Clinical Rehabilitation

 

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Clinical Rehabilitation, Vol. 21, No. 9, 771-781 (2007)
DOI: 10.1177/0269215507077602

Effects of balance exercises on people with multiple sclerosis: a pilot study

D. Cattaneo

LaRICE: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, Don Gnocchi Foundation, Milan, Italy, dcattaneo{at}dongnocchi.it

J. Jonsdottir

LaRICE: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, Don Gnocchi Foundation, Milan, Italy

M. Zocchi

LaRICE: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, Don Gnocchi Foundation, Milan, Italy

A. Regola

LaRICE: Gait and Balance Disorders Laboratory, Department of Neurorehabilitation, Don Gnocchi Foundation, Milan, Italy

Objective: To evaluate the effects of balance retraining in a sample of people with multiple sclerosis.

Design: Randomized controlled trial.

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.


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