Effects of Pilates-Based Core Stability Training in Ambulant People With Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial

Fox, Esther; Hough, Alan D.; Creanor, Siobhan; Gear, Margaret; Freeman, Jennifer

doi:10.2522/ptj.20150166

Cited by 57 publications

(66 citation statements)

References 35 publications

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“…Other smaller studies have also shown that incorporating trunk exercises or Pilates exercises can be beneficial for PwMS [64, 65]. On the other hand a recent study showed that Pilates based core stability exercises had no effect on 10-meter walking, the MSWS-12, or the ABC scale compared to relaxation exercises [66]. In the beginning of the intervention period in the present study focus was on activating the deep abdominal muscles in neutral spinal alignment.…”

Section: Discussionmentioning

confidence: 72%

Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis: A Multicenter Randomized Controlled Trial

Forsberg

Koch

Nilsagård

2016

Multiple Sclerosis International

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Background. Balance and walking impairments are frequent in people with multiple sclerosis (MS). Objective. The aim was to investigate the effects of a group-based balance exercise program targeting core stability, dual tasking, and sensory strategies (CoDuSe) on balance, postural sway, walking, perceived walking limitations, and balance confidence. Design. A single-blinded randomized multicenter trial. No intervention was given to controls. Participants. People with MS able to walk 100 meters but unable to maintain tandem stance ≥30 seconds. Eighty-seven participants were randomized to intervention or control. Intervention. The 60-minute CoDuSe group program, twice weekly for seven weeks, supervised by physical therapists. Measurements. Primary outcome was dynamic balance (Berg Balance Scale (BBS)). Secondary outcomes were postural sway, walking (Timed-Up and Go test; Functional Gait Assessment (FGA)), MS Walking Scale, and Activities-specific Balance Confidence (ABC) Scale. Assessments were performed before and after (week 8) the intervention. Results. 73 participants fulfilled the study. There were significant differences between the intervention and the control groups in change in the BBS and in the secondary measures: postural sway with eyes open, FGA, MS Walking Scale, and ABC scale in favor of the intervention. Conclusions. The seven-week CoDuSe program improved dynamic balance more than no intervention.

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Section: Discussionmentioning

confidence: 72%

Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis: A Multicenter Randomized Controlled Trial

Forsberg

Koch

Nilsagård

2016

Multiple Sclerosis International

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“…Individually tailored programmes supervised by a physiotherapist covering both motor and sensory strategies were found to improve balance performance and reduce the number of falls more e ciently than motor strategies alone [10,11]. Another therapeutic strategy is exercise focused on core stability exercise [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Biofeedback Based Home Balance Training can Improve Balance but Not Gait in People with Multiple Sclerosis

Novotná

Janatová

Hána

et al. 2019

Multiple Sclerosis International

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Background. Impaired balance is common in people with multiple sclerosis (MS) and can be present even in those with a mild disability level. With increasing disability, gait, and balance impairment progress, and lead to increased risk of falls. In some recent studies, interactive commercial video games were used for improving balance, but their limitation is their lack of individual training parameter settings needed for rehabilitation purposes. The aim of this study was to evaluate the feasibility and effect of balance exercise in the home setting using the rehabilitation Homebalance® system. Methods. A single-centre, controlled, single blind study with allocation to intervention group or to control group was utilised. Participants were assessed at baseline, after four weeks of home-based balance training, and follow-up after four weeks. The primary outcomes were the Berg Balance Test (BBT). The secondary outcome measures included the Mini-BESTest, Timed Up, and Go Test (part of Mini-BESTest), and spatio-temporal gait parameter evaluation using the GAITRite instrument. The patient reported outcomes (PRO) included the 12-Item MS Walking Scale, Activities-specific Balance Confidence Scale, and the Falls Efficacy Scale. Results. A total of 39 people with Multiple Sclerosis (10 men) were enrolled into the study. The mean age of participants was 40.69 ± 10.2 years, with a mean disease duration 14.76 ± 9.1 years and mean disability level 3.8 ± 1.9 EDSS (EDSS range 1.5–7). Statistically significant improvements within the home exercise group were present for the BBT and the Mini-BESTest. This improvement was more significant in the subgroup with moderate and higher disability (EDSS 4.5–7). All other gait parameters and PRO did not show any improvement. Follow-up assessment after four weeks showed that the reached improvement persisted for a short time period after finishing the regular training regimen. Conclusion. In comparison with no intervention, a short-term programme of home-based balance training using Homebalance® improved balance but not gait performance in a group of people with MS. It seems that home-based balance training tailored according to individual needs by a physiotherapist may be a future approach to consider for telerehabilitation of people with MS.

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“…Quantitative information on pathology‐specific trunk instability during gait may help to develop the following: (1) interventions aimed at restoring physiologic trunk movements using traditional approaches and/or (2) instrumental systems able to measure trunk motion in real‐time and provide feedback information to the user during balance and gait rehabilitation …”

Section: Discussionmentioning

confidence: 99%

Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

Anastasi

Carpinella

Gervasoni

et al. 2019

PM&R

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Background: Gait instability is common in adults with neurologic disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. Objective: To develop and validate an instrumented version of the mDGI. Design: Cross-sectional study. Setting: Clinical setting. Participants: Thirty adults with neurologic disorders (10 with multiple sclerosis, 10 with Parkinson disease, and 10 with stroke) and 20 healthy volunteers. Methods: Participants were assessed with the Timed Up and Go test (TUG) and with the mDGI. During the assessment of mDGI, data were collected by a single Inertial Measurement Unit (IMU) positioned on the sternum. Principal component analysis (PCA) was performed on the instrumented data extracting eight PC scores (ImPC) describing dynamic balance. The instrumented overall score (ImDGI) was then calculated as the sum of the mPCs. PCA revealed two components associated with stride features and regularity (ImDGI_Gait_Pattern) and trunk movements (ImDGI_Trunk_Sway). Spearman coefficients were calculated between mDGI and ImDGI, whereas Mann-Whitney (U) and Kruskal-Wallis (H) tests assessed differences between groups and neurologic conditions. Main Outcome Measurements: ImDGI. Results: ImDGI did not show ceiling effects, and good correlations were found between ImDGI and mDGI (r = .84), and TUG (r = .84) for people with neurologic disorders (P < .001). Significant differences among pathologies (H test (2) =12.5, P = .002) and between healthy participants and adults with neurologic disorders (U test = 47.0, P = .001) were found. ImDGI_Trunk_Sway discriminated between people using or not using walking aids and among the three pathologies (H (2) = 10.0, P = .007). Conclusions:The ImDGI test seems to provide valid measures to objectively assess dynamic balance in neurologic conditions and possibly quantify balance deficits also in adults with neurologic disorders.

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Effects of Pilates-Based Core Stability Training in Ambulant People With Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial

Abstract: Participants did not improve significantly, either in the short term or at the 4-week follow-up, on the 10MTW after 12 weeks of Pilates exercises compared with 12 weeks of relaxation.

Cited by 57 publications

References 35 publications

Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis: A Multicenter Randomized Controlled Trial

Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis: A Multicenter Randomized Controlled Trial

Biofeedback Based Home Balance Training can Improve Balance but Not Gait in People with Multiple Sclerosis

Instrumented Version of the Modified Dynamic Gait Index in Patients With Neurologic Disorders

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