title: Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis.
abstract: 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.
  
  
  
  A cohort design, where subjects were evaluated before and after a 6-week intervention period.
  
  
  
  Clinical laboratory setting.
  
  
  
  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.
  
  
  
  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.
  
  
  
  The Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Davies
authors.affiliation: Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE.
authors.forename: David J
authors.initials: DJ
authors.lastname: Arpin
authors.affiliation: Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Heidi
authors.initials: H
authors.lastname: Reelfs
authors.affiliation: Department of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Volkman
authors.affiliation: Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Healey
authors.affiliation: Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Rana
authors.initials: R
authors.lastname: Zabad
authors.affiliation: Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE. Electronic address: mkurz@unmc.edu.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Kurz
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D020529:Multiple Sclerosis, Relapsing-Remitting; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D016037:Single-Blind Method; D016138:Walking
keywords: Exercise; Gait; Posture; Rehabilitation; Walking