https:\/\/doi.org\/10.1212\/wnl.33.11.1444 (1983).","DOI":"10.1212\/wnl.33.11.1444"},{"key":"57507_CR9","doi-asserted-by":"publisher","unstructured":"Motl, R. W. et al. Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis. Multiple Sclerosis 23, 704\u2013710. https:\/\/doi.org\/10.1177\/1352458517690823 (2017).","DOI":"10.1177\/1352458517690823"},{"key":"57507_CR10","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1177\/135245859900500409","volume":"5","author":"JS Fischer","year":"1999","unstructured":"Fischer, J. S., Rudick, R. A., Cutter, G. R. & Reingold, S. C. The Multiple Sclerosis Functional Composite measure (MSFC): an integrated approach to MS clinical outcome assessment. Multiple Scler. J. 5, 244\u2013250 (1999).","journal-title":"Multiple Scler. J."},{"key":"57507_CR11","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.gaitpost.2011.11.026","volume":"35","author":"RI Spain","year":"2012","unstructured":"Spain, R. I. et al. Body-worn motion sensors detect balance and gait deficits in people with multiple sclerosis who have normal walking speed. Gait Posture. 35, 573\u2013578 (2012).","journal-title":"Gait Posture"},{"key":"57507_CR12","doi-asserted-by":"crossref","unstructured":"Helmlinger, B. et al. Evaluation of the T25FW in minimally disabled people with multiple sclerosis. J. Neurol. Sci. 462, (2024).","DOI":"10.1016\/j.jns.2024.123073"},{"key":"57507_CR13","doi-asserted-by":"publisher","first-page":"E1395","DOI":"10.1212\/WNL.0000000000008938","volume":"94","author":"R Brandstadter","year":"2020","unstructured":"Brandstadter, R. et al. Detection of subtle gait disturbance and future fall risk in early multiple sclerosis. Neurology 94, E1395\u2013E1406 (2020).","journal-title":"Neurology"},{"key":"57507_CR14","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1352458508096874","volume":"15","author":"D Cattaneo","year":"2009","unstructured":"Cattaneo, D. & Jonsdottir, J. Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult. Scler. 15, 59\u201367 (2009).","journal-title":"Mult. Scler."},{"key":"57507_CR15","doi-asserted-by":"crossref","unstructured":"Carpinella, I. et al. Balance impairments in people with early-stage multiple sclerosis: boosting the integration of instrumented assessment in clinical practice. Sensors. 22, (2022).","DOI":"10.3390\/s22239558"},{"key":"57507_CR16","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.1177\/13524585221108297","volume":"28","author":"SC Krieger","year":"2022","unstructured":"Krieger, S. C., Antoine, A. & Sumowski, J. F. EDSS 0 is not normal: Multiple sclerosis disease burden below the clinical threshold. Multiple Scler. J. 28, 2299\u20132303 (2022).","journal-title":"Multiple Scler. J."},{"key":"57507_CR17","doi-asserted-by":"crossref","unstructured":"Inojosa, H., Schriefer, D., Kl\u00f6ditz, A., Trentzsch, K. & Ziemssen, T. Balance testing in multiple sclerosis\u2014improving neurological assessment with static posturography? Front. Neurol. 11, (2020).","DOI":"10.3389\/fneur.2020.00135"},{"key":"57507_CR18","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.gaitpost.2020.10.015","volume":"83","author":"SB Richmond","year":"2021","unstructured":"Richmond, S. B., Whittier, T. T., Peterson, D. S. & Fling, B. W. Advanced characterization of static postural control dysfunction in persons with multiple sclerosis and associated neural mechanisms. Gait Posture. 83, 114\u2013120 (2021).","journal-title":"Gait Posture"},{"key":"57507_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fnhum.2014.00814","volume":"8","author":"BW Fling","year":"2014","unstructured":"Fling, B. W., Dutta, G. G., Schlueter, H., Cameron, M. H. & Horak, F. B. Associations between proprioceptive neural pathway structural connectivity and balance in people with multiple sclerosis. Front. Hum. Neurosci. 8, 1\u201311 (2014).","journal-title":"Front. Hum. Neurosci."},{"key":"57507_CR20","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1113\/jphysiol.1994.sp020240","volume":"478","author":"R Fitzpatrick","year":"1994","unstructured":"Fitzpatrick, R. & McCloskey, D. I. Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. J. Physiol. 478, 173\u2013186 (1994).","journal-title":"J. Physiol."},{"key":"57507_CR21","doi-asserted-by":"crossref","unstructured":"Yang, F. & Liu, X. Relative importance of vision and proprioception in maintaining standing balance in people with multiple sclerosis. Mult. Scler. Relat. Disord. 39, (2020).","DOI":"10.1016\/j.msard.2019.101901"},{"key":"57507_CR22","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1159\/000529579","volume":"85","author":"A Ayd\u0131n Cant\u00fcrk","year":"2023","unstructured":"Ayd\u0131n Cant\u00fcrk, A., Mutlu, \u0130., \u00d6, B., Y\u0131lmaz, Y. & Bayaz\u0131t, O. Peripheral Vestibular System Involvement in Multiple Sclerosis and Associations with the Disease Severity. ORL 85, 150\u2013155 (2023).","journal-title":"ORL"},{"key":"57507_CR23","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.msard.2017.03.008","volume":"14","author":"F Melillo","year":"2017","unstructured":"Melillo, F. et al. Computerized posturography is more sensitive than clinical Romberg Test in detecting postural control impairment in minimally impaired multiple sclerosis patients. Mult Scler. Relat. Disord. 14, 51\u201355 (2017).","journal-title":"Mult Scler. Relat. Disord"},{"key":"57507_CR24","doi-asserted-by":"crossref","unstructured":"Cofr\u00e9 Lizama, L. E., He, X., Kalincik, T., Galea, M. P. & Panisset, M. G. Sample entropy improves assessment of postural control in early-stage multiple sclerosis. Sensors. 24, (2024).","DOI":"10.3390\/s24030872"},{"key":"57507_CR25","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.rehab.2011.02.004","volume":"54","author":"A Yahia","year":"2011","unstructured":"Yahia, A., Ghroubi, S., Mhiri, C. & Elleuch, M. H. Relationship between muscular strength, gait and postural parameters in multiple sclerosis. Ann. Phys. Rehabil Med. 54, 144\u2013155 (2011).","journal-title":"Ann. Phys. Rehabil Med."},{"key":"57507_CR26","doi-asserted-by":"crossref","unstructured":"Solomon, A. J., Jacobs, J. V., Lomond, K. V. & Henry, S. M. Detection of postural sway abnormalities by wireless inertial sensors in minimally disabled patients with multiple sclerosis: A case-control study. J. Neuroeng. Rehabil. 12, (2015).","DOI":"10.1186\/s12984-015-0066-9"},{"key":"57507_CR27","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.gaitpost.2017.03.016","volume":"54","author":"A Kalron","year":"2017","unstructured":"Kalron, A. The Romberg ratio in people with multiple sclerosis. Gait Posture. 54, 209\u2013213 (2017).","journal-title":"Gait Posture"},{"key":"57507_CR28","doi-asserted-by":"crossref","unstructured":"Schmitz-H\u00fc, T. et al. Scale for the assessment and rating of ataxia development of a new clinical scale. Neurology. 66 (2006).","DOI":"10.1212\/01.wnl.0000219042.60538.92"},{"key":"57507_CR29","doi-asserted-by":"publisher","unstructured":"Feys, P. et al. The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. Multiple Sclerosis. 23, 711\u2013720. https:\/\/doi.org\/10.1177\/1352458517690824 (2017).","DOI":"10.1177\/1352458517690824"},{"key":"57507_CR30","doi-asserted-by":"crossref","unstructured":"Hobart, J. C., Riazi, A., Lamping, D. L., Fitzpatrick, R. & Thompson, A. J. Measuring the Impact of MS on Walking Ability The 12-Item MS Walking Scale (MSWS-12). https:\/\/www.neurology.org (2003).","DOI":"10.1212\/WNL.60.1.31"},{"key":"57507_CR31","doi-asserted-by":"crossref","unstructured":"Mancini, M. et al. ISway: A sensitive, valid and reliable measure of postural control. J. Neuroeng. Rehabil. 9, (2012).","DOI":"10.1186\/1743-0003-9-59"},{"key":"57507_CR32","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1123\/jsr.2021-0178","volume":"31","author":"GT Saleem","year":"2022","unstructured":"Saleem, G. T., Slomine, B. S. & Suskauer, S. J. Thirty-second single-leg stance identifies impaired postural control in children after concussion: A preliminary report. J. Sport Rehabil. 31, 511\u2013516 (2022).","journal-title":"J. Sport Rehabil"},{"key":"57507_CR33","doi-asserted-by":"publisher","unstructured":"Horn, L. B. et al. Measurement characteristics and clinical utility of the clinical test of sensory interaction on balance (CTSIB) and modified CTSIB in individuals with vestibular dysfunction. Arch. Phys. Med. Rehabil. 96, 1747\u20131748. https:\/\/doi.org\/10.1016\/j.apmr.2015.04.003 (2015).","DOI":"10.1016\/j.apmr.2015.04.003"},{"key":"57507_CR34","doi-asserted-by":"publisher","first-page":"596","DOI":"10.3109\/02699052.2013.772237","volume":"27","author":"GL Iverson","year":"2013","unstructured":"Iverson, G. L. & Koehle, M. S. Normative data for the modified balance error scoring system in adults. Brain Inj. 27, 596\u2013599 (2013).","journal-title":"Brain Inj"},{"key":"57507_CR35","doi-asserted-by":"crossref","unstructured":"Moreno-Navarro, P. et al. Understanding the deterioration of gait, postural control, lower limb strength and perceived fatigue across the disability spectrum of people with multiple sclerosis. J. Clin. Med 9, (2020).","DOI":"10.3390\/jcm9051385"},{"key":"57507_CR36","doi-asserted-by":"publisher","first-page":"182","DOI":"10.14740\/jocmr1878w","volume":"7","author":"T Chomiak","year":"2015","unstructured":"Chomiak, T., Pereira, F. V. & Hu, B. The single-leg-stance test in Parkinson\u2019s disease. J. Clin. Med. Res. 7, 182\u2013185 (2015).","journal-title":"J. Clin. Med. Res."},{"key":"57507_CR37","doi-asserted-by":"crossref","unstructured":"Oliveira, M. R. et al. One-legged stance sway of older adults with and without falls. PLoS One 13, (2018).","DOI":"10.1371\/journal.pone.0203887"},{"key":"57507_CR38","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.gaitpost.2011.05.015","volume":"34","author":"S Citaker","year":"2011","unstructured":"Citaker, S. et al. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 34, 275\u2013278 (2011).","journal-title":"Gait Posture"},{"key":"57507_CR39","doi-asserted-by":"crossref","unstructured":"Abas\u0131yan\u0131k, Z., Kahraman, T., Ertekin, \u00d6., Baba, C. & \u00d6zakba\u015f, S. Prevalence and determinants of falls in persons with multiple sclerosis without a clinical disability. Mult. Scler. Relat. Disord. 49, (2021).","DOI":"10.1016\/j.msard.2021.102771"},{"key":"57507_CR40","doi-asserted-by":"crossref","unstructured":"Berg-Hansen, P. et al. The instrumented single leg stance test detects early balance impairment in people with multiple sclerosis. Front. Neurol. 14, (2023).","DOI":"10.3389\/fneur.2023.1227374"},{"key":"57507_CR41","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1007\/s00415-011-6366-5","volume":"259","author":"MHJ Fanchamps","year":"2012","unstructured":"Fanchamps, M. H. J. et al. Screening for balance disorders in mildly affected multiple sclerosis patients. J. Neurol. 259, 1413\u20131419 (2012).","journal-title":"J. Neurol."},{"key":"57507_CR42","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1097\/MRR.0000000000000142","volume":"39","author":"DK Fry","year":"2016","unstructured":"Fry, D. K., Huang, M. H. & Rodda, B. J. Predictors of static balance in ambulatory persons with multiple sclerosis. Int. J. Rehabil. Res. 39, 42\u201347 (2016).","journal-title":"Int. J. Rehabil. Res."},{"key":"57507_CR43","doi-asserted-by":"crossref","unstructured":"Horak, F. B. Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age Ageing 35 (2006).","DOI":"10.1093\/ageing\/afl077"},{"key":"57507_CR44","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.gaitpost.2016.02.023","volume":"47","author":"DS Peterson","year":"2016","unstructured":"Peterson, D. S., Gera, G., Horak, F. B. & Fling, B. W. Supraspinal control of automatic postural responses in people with multiple sclerosis. Gait Posture. 47, 92\u201395 (2016).","journal-title":"Gait Posture"},{"key":"57507_CR45","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1177\/1545968316680487","volume":"31","author":"DS Peterson","year":"2017","unstructured":"Peterson, D. S., Gera, G., Horak, F. B. & Fling, B. W. Corpus callosum structural integrity is associated with postural control improvement in persons with multiple sclerosis who have minimal disability. Neurorehabil. Neural Repair. 31, 343\u2013353 (2017).","journal-title":"Neurorehabil. Neural Repair."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-57507-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-57507-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-57507-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:06:58Z","timestamp":1786111618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-57507-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["57507"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-57507-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"6 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":1,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ko\u00e7 University Ethics Committee (2020.418.IRB.157), aligning with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical considerations","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"24522"}}