title: Balance and Gait in People with Multiple Sclerosis: A Comparison with Healthy Controls and the Immediate Change after an Intervention based on the Bobath Concept.
abstract: OBJECTIVE
  The objective of this study is to compare the balance and gait of 11 people with multiple sclerosis (MS) to 11 healthy controls and to investigate the immediate change after a single intervention based on the Bobath concept on these activities in the MS group.
  
  
  METHODS
  Balance was assessed by ground reaction forces (GRF) and centre of pressure movements during single limb standing (SLS), the Lateral Reach Test (LRT) and the Four Square Step Test (FSST). Gait was evaluated by GRF, ankle kinematics and spatiotemporal measures.
  
  
  RESULTS
  Baseline measures in the MS group showed significantly greater vertical GRF variability (p = 0.008) during SLS reached less distance on the LRT (p = 0.001) and were slower completing the FSST (p < 0.001). During gait, the MS group walked slower (p = 0.005) and had less ankle plantarflexion (PF) (p = 0.001) than the control group. Less peak vertical GRF (p < 0.001) and peak propulsive GRF (p = 0.004) at terminal stance and increased vertical GRF in midstance (p = 0.005) were observed. The measures of balance and gait were re-assessed in the MS group immediately after a 20-min intervention based on the Bobath concept delivered to the most impaired foot and ankle. After the intervention, the MS group had significant changes towards the control group values with reduced mediolateral (p = 0.002) and vertical (p = 0.016) GRF variability in the SLS task, faster FSST time (p = 0.006) and increased ankle PF during gait (p = 0.002).
  
  
  CONCLUSIONS
  This study provides further evidence of balance and gait limitations in people with MS and indicates that a single treatment based on principles of the Bobath concept to the foot and ankle can result in immediate improvements in balance and ankle PF during gait in people with MS. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: St Vincent's Health Melbourne, Melbourne, Australia.|School of Physiotherapy, The University of Melbourne, Melbourne, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Ilett
authors.affiliation: Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Melbourne, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Lythgo
authors.affiliation: Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.affiliation: St Vincent's Health Melbourne, Melbourne, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Brock
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000592:standards*; D004856:Postural Balance / Q000502:physiology*; D012016:Reference Values; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: gait; multiple sclerosis; physical therapy modalities; postural balance