Home-Based Balance Training on Balance and Mobility in Persons With Multiple Sclerosis: A Systematic Review and...

Area of Science:

• Neurology
• Rehabilitation Science
• Exercise Physiology

Background:

• Multiple Sclerosis (MS) significantly impacts balance and mobility.
• Home-based exercise programs offer accessibility but require evaluation for efficacy.
• Optimizing balance and mobility is crucial for maintaining functional independence in MS.

Purpose of the Study:

• To assess the efficacy of home-based balance training on balance and mobility in individuals with MS.
• To compare the effects of home-based versus center-based balance training.
• To investigate the influence of supervision levels and training dose on outcomes.
• To explore dose-response relationships in home-based balance interventions.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials.
• Searched multiple databases (MEDLINE, EMBASE, PsycINFO, etc.) up to April 2023.
• Extracted data on participant characteristics, intervention details (dose, supervision), and outcomes.
• Evaluated study quality using the Tool for the Assessment of Study Quality and Reporting in Exercise.

Main Results:

• Eleven studies were included in the meta-analysis.
• Home-based and center-based balance training yielded comparable improvements in balance and mobility.
• No significant superiority of home-based training over no training was found, except for static balance.
• Training volume (sessions >36, time >1100 min) significantly moderated overall balance improvements.

Conclusions:

• Home-based balance training is a viable alternative to center-based programs for individuals with MS.
• Adequate training volume is essential for maximizing balance improvements.
• Indirect supervision (e.g., weekly calls) is recommended to enhance adherence and treatment effects.