Summary: A controlled trial published in Neurology suggests that a targeted program of balance and eye-movement exercises can reduce balance impairment and fatigue in people with multiple sclerosis (MS).
Source: AAN.
A structured rehabilitation program combining balance training with eye movement exercises improved balance and reduced fatigue in people with multiple sclerosis (MS), according to a study published online January 31, 2018, in Neurology.
Balance problems and fatigue are among the most common complaints for people living with MS. These symptoms contribute to falls, reduced mobility and limitations in daily activities and work. Vision and gaze-control issues are also frequently present in MS and can lead to inappropriate or exaggerated corrective movements that destabilize posture and increase the risk of imbalance.
Most conventional rehabilitation programs for balance emphasize strength and general balance training, but they do not always address the specific combination of sensory and eye-movement challenges faced by many people with MS. The research team, led by Jeffrey R. Hebert, PT, PhD, from the University of Colorado School of Medicine in Aurora, evaluated whether a program that combines balance tasks with deliberate eye and head movement challenges — while requiring the brain to integrate multiple sensory inputs — could produce measurable benefits for balance and fatigue.
The trial enrolled 88 participants with MS who could walk at least 100 meters with a cane or a single support device. At study start all participants completed standardized assessments that measured balance, fatigue, dizziness and other relevant outcomes. Participants were then assigned either to the active exercise program or to a wait-list control group.
Those in the active group completed a six-week supervised exercise period with sessions twice weekly, along with daily home practice. After the initial six weeks, participants transitioned to a maintenance phase that provided one supervised session per week for eight more weeks, while continuing daily at-home exercises. The control group was informed they were on a waiting list to receive the program at a later date. All participants were reassessed at six weeks and again at the end of the program.
The exercise program combined standing and walking balance tasks across different surfaces and conditions, with and without head movements, and with eyes open and closed. In addition to standing and gait challenges, the program included specific eye movement exercises designed to improve visual stability and the coordination of eye–head control. Exercises were progressed to increase demand on sensory processing, forcing the integration of visual, vestibular and somatosensory cues during balance tasks.
At six weeks, participants who completed the exercise program showed statistically and clinically meaningful improvements in balance relative to the control group. On a computerized balance measure in which healthy adults typically score around 90 or above out of 100, the active group’s average score increased from 63 at baseline to 73 at six weeks. By comparison, the control group’s average score changed only modestly, from 62 at baseline to 66 at six weeks. Improvements in balance in the exercise group were sustained through the end of the study period.
Participants who completed the combined balance and eye movement program also reported greater reductions in fatigue and dizziness compared with the control group. These findings suggest that addressing the visual and sensory integration components of balance — not just muscle strength or basic postural exercises — may offer added benefit for people with MS who experience balance impairment and related fatigue.
Study author Jeffrey R. Hebert noted that most current rehabilitation approaches do not specifically target the sensory and eye-movement problems common in MS, and that this program was designed to challenge those systems in a progressive, task-specific way. Hebert emphasized that additional research is needed to determine how long the benefits persist, how the program compares directly with other forms of balance training, and which patients are most likely to gain the greatest improvements.
Source: Renee Tessman – AAN
Publisher: Organized by NeuroscienceNews.com
Image source: NeuroscienceNews.com image is in the public domain.
Original research: Published in Neurology.
AAN. “Balance Exercises May Help People With Multiple Sclerosis.” NeuroscienceNews, February 2, 2018. (Source report by Renee Tessman.)