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Center-Based Group and Home-Based Individual Exercise Programs Have Similar Impacts on Gait and Balance in People
Katrina Louise Williams1, Nancy Louise Low Choy2, Sandra Gail Brauer1
1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Background:
Group and home-based exercises to improve function in people with multiple sclerosis (MS) are common but have little underpinning evidence.
Objective:
To determine the comparative effectiveness of a center-based group versus home-based individual 8-week exercise program to improve gait and balance in people with MS.
Design:
Prospective, randomized controlled trial.
Setting:
Community center-based and home-based exercise program.
Participants:
Fifty people with MS were randomized and completed allocated intervention (n = 26 center, n = 24 home), 47 completed post-assessment and 44 follow-up assessment.
Methods:
The center- and home-based groups completed an 8-week progressive functional and balance training exercise program. The center-based groups of four to six were supervised by a physiotherapist. The home-based group was provided with telephone support.
Main Outcome Measurements:
The primary outcome was gait speed (10-meter walk test). Secondary outcomes were gait endurance (6-minute walk test) and balance (Berg Balance Scale). Outcome assessments were conducted at baseline, immediately postintervention and at 8-week follow-up.
Results:
There was no statistically significant difference between groups in gait speed post training, with a mean difference of 0.01 m/s, 95% CI -0.36 to 0.37. There were no group effects, time effects, or interactions for gait speed, endurance, or balance. In both groups, gait speed improved to a level that met minimal clinically important differences.
Conclusions:
Gait speed, endurance, and balance did not statistically improve in either group; however, gait speed changes met minimally important differences.
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