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Wednesday, February 14, 2018

Integrated Exercise Program Improves Balance in People with MS



A special exercise program that focuses on balance and eye movements improved balance-related symptoms of multiple sclerosis (MS) such as fatigue, dizziness, and vision problems, according to a study published online in Neurology on January 31.

Poor Balance Is Common for People with MS

Impaired balance, along with fatigue, dizziness, and vision problems, are common symptoms associated with MS and can lead to limited mobility and falls, as well as a reluctance to pursue social activities.

Integrating information from the eyes, ears, and proprioception (a sense of one's self in space) is what allows the body to maintain balance. For many people with MS, the ability to integrate that information is impaired and balance is affected. To date, rehabilitation programs aimed at improving balance and walking ability have focused on strength exercises that do not address the accompanying balance and fatigue problems many people with MS experience.

A Better Balance Program

To find out if a program called Balance and Eye Movement Exercises for Persons with Multiple Sclerosis (BEEMS) that allows patients to process a variety of sensory information while also performing balance and eye movement exercises could help improve balance and reduce dizziness and fatigue, researchers at the University of Colorado School of Medicine in Aurora recruited 88 MS patients to take part in the study. Eligible participants, who ranged in age from 18 to 60, had to be able to walk 100 meters with a cane or other assistive device on one side. They also were assessed for balance, fatigue, and dizziness

Half of the patients were then assigned to BEEMS training while the other half (the control group) were offered the intervention after the end of the 14-week study. The BEEMS group engaged in six weeks of supervised exercises twice a week and received instructions for at-home exercises, which they were expected to perform daily.

Exercises involved maintaining balance on difference surfaces and while walking, both with and without head movements and with the eyes open and closed. During the remaining eight weeks, patients completed one supervised exercise session each week, along with the daily home exercises.

Program Improved Balance

At the six-week mark, improved balance was seen in patients in the exercise program, compared to the control group, as measured on a balance test. People in the BEEMS group saw their test scores improve 10 points compared to three points for those in the control group. After 14 weeks, improvements among MS patients continued to remain significant.

The BEEMS participants also experienced improvements in dizziness and fatigue by doing exercises that focused on controlling eye movement and head movements while standing and walking.

Integrative Exercise Makes a Difference

The study suggests an exercise program that incorporates processing multiple sensory information while doing balance and eye movement exercises should be included in physical interventions for MS patients. The BEEMS program paired with a functional training program could potentially lead to further improvements in gait, which could help patients safely do daily activities.

Still, further research is warranted to determine how long improvements can last beyond the 14-week mark with interventions such as physical therapy exercises that involve eye/head/limb coordination under the supervision of a health care professional.

For more about balance, read our story in Healthy Brain called Balancing Act.