Group Balance Training for People With Multiple Sclerosis

Study Overview
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Brief Summary
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People with multiple sclerosis (MS) often have affected balance capacity and an increased risk for falls. A risk factor for falls are activities requiring dual attention. Another factor leading to reduced balance capacity is trunk stability, and decreased trunk stability has been seen in people with MS compared to healthy controls. Earlier studies using core stability exercises have shown positive effects on balance, compared to no training. In Sweden, physical therapy for people with MS has often included group training. However, evidence for this intervention is scarce. The aim of this study is therefore to investigate balance training in group. The balance training includes core stability exercises and dual attention activities. A multi-centre study is planned with a waiting-list design. Participants are randomised to either exercise group with early start or with late start. The group balance training includes training 60 minutes 2 times per week for 7 weeks.

Official Title
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Group Balance Training for People With Multiple Sclerosis

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Other: Group balance training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed multiple sclerosis by a neurologist, being able to walk 100 m with or without walking device, being able to get down on the floor with minor assistance Exclusion Criteria: No balance deficit here defined as being able to stand still heel-toe for 30 seconds with arms crossed. Ongoing relapse, cognitive- or language difficulties that prohibits performing the outcome measures.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group balance training early start<br> | Other: Group balance training<br>* Balance training i group with focus on core stability exercises and dual attention activities.<br>|
| Experimental: Group balance training late start<br> | Other: Group balance training<br>* Balance training i group with focus on core stability exercises and dual attention activities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Bergs balance scale | Functional balance scale in sitting, standing and walking. | Change from Baseline in Bergs balance scale at 7 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in Four Square step test | Dynamic balance | Change from Baseline in Four Square step test at 7 weeks | 
| Change from baseline in Timed chair stands test | Functional leg strength, rising 10 times from a chair. | Change from baseline in Times Chair stands test at 7 weeks | 
| Change from baseline in Timed Up and Go test | Functional mobility. | Change from baseline in Timed Up and Go test at 7 weeks | 
| Change from baseline in Functional Gait Assessment | Gait-related activities | Change from baseline in Functional Gait Assessment at 7 weeks | 
| Change from baseline in Postural sway | Using a sway meter postural sway in standing still is assessed. | Change from baseline in Postural sway at 7 weeks | 
| Change from baseline in Activities-specific Balance scale | 16 item questionnaire that includes items on balance self-efficacy | Change from baseline in Activities-specific Balance scale at 7 weeks | 
| Change from baseline in 12-item Multiple Sclerosis Walking scale | self-reported limitations in walking. | Change from baseline in 12-item Multiple Sclerosis Walking scale at 7 weeks | 
| Change from Baseline in Bergs balance scale | Functional balance in sitting, standing and walking | Change from Baseline in Bergs balance scale at 14 weeks | 
| Change from Baseline in Four Square step test | Dynamic balance | Change from baseline in Four Square step test at 14 weeks | 
| Change from baseline in Times Chair stands test | Functional lower extremity strength | Change from baseline in Times Chair stands test at 14 weeks | 
| Change from baseline in Timed Up and Go test | Functional mobility | Change from baseline in Timed Up and Go test at 14 weeks | 
| Change from baseline in Functional Gait Assessment | Gait-related activities | Change from baseline in Functional Gait Assessment at 14 weeks | 
| Change from baseline in postoral sway | Using a sway meter postural sway in standing still is assessed. | Change from baseline in postoral sway at 14 weeks | 
| Change from baseline in Activities-specific Balance scale | Balance self-efficacy | Change from baseline in Activities-specific Balance scale at 14 weeks | 
| Change from baseline in 12-item Multiple Sclerosis Walking scale | self-reported limitations in walking | Change from baseline in 12-item Multiple Sclerosis Walking scale at 14 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multiple sclerosis, physical therapy, postural control