Perturbation-based Balance Training to improve postural responses and falls in people with multiple sclerosis: a randomized controlled trial

Abstract

Purpose

To determine the effects of Perturbation-based Balance Training (PBT) on postural responses and falls in people with multiple sclerosis (PwMS) and compare the results with conventional balance training (CBT).

Materials and methods

Thirty-four PwMS were randomized to receive 4 weeks of PBT or CBT. Latency of postural responses to external perturbations, Timed-Up-and-Go (TUG), 10-meter-walk (10MW), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC) were measured at baseline and post-training. Also, the proportion of fallers and fall rate were assessed at a 3-month follow-up.

Results

The latency of postural responses significantly decreased in PBT compared to CBT. TUG, 10MW, BBS, and ABC, at post-training, and relative risk of falls and fall rate at 3-month follow-up had no statistically significant between-group differences.

Conclusions

The results show that PBT is at least as effective as CBT in improving balance and decreasing falls, while it has superiority over CBT whenever the clinicians mainly aim to improve reactive balance strategies. Future studies with a larger sample size are warranted to complement the results of this study.

Implication for rehabilitation

• Perturbation-based Balance Training is at least as effective as conventional balance training (CBT) in improving proactive postural control in people with multiple sclerosis (PwMS).

• Perturbation-based Balance Training has superiority over CBT in improving reactive postural control in PwMS.

• Perturbation-based Balance Training has no superiority over CBT in improving fall-related outcomes.

Keywords:

• Accidental falls
• postural balance
• rehabilitation
• perturbation
• exercise
• multiple sclerosis

Acknowledgements

The authors specially thank Ahvaz Jundishapur University of Medical Sciences for financial support (Grant number: PHT-9721). The authors thank Khuzestan MS Society and PwMS participated in this study.

Registration ID: IRCT20140519017752N.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by the Ahvaz Jundishapur University of Medical Sciences under Grant Number: PHT-9721.