“In response to some of the questions generated by yesterday’s post on balance rehabilitation I have pulled up this small study published in 2007. The answer is yes, you can do something about it and balance rehabilitation works. The other question is can you do these exercises yourself. Yes, I suspect so but you need to discuss this with your physiotherapist and if you don’t have a physiotherapist with your MSologist or MS nurse specialist. There are numerous causes of balance problems in MS and the type of therapy needs to be targeted to the cause of the problem. For example, balance disorders can be due to malfunctioning of cerebellar, vestibular, joint position, visual or motor pathways. Each of these pathways require a different rehabilitation approach.”
“The following YouTube video from the MS Society touches on these issues.”
“You may find this self-help video from the NMSS helpful as well.”
Cattaneo et al. Effects of balance exercises on people with multiple sclerosis: a pilot study. Clin Rehabil. 2007 Sep;21(9):771-81.
SETTING: Rehabilitation unit.
SUBJECTS: A consecutive sample of 44 subjects was randomized into two experimental groups and one control group. The inclusion criteria were: ability to stand independently more than 30 seconds, ability to walk for 6 m.
INTERVENTIONS: Group 1 received balance rehabilitation to improve motor and sensory strategies. Group 2 received balance rehabilitation to improve motor strategy. Group 3 received treatments not specifically aimed at improving balance.
MAIN OUTCOME MEASURE: Berg Balance Scale, Dynamic Gait Index and fall frequency were used to assess balance impairments. Dizziness Handicap Inventory and Activities-specific Balance Confidence were used to assess handicap and the level of balance confidence.
RESULTS: Frequency of falls post treatment was statistically different among groups (P=0.0001); The Berg Balance Scale showed an overall statistically significant difference (P=0.0008) among groups. Change pre-post scores were 6.7, 4.6 and 0.8 points for groups 1, 2 and 3. Dynamic Gait Index showed an overall near statistically significant difference among groups (P=0.14), with change pre-post scores of 3.85, 1.6 and 1.75 points for groups 1, 2 and 3; after the exclusion of drop-outs a statistically significant difference was observed (P=0.04). The self-administered tests (Activities-specific Balance Confidence and Dizziness Handicap Inventory) did not show clinically relevant improvements.
CONCLUSIONS: Balance rehabilitation appeared to be a useful tool in reducing the fall rate and improving balance skills in subjects with multiple sclerosis. Exercises in different sensory contexts may have an impact in improving dynamic balance.