Postural Control Deficits in Patients With Chronic Inflammatory Demyelinating Polyradiculoneuropathy Undergoing Immunomodulatory Therapy

INTRODUCTION/AIMS: Despite individuals with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) often reporting impaired balance as a main concern, there is a lack of research characterizing balance impairments or evaluating whether immunomodulatory therapy improves balance. Therefore, this study aimed to determine how treatment affects static and dynamic balance in CIDP using objective, laboratory-based measures. METHODS: Ten participants diagnosed with CIDP and receiving regular intravenous immunoglobulin (IVIg) treatments, and 13 healthy controls (HC) participated in this study. Participants completed two testing sessions corresponding to end- and mid-cycle IVIg treatment, which included: (1) clinical assessments of strength, sensation, balance, mobility and balance confidence and (2) standing balance and modified gait tasks while wearing a belt-worn velocity transducer to measure trunk sway. RESULTS: Clinical assessments revealed reduced strength, sensation, balance confidence and balance in the CIDP group compared to the HC group (all p < 0.05). Significantly larger trunk sway amplitudes were observed in the CIDP compared to the HC group across most balance tasks (ranging from 62% to 181% larger amplitudes; p < 0.05), with the largest group differences observed when vision was removed and tasks emphasized proximal lateral instability. IVIg treatment was associated with significantly reduced trunk sway during the most challenging postural tasks (tandem stance without vision by 47%-53%; p < 0.05). DISCUSSION: CIDP affects postural control during both static and dynamic balance tasks. IVIg may be associated with improved balance during more challenging, dynamic balance tasks, although further research is needed to demonstrate the full extent to which immunomodulatory treatments can improve balance function in CIDP.