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Abstract
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OBJECTIVE: To evaluate the effects of a balance exercise program on falls in people with mild-to-moderate multiple sclerosis (MS).
DESIGN: Multi-center, single-blinded single group pretest posttest trial. SETTING: Seven rehabilitation units within five county councils. PARTICIPANTS: Community-dwelling adults with MS (N=32) able to walk 100 meters but unable to maintain 30-second tandem stance with arms alongside the body. INTERVENTION: Seven weeks of twice-weekly physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dual tasking, and sensory strategies (CoDuSe). MAIN OUTCOME MEASURES: Primary outcomes: number of prospectively-reported falls and proportion of participants classified as fallers during 7 pre-intervention weeks, intervention period, and 7 post-intervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale, Four Square Step Test, Sit-to-Stand Test, Timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale; perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scale rated 7 weeks before intervention directly after intervention, and 7 weeks later.
RESULTS: Number of falls (166 to 43; p ≤ 0.001) and proportion of fallers (17/32 to 10/32; p ≤ 0.039) decreased significantly between the pre-intervention and post-intervention periods. Balance performance improved significantly. No significant differences were detected for perceived limitations in walking, balance confidence, the Timed Up and Go test, or Sit-to-Stand Test.
CONCLUSIONS: The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild-to-moderate MS, but did not significantly alter perceived limitations in walking and balance confidence.
Language: en |