Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis

Brenda L Davies; David J Arpin; Min Liu; Heidi Reelfs; Kathleen G Volkman; Kathleen Healey; Rana Zabad; Max J Kurz

doi:10.1016/j.apmr.2016.05.024

Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis

Arch Phys Med Rehabil. 2016 Dec;97(12):2095-2101.e3. doi: 10.1016/j.apmr.2016.05.024. Epub 2016 Jul 1.

Authors

Brenda L Davies¹, David J Arpin¹, Min Liu¹, Heidi Reelfs¹, Kathleen G Volkman², Kathleen Healey³, Rana Zabad³, Max J Kurz⁴

Affiliations

¹ Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE.
² Department of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE.
³ Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE.
⁴ Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE. Electronic address: mkurz@unmc.edu.

PMID: 27373745
DOI: 10.1016/j.apmr.2016.05.024

Abstract

Objective: To evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) who participated in a motor adaptation protocol and a cohort of persons with MS who participated in a therapeutic exercise protocol.

Design: A cohort design, where subjects were evaluated before and after a 6-week intervention period.

Setting: Clinical laboratory setting.

Participants: Individuals (N=42) with relapsing-remitting or secondary progressive MS (Expanded Disability Status Scale [EDSS] scores, 3.0-6.5) were initially screened for eligibility for participation in the study, from which those who fit the inclusion criteria (n=32) were enrolled in the study. Subjects were pseudorandomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the motor adaptation cohort (MAC) (mean age ± SD, 52.6±9y; mean EDSS score ± SD, 5.5±0.9) and 13 individuals in the therapeutic exercise cohort (TEC) (mean age ± SD, 54.0±9y; mean EDSS score ± SD, 5.3±0.9) completed the entire duration of their respective programs.

Interventions: Both cohorts completed their therapy twice a day, 5 days each week, for 6 weeks. Each session of the MAC program consisted of balance and gait training that encouraged new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program.

Main outcome measures: The Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics.

Results: Collectively, both treatment groups had improvements in postural balance (P=.001), walking endurance (P=.002), walking speed (P=.004), and step length (P<.001) after therapy. However, there were no statistical differences between the 2 treatment groups for any of the outcome variables (P values >.01).

Conclusions: Our exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS.

Trial registration: ClinicalTrials.gov NCT02524483.

Keywords: Exercise; Gait; Posture; Rehabilitation; Walking.

Publication types

Clinical Trial
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Aged
Disability Evaluation
Exercise Therapy / methods
Female
Humans
Male
Middle Aged
Multiple Sclerosis / rehabilitation*
Multiple Sclerosis, Relapsing-Remitting
Persons with Disabilities / rehabilitation
Physical Therapy Modalities*
Postural Balance / physiology*
Prospective Studies
Single-Blind Method
Walking*

Associated data

ClinicalTrials.gov/NCT02524483