THE EFFECT OF BALANCE TRAINING ON FUNCTIONAL MOBILITY AND QUALITY OF LIFE IN PATIENTS WITH MULTIPLE SCLEROSIS
DOI:
https://doi.org/10.32782/health-2025.1.18Keywords:
multiple sclerosis, functional mobility, quality of life, physical therapy, balance trainingAbstract
Multiple sclerosis (MS) is a common chronic disease of the central nervous system (CNS). Balance impairment is one of the most common consequences of MS, leading to impaired mobility, increased risk of falls, and a poorer quality of life for people with the disease. Balance training is an important part of rehabilitation programs for MS, but the optimal methods and parameters of such training have not been determined. The aim of the study is to evaluate the effect of different methods of balance training on functional mobility and quality of life in patients with MS. The study design was a randomized clinical non-blinded trial comparing the effectiveness of physical therapy programs using different methods of balance training for people with MS. The study involved 57 patients with MS who were randomly assigned to two groups – an intervention group and a comparison group. In the intervention group, a physical therapy program using the Neurac neuromuscular activation method was implemented, and in the comparison group, a physical therapy program using conventional exercises to develop balance and coordination was used. The Rivermead Mobility Index and the World Health Organization Short Form Quality of Life Questionnaire were used to assess outcome measures.Reassessment was conducted 21 days after the start of rehabilitation interventions. Evaluation of the effectiveness of the Neurac therapy physical therapy program for people with MS demonstrated a statistically significant effect size for functional mobility and quality of life in the intervention group compared to the group that used conventional balance exercises. A physical therapy program using the Neurac therapy method contributed to clinically significant changes in functional mobility and quality of life for patients with MS, while in the intervention group clinically significant changes were observed only for functional mobility. These results open up prospects for further studies of the long-term efficacy of the Neurac technique in patients with MS.
References
Multiple sclerosis / M. Filippi et al. Nat Rev Disease Primers. 2018. Vol. 4(1). P. 43. DOI: 10.1038/s41572-018-0050-3.
Cameron M.H., Nilsagard Y. Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol. 2018. Vol. 159. P. 237–250. DOI: 10.1016/B978-0-444-63916-5.00015-X.
Fall definitions, faller classifications and outcomes used in falls research among people with multiple sclerosis: a systematic review / N. O’Malley et al. Disabil Rehabil. 2022. Vol. 44(6). P. 856–864. DOI: 10.1080/09638288.2020.1786173.
Kinesiophobia in People with Multiple Sclerosis and Its Relationship with Physical Activity, Pain and Acceptance of Disease / D. Wasiuk-Zowada et al. Medicina (Kaunas). 2022. Vol. 10. No. 58(3). P. 414. DOI: 10.3390/medicina58030414.
Effects of Balance Exercise Interventions on Balance-Related Performance in People With Multiple Sclerosis: A Systematic Review and a Meta-Analysis of Randomized Controlled Trials / A. Wallin et al. Neurorehabilitation and neural repair. 2024. Vol. 38(10). P. 775–790. DOI: https://doi.org/10.1177/15459683241273402.
Mobility and balance rehabilitation in multiple sclerosis: A systematic review and dose-response meta-analysis / C. Corrini et al. Mult Scler Relat Disord. 2023. Vol. 69. P. 104424. DOI: 10.1016/j.msard.2022.104424.
Prosperini L., Castelli L. Spotlight on postural control in patients with multiple sclerosis. Degener Neurol Neuromuscul Dis. 2018. Vol. 8. P. 25–34. DOI: https://doi.org/10.2147/DNND.S135755.
Postural control deficits in people with Multiple Sclerosis: A systematic review and meta-analysis / L. Comber et al. Gait Posture. 2018. Vol. 61. P. 445–452. DOI: 10.1016/j.gaitpost.2018.02.018.
Sharma N., Classen J., Cohen L.G. Neural plasticity and its contribution to functional recovery. Handb Clin Neurol. 2013. Vol. 110. P. 3–12. DOI: https://doi.org/10.1016/B978-0-444-52901-5.00001-0.
Motor Control: Theory and Practical Applications / ed. A. Shumway-Cook A., M.H. Woollacott. 2 ed, Philadelphia : Lippincott Williams & Wilkins, 2001. 614 p.
Hao Z., Zhang X., Chen P. Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients – A Network Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2022. Vol. 11, No.19(12). P. 7175. DOI: 10.3390/ijerph19127175.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013. № 310(20). P. 2191–2194. DOI: 10.1001/jama.2013.281053.
Основи законодавства України про охорону здоров’я : Закон України від 19.11.1992 № 2802 XII. URL: https:// zakon.rada.gov.ua/laws/show/2801-12# (дата звернення: 20.03.2025).
Selecting Rehabilitation Outcome Measures for People with Multiple Sclerosis / E.T. Cohen et al. Int J MS Care. 2015 Vol. 17(4). P. 181–189. DOI: 10.7224/1537-2073.2014-067.
Responsiveness and meaningful improvement of mobility measures following MS rehabilitation / I. Baert et al. Neurology. 2018. Vol. 13, No. 91(20). P. e1880–e1892. DOI: https://doi.org/10.1212/WNL.0000000000006532.
WHO. WHOQOL: Measuring Quality of Life WHOQOL-BREF. URL: https://www.who.int/tools/whoqol/whoqol-bref.
Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course / R. Kalb et al. Multiple sclerosis (Houndmills, Basingstoke, England). 2020. Vol. 26(12). P. 1459–1469. DOI: 10.1177/1352458520915629.
Neurac. Redcord. URL: https://www.redcord.com/neurac (date of access: 20.03.2025).
The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment / F.M. Collen et al. Int Disabil Stud. 1991. Vol. 13(2). P. 50–54. DOI: https://doi.org/10.3109/03790799109166684.
Lord S.E., Wade D.T., Halligan P.W. A comparison of two physiotherapy treatment approaches to improve walking in multiple sclerosis: a pilot randomized controlled study. Clin Rehabil. 1998. Vol. 12. P. 477–486. DOI: https://doi.org/10.1191/026921598675863454.
Satisfactory results of a psychometric analysis and calculation of minimal clinically important differences of the World Health Organization quality of life-BREF questionnaire in an observational cohort study with lung cancer and mesothelioma patients / M. de Mol et al. BMC Cancer. 2018. Vol. 18. P. 1173. DOI: https://doi.org/10.1186/s12885-018-4793-8.
Muscle Energy Technique plus Neurac Method in Stroke Patients with Hemiplegia Complicated by Diabetes Mellitus and Assessment of Quality of Life / J. Wang et al. Disease markers. 2022. Vol. 2022. P. 6318721. DOI: https://doi.org/10.1155/2022/6318721.
The effect of the neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain patients / J.H. Kim et al. Journal of physical therapy science. 2013. Vol. 25(8). P. 1015–1019. DOI: https://doi.org/10.1589/jpts.25.1015.
Gwon A.J., Kim S.Y., Oh D.W. Effects of integrating Neurac vibration into a side-lying bridge exercise on a sling in patients with chronic low back pain: a randomized controlled study. Physiother Theory Pract. 2020. Vol. 36(8). P. 907–915. DOI: 10.1080/09593985.2018.1513616.
