title: Effects of motor-motor and motor-cognitive tasks on balance in patients with multiple sclerosis.
abstract: BACKGROUND
  Dual tasking is frequently impaired in Multiple Sclerosis (MS), substantially impairing quality of life (QoL). We aimed to examine the effects of motor-motor and motor-cognitive tasks on balance in highly mobile patients with relapsing-remitting MS (RRMS), with mild disability.
  
  
  METHODS
  Thirty-eight patients and 34 controls were included. Steady Stance Test (SST), Berg Balance Scale (BBS) and Activities-specific Balance Confidence Scale (ABC) were used to evaluate the balance. Expanded Disability Status Scale (EDSS), Mini-mental State Examination (MMSE), Beck Depression Inventory (BDI) and Fatigue Impact Scale (FIS) were used to evaluate disability, cognitive impairment, depression and fatigue, respectively.
  
  
  RESULTS
  BBS and ABC scores were significantly different between the groups. Also, balance was significantly impaired in patients. Eyes-open left single stance test was the most efficient test to reveal the balance impairment in RRMS patients independent of dual-task. Physical component of FIS affected this test independent of age and BMI. Visual input significantly increased the stance durations in majority of SST, especially in tough stance positions with reduced balance area. However, visual input during dual-tasking impaired the balance. In addition, eyes-closed left tandem stance test with MM dual task significantly improved the balance in patients. BBS was significantly correlated with EDSS(r: -0.336), ABC(r: 0.688), FIS physical subgroup(r: -0.614) and FIS social subgroup(r: -0.475).
  
  
  CONCLUSIONS
  Dual-tasking improves balance and increases QoL in patients with RRMS. Eyes closed balance treatment with motor-dual task could be beneficial.
authors.affiliation: Department of Physical Therapy and Rehabilitation, Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, 35170 Izmir, Turkey. Electronic address: fulyamercan.d@gmail.com.
authors.forename: Fulya
authors.initials: F
authors.lastname: Mercan
authors.affiliation: Dokuz Eylul University School of Physical Therapy and Rehabilitation, Izmir, Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Kara
authors.affiliation: Department of Neurology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Bedile Irem
authors.initials: BI
authors.lastname: Tiftikcioglu
authors.affiliation: Department of Physical Therapy and Rehabilitation, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Mercan
authors.affiliation: Department of Physical Therapy and Rehabilitation, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Filiz Meryem
authors.initials: FM
authors.lastname: Sertpoyraz
mesh_terms: D000328:Adult; D001288:Attention; D003071:Cognition; D003863:Depression; D004185:Disability Evaluation; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D009483:Neuropsychological Tests; D004856:Postural Balance; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D062606:Tertiary Care Centers; D014796:Visual Perception; D055815:Young Adult
keywords: Balance; Dual task; Multiple sclerosis; Quality of life; Rehabilitation