Balance
Sosnoff JJ, Socie MJ, Boes MK, et al. Mobility, balance and falls in persons with multiple sclerosis. PLoS One. 2011; 6(11):e28021
This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). It suggests that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year.
Sosnoff JJ, Gappmaier E, Frame A, et al. Influence of spasticity on mobility and balance in persons with multiple sclerosis. J Neurol Phys Ther. 2011; 35(3):129-32.
Participants were 34 ambulatory persons with a definite diagnosis of MS. Fifteen participants had spasticity of the gastroc-soleus muscles based on modified Ashworth scale scores. It was concluded that spasticity in the gastroc-soleus muscles appears to have negative effect on mobility and balance in persons with MS.
Kasser SL, Jacobs JV, Foley JT, et al. A prospective evaluation of balance, gait, and strength to predict falling in women with multiple sclerosis. Arch Phys Med Rehabil. 2011; 92(11):1840-6.
This prospective study confirmed the prevalence and multifactorial nature of falls in this MS sample. In addition to advancing disease status, impaired forward limits of stability (LOS) and visually dependent sway (as well as gait asymmetries and leg flexor-extensor weakness for recurrent fallers) predict future falls in women with MS.
Negahban H, Mofateh R, Arastoo AA, et al. The effects of cognitive loading on balance control in patients with multiple sclerosis. Gait Posture. 2011; 34(4):479-84.
The aim of this study was to compare the effects of concurrent cognitive task (silent backward counting) on balance performance. Three levels of postural difficulty were studied on a force platform, i.e. rigid surface with eyes open, rigid surface with eyes closed, and foam surface with eyes closed.
Findling O, Sellner J, Meier N, et al. Trunk sway in mildly disabled multiple sclerosis patients with and without balance impairment. Exp Brain Res. 2011; 213(4):363-70.
This study analysed differences in trunk sway between mildly disabled MS patients with and without subjective balance impairment, all with normal CBT.
Fjeldstad C, Pardo G, Bemben D, et al. Decreased postural balance in multiple sclerosis patients with low disability. Int J Rehabil Res. 2011; 34(1):53-8.
Women with low disability and minimal clinical impairment (EDSS scores 3.5 or below) were compared with age matched controls. There was a significant difference between the two groups
Bronson C, Brewerton K, Ong J, et al. Does hippotherapy improve balance in persons with multiple sclerosis: a systematic review. Eur J Phys Rehabil Med 2010; 46(3):347-53.
Reviewed the evidence for hippotherapy (utilising the movement of the horse to provide sensory feedback) as an intervention to improve balance in persons with MS. It was concluded that hippotherapy has a positive effect on balance in persons with MS and has an added benefit of enhancing quality of life
Freeman JA, Gear M, Pauli A, et al. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler 2010; 16(11):1377-84.
Core stability training is popular in the management of people with multiple sclerosis; however, scientific evidence to support its effectiveness is scarce. A multi-centre series of eight single case studies was undertaken. This study provides preliminary evidence of the effectiveness of an 8-week core stability training programme in improving balance and mobility in ambulant people with MS.
Porosińska A, Pierzchała K, Mentel M, et al. Evaluation of postural balance control in patients with multiple sclerosis - Effect of different sensory conditions and arithmetic task execution. A pilot study. Neurologia i Neurochirurgia Polska 2010; 44(1):35-42.
Investigates the effect of concomitant cognitive task execution and different sensory conditions on balance control in patients with multiple sclerosis (MS). Material and methods: Thirty-two subjects with MS and 30 healthy age- and sex-matched control subjects were included in the study. Postural stability in patients with MS is significantly decreased in comparison with the control group in all evaluated conditions.
Ahmadi A, Nikbakh M, Arastoo A, et al. The Effects of a yoga intervention on balance, speed and endurance of walking, fatigue and quality of life in people with multiple sclerosis. J Human Kinet 2010; 23 (1): 71-78.
Investigated the effect of a yoga intervention on balance, speed and endurance of walking, fatigue and quality of life in MS patients. Yoga group subjects participated in a thrice weekly 60-70 minute sessions of Hatha yoga intervention for 8-weeks. Balance, speed and endurance of walking, fatigue and quality of life were measured.
Widener GL, Allen DD, Gibson-Horn C. Randomized clinical trial of balance-based torso weighting for improving upright mobility in people with multiple sclerosis. Neurorehab Neur Repair 2009; 23 (8): 784-791.
.Investigates whether balance-based torso weighting (BBTW) has immediate effects on upright mobility in people with multiple sclerosis. Concludes that BBTW can have immediate advantages over a non-weighted condition for gait velocity and over a standardized weighted condition for a functional activity in people with multiple sclerosis (MS) who are ambulatory but have balance and mobility abnormalities.
Widener GL, Allen DD, Gibson-Horn C. Balance-based torso-weighting may enhance balance in persons with multiple sclerosis: preliminary evidence. Arch Phys Med Rehabil 2009; 90 (4): 602-609
Study set out to determine whether weight placed on the trunk in response to directional balance loss would enhance function and stability in people with MS. 16 people with MS took part in the study. Improved performance in a group of adults with MS was seen when light weights were placed on the torso to counteract balance loss. Placement of weights may have the potential to produce immediate improvements in balance in this population
Nilsagård Y, Lundholm C, Denison E, et al. Predicting accidental falls in people with multiple sclerosis - a longitudinal study. Clin Rehabil 2009; 23(3): 259-269
Study investigated accidental falls and near fall incidents in people with multiple sclerosis with respect to clinical variables and the predictive values of four tests. In clinical practice, looking at the use of walking aids, investigating proprioception and spasticity, rating Expanded Disability Status Score and using Berg Balance Scale or Timed Up and Go, all contribute when identifying fallers
Cattaneo D, Jonsdottir J, Zocchi M, et al. Effects of balance exercises on people with multiple sclerosis: a pilot study. Clin Rehabil 2007; 21(9):771-781
Study evaluates the effects of balance retraining in a sample of people with multiple sclerosis. Particpants were divided between three groups: group 1 received balance rehabilitation to improve motor and sensory strategies; group 2 received balance rehabilitation to improve motor strategy; and group 3 received treatments not specifically aimed at improving balance. Balance rehabilitation appeared to be a useful tool in reducing the fall rate and improving balance skills in subjects with multiple sclerosis
Hammer A, Nilsagard Y, Forsberg A, Pepa H, Skargren E, Oberg B. Evaluation of therapeutic riding (Sweden)/hippotherapy(United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis. Physiother Ther Pract 2002;21(1):51-77.
This small study suggests that therapeutic riding can positively benefit balance and some elements of quality of life.
Karst GM, Venema DM, Roehrs TG, Tyler AE. Center of pressure measures during standing tasks in minimally impaired persons with multiple sclerosis. Journal of Neurologic Physical Therapy 2005;29(4):170-80.
Study demonstrates that balance problems are evident early on in people with MS, however, they are able to compensate for this. Center of pressure measures are identified as a useful assessment of changes in postural control in people with MS.
Frohman EM, Kramer PD, Dewey RB, Kramer L, Frohman TC.Benign paroxysmal positioning vertigo in multiple sclerosis: diagnosis, pathophysiology and therapeutic techniques. Mult Scler 2003;9(3):250-5.
Discusses frequency, causes and treatment of people with MS who experience vertigo. Review of patients seen over 4 years discusses success of particle repositioning manoeuvres, particularly the Epley and Semont manoeuvres.
Cattaneo D, Marazzini F, Crippa A, Cardini R. Do static or dynamic AFOs improve balance? Clin Rehabil 2002;16(8):894-9.
14 people with MS with balance disorders were fitted with dynamic and static ankle foot orthoses. Static AFOs were found to worsen dynamic balance problems, but dynamic AFOs improved static balance and had a less negative impact on dynamic balance.
Stephens J, DuShuttle D, Hatcher C, Shmunes J, Slaninka C. Use of awareness through movement improves balance and balance confidence in people with multiple sclerosis: a randomized controlled study. Neurology Report 2001;25(2):39-49.
Compared a structured group of balance exercises, conducted over 8 classes, with no balance training. The exercise group improved on several measures, particularly in relation to centre of pressure measures.