Development of an exercise programme for balance abilities in people with multiple sclerosis: a development of...

Area of Science:

• Neurology
• Rehabilitation Science
• Biomedical Engineering

Background:

• Multiple sclerosis (MS) frequently causes early-stage balance impairment in people with MS (PwMS).
• Current balance difficulty categories lack scientific validation.
• Targeted, optimal challenge exercises are needed for PwMS balance rehabilitation, but exercise difficulty is often unknown.

Purpose of the Study:

• To develop a scientifically-grounded balance exercise program for PwMS.
• To categorize exercises by difficulty and link them to specific balance problems.
• To evaluate the program's content and structural validity.

Main Methods:

• A construct map approach was used to design the program.
• Physiotherapists and 65 PwMS rated exercise relevance, comprehensibility, and difficulty.
• Rasch modeling and a rating scale model analyzed exercise difficulty and fit to a unidimensional latent trait.

Main Results:

• The exercise program demonstrated adequate content validity.
• Rasch analysis identified three subdimensions of balance: stable base of support, sway, and step/walk.
• The 19 exercises fit the dimensions and covered the PwMS ability spectrum.

Conclusions:

• A validated balance exercise program for PwMS was developed, comprising three dimensions.
• Established difficulty estimates allow for targeted balance training.
• The program exhibits adequate content and structural validity for clinical use.