Two Different Types of High-frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons with Multiple Sclerosis

Publication date: Available online 1 July 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Brenda L. Davies, David J. Arpin, Min Liu, Heidi Reelfs, Kathleen G. Volkman, Kathleen Healey, Rana Zabad, Max J. Kurz
ObjectiveTo evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) that participated in a motor adaptation protocol (MAC) and a cohort of persons with MS who participated in a therapeutic exercise protocol (TEC).DesignA cohort design, where subjects were evaluated before and after a six week intervention period.SettingClinical laboratory setting.ParticipantsForty-two individuals with relapsing-remitting or secondary progressive MS (EDSS = 3.0-6.5) were initially screened for eligibility for participation in the study, from which 32 persons fit the inclusion criteria and enrolled in the study. Subjects were pseudo-randomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the MAC (Mean age: 52.6±9 years; EDSS: 5.5±0.9) and 13 individuals in the TEC (Mean age: 54.0±9 years; EDSS: 5.3±0.9) completed the entire duration of their respective programs.InterventionsBoth cohorts completed their therapy twice-a-day, five days each week, for six weeks. Each MAC session consisted of balance and gait training that encouraging new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program.Main Outcome MeasuresThe main outcome measures were the sensory organization test, 6-minute walk test, and gait spatiotemporal kinematics.ResultsCollectively, both treatment groups had improvements in postural balance (p=0.001), walking endurance (p=0.002), walking speed (p=0.004), and step length (p<0.001) after therapy. However, there were no statistical differences between the two treatment groups for any of the outcome variables (ps>0.01).ConclusionsOur exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS.



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