Effects of Balance Exercise Interventions on Balance-Related Performance in People With Multiple Sclerosis: A
Andreas Wallin1,2, Sverker Johansson1,2, John Brincks3
1Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Neurorehabilitation and Neural Repair
|August 20, 2024
Summary
Balance training improves multiple sclerosis outcomes when measured by balance scores, but not gait speed. Cognitive dual-task training showed significant benefits, highlighting the need for standardized intensity definitions.
Area of Science:
- Neurology
- Rehabilitation Science
- Physical Therapy
Background:
- Balance training for multiple sclerosis (MS) encompasses diverse methods.
- Identifying specific intervention components that predict outcomes is crucial for effective treatment.
Purpose of the Study:
- To systematically evaluate the impact of various balance training interventions on gait and dynamic balance in individuals with MS.
- To identify which types of balance training yield the most significant improvements.
Main Methods:
- A systematic review of randomized controlled trials was conducted across four databases.
- Studies included individuals with MS (Expanded Disability Status Scale ≤7.5) with at least 50% of the intervention focused on balance control.
- Interventions were categorized, and risk of bias was assessed using the TESTEX scale.
Main Results:
- Eighteen studies involving 902 participants with MS were analyzed.
- Balance composite scores and mobility tests showed moderate to small effect sizes (ES=0.46 and ES=0.19, respectively).
- Cognitive dual-task training demonstrated a significant effect (ES=0.81) on mobility outcomes in a subgroup analysis. Stepping and gait speed showed no significant improvement.
Conclusions:
- Balance training positively impacts balance and mobility in MS, as measured by composite scores and mobility tests, but not by gait speed.
- Higher training volume correlates with improved balance outcomes.
- Standardized definitions for balance training intensity are needed to better evaluate intervention effectiveness.
