Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept

Smedal, Tori; Lygren, Hildegunn; Myhr, Kjell–Morten; Moe‐Nilssen, Rolf; Gjelsvik, Bente E. Bassøe; Gjelsvik, Olav; Strand, Liv Inger

doi:10.1002/pri.327

Cited by 61 publications

(39 citation statements)

References 166 publications

(257 reference statements)

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“…As a result, new approaches are demanded. In recent literature, physiotherapy based on the Bobath concept has been used to improve functions in MS patients [14].…”

Section: Discussionmentioning

confidence: 99%

“…Bobath-based exercises have recently been recommended for use in MS rehabilitation [14]. According to the Bobath concept, the trunk has a key role in functional recovery.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of trunk-specific rehabilitation has been shown for different neurological diseases, including stroke [11] and Parkinson disease [12]. However, there is little data focused on MS [13][14]. The trunk can be affected at any stage of the disease, which may affect the level of disability.…”

Section: Introductionmentioning

confidence: 99%

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Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: Pilot study

Keser

Kırdı²,

Meriç³

et al. 2013

JRRD

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Abstract-This study compared trunk exercises based on the Bobath concept with routine neurorehabilitation approaches in multiple sclerosis (MS). Bobath and routine neurorehabilitation exercises groups were evaluated. MS cases were divided into two groups. Both groups joined a 3 d/wk rehabilitation program for 8 wk. The experimental group performed trunk exercises based on the Bobath concept, and the control group performed routine neurorehabilitation exercises. Additionally, both groups performed balance and coordination exercises. All patients were evaluated with the Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), International Cooperative Ataxia Rating Scale (ICARS), and Multiple Sclerosis Functional Composite (MSFC) before and after the physiotherapy program. In group analysis, TIS, BBS, ICARS, and MSFC scores and strength of abdominal muscles were significantly different after treatment in both groups (p < 0.05). When the groups were compared, no significant differences were found in any parameters (p > 0.05). Although trunk exercises based on the Bobath concept are rarely applied in MS rehabilitation, the results of this study show that they are as effective as routine neurorehabilitation exercises. Therefore, trunk exercises based on the Bobath concept can be beneficial in MS rehabilitation programs.

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“…As a result, new approaches are demanded. In recent literature, physiotherapy based on the Bobath concept has been used to improve functions in MS patients [14].…”

Section: Discussionmentioning

confidence: 99%

“…Bobath-based exercises have recently been recommended for use in MS rehabilitation [14]. According to the Bobath concept, the trunk has a key role in functional recovery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: Pilot study

Keser

Kırdı²,

Meriç³

et al. 2013

JRRD

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show abstract

“…[64] It has been demonstrated that human action execution (i.e., to make a cup of coffee) required three main phases: motor planning, motor execution, and movement control. [62] It is necessary in patients with SM to stimulate feedback and feed forward mechanisms and sensorimotor integration especially during the motion control phase [65].…”

Section: Discussionmentioning

confidence: 99%

Effect of Two Different Rehabilitation Training with a Robotic Gait System in Body Weight Support and a Proprioceptive Sensory-motor Exercises on Unstable Platforms in Rehabilitation of Gait and Balance Impairment and Fatigue in Multiple Sclerosis

Saggini¹,

Ancona²,

Supplizi³

et al. 2017

Int J Phys Med Rehabil

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Walking and balance disturbances and fatigue are key symptoms in patients with MS, and major causes of discomfort, even in patients with mild disability since the early stages of the disease.The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and proprioceptive sensory-motor exercises on unstable platforms in improving walking and balance performance. We enrolled 41 patients with relapsing-remitting MS at early stage and low or mild disability: patients in group A underwent a robotic gait rehabilitation treatment which involved the use of SPAD (Sistema Posturale Antigravitario Dinamico), patients in group B underwent a cycle of sensory-motor training in our laboratory of performance enhancement; patients in both groups were subjected to neuromuscular manual therapy. All treatment was provided with 3 sessions per week for 6 weeks (for a total of 18 sessions). Patients were evaluated by administration of the Functional Independence Measure (FIMTM), the Expanded Disability Status Scale (EDSS), the Berg Balance Scale (BBS), the Fatigue Severity Scale (FSS), and the Modified Fatigue Impact Scale (MFIS), and by performing stabilometric and gait analysis.Results show statistically significant improvement of the FIMTM and the BBS average score in all patients, reduction of the EDSS average score in all patients (but in a statistically significant manner only in group A), reduction in average scores obtained in both evaluation questionnaires of fatigue (non-significant improvement of the FSS average score in the overall sample and in both groups, statistically significant reduction of the MFIS average scores), improvement in stabilometric parameters in all patients (but in a statistically significant manner only in group B) and statistically significant improvement in temporal parameters of gait in all patients.So body weight supported gait training and sensory-motor exercises on unstable platforms are feasible and could be safely used as additional therapeutic.

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“…As such, core strengthening in various forms has been the subject of intervention [16][17][18][39][40]. Although these studies generally have limitations in design and have used different approaches and outcomes, together they show an overall positive effect on gait and mobility outcomes.…”

Section: Discussionmentioning

confidence: 99%

Core muscle characteristics during walking of patients with multiple sclerosis

et al. 2015

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Abstract-The purpose of this study was to investigate core muscle characteristics during walking in patients with multiple sclerosis (MS). Eight patients (4 men) with relapsing-remitting MS (aged 44.9 +/-8.6 yr) and sex-matched controls (37.9 +/-8.4 yr) walked on a treadmill for 15 min at a self-selected speed. Positron emission tomography/computed tomography imaging was used to measure core muscle activity immediately after walking based on glucose uptake. Activity was not different between the MS and control group for any of the identified muscles (p > 0.28). Within the MS group, side differences in activity were identified in the lateral flexor group, the external and internal obliques, and the rectus abdominis (p < 0.05), with the lessaffected side being activated more. Furthermore, greater muscle volume was found on the more-affected side of the transversus abdominis, quadratus lumborum, and the low-back extensor group (p < 0.03). These muscle characteristics suggest patients with MS utilize compensatory mechanisms during walking to maintain balance and posture. These strategies likely result in increased muscle energy cost and early fatigability.

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Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept

Abstract: The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.

Cited by 61 publications

References 166 publications

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: Pilot study

Comparing routine neurorehabilitation program with trunk exercises based on Bobath concept in multiple sclerosis: Pilot study

Effect of Two Different Rehabilitation Training with a Robotic Gait System in Body Weight Support and a Proprioceptive Sensory-motor Exercises on Unstable Platforms in Rehabilitation of Gait and Balance Impairment and Fatigue in Multiple Sclerosis

Core muscle characteristics during walking of patients with multiple sclerosis

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