Tailored balance exercises on people with multiple sclerosis: A pilot randomized, controlled study.
BACKGROUND
Altered integration of signals from visual (VIS), somatosensory (PROP) and vestibular system (VEST) lead to balance control impairments affecting the daily living activities of patients with multiple sclerosis (PwMS). As a consequence, tailored interventions could be crucial in improving efficacy of balance rehabilitation treatments.


OBJECTIVE
The objective of this paper is to assess the efficacy of tailored rehabilitation treatments for balance disorders based on visual, somatosensory and vestibular deficits versus traditional rehabilitation exercises.


METHODS
Thirty-two PwMS were assessed with the Berg Balance Scale (BBS), the composite score (CS) obtained by computerized dynamic posturography (CDP) test and the Modified Fatigue Impact Scale (MFIS). Based on CDP analysis, prevalent VIS, PROP or VEST deficits were identified and patients randomly allocated to a personalized (PRG) or traditional (TRG) rehabilitation group.


RESULTS
BBS score showed a significant difference between pre- and post-treatment scores of 6.3 and 2.0 points respectively for PRG and TRG. CS showed a significant difference between pre- and post-treatment scores of 16.6 and 7.6 points respectively for PRG and TRG. No interaction effect was found for MFIS score.


CONCLUSIONS
BBS and CS showed changes in the PRG group that met clinical relevant difference, underlining that tailored rehabilitation interventions based on patient-specific sensory system impairment could improve balance and postural control in PwMS.
Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Italy giampaolo.brichetto@aism.it.
Giampaolo
G
Brichetto
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
Elisa
E
Piccardo
Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Italy.
Ludovico
L
Pedullà
Department of Physiopathology, Experimental Medicine and Public Health, University of Siena, Italy.
Mario Alberto
MA
Battaglia
Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Italy.
Andrea
A
Tacchino
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D018763:Muscle Fatigue; D010865:Pilot Projects; D004856:Postural Balance; D011187:Posture; D057285:Precision Medicine; D016896:Treatment Outcome
Balance disorders; computerized dynamic posturography; multiple sclerosis; rehabilitation; sensory analysis; tailored interventions