Gait and balance improved in patients with multiple sclerosis after inpatient physiotherapy

• Published in: Multiple sclerosis Vol. 14; p. S152
• Main Authors: Smedal, T, Myhr, K-M, Gjelsvik, B, Beiske, A, Glad, S B, Skar, A-BR, Huser, K-A, Aarseth, J H, Strand, LI
• Format: Journal Article
• Language: English
• Published: 01.09.2008
• ISSN: 1352-4585

Background: Multiple sclerosis (MS) may lead to gait and balance problems, and appropriate treatment is needed. Physiotherapy has been shown to improve and maintain gait and balance in various populations. Objective: To investigate whether gait and balance improved after inpatient physiotherapy for patients with MS, both in short and long-term perspectives. Methods: 56 patients with MS (34 relapsing-remitting MS, 18 secondary progressive MS and 4 primary progressive MS) with clinical stable disease and Expanded Disability Status Scale score between 4.0 and 6.5 received individualized physiotherapy according to the Bobath concept, for four weeks. Gait and balance were measured by: six-minute walk test (6MWT) (main outcome), 10m timed walk (10MTW), Timed Up&Go (TUG), Trunk Impairment Scale (TIS) and Berg Balance Scale (BBS) at screening, baseline (6 weeks after screening), immediately after treatment and after three and six months. Changes were analyzed by general linear model for repeated measures (GLM) with one within subject factor (time). If the time factor was significant (p less than or equal to 0.05), Bonferroni-adjusted paired t-tests were used for pair wise comparisons between the different time periods. Results: GLM showed significant change for all measures (p<0.05). Stability from screening to baseline was demonstrated for all measures, except TIS which demonstrated decline (mean -1.7, p<0.001). Improvement from baseline to after treatment was demonstrated for all measures; 6MWT (mean 54.5m, p<0.001), TIS (mean 4.5, p<0.001), BBS (mean 3.2, p<0.001), TUG (mean -1.3, p<0.001) and 10MTW (mean -1.0, p=0.019). Improvement was still significant after three and six months for TIS (p<0.001), 6MWT (p<0.001 and p=0.003 respectively), and for BBS (p=0.015 and p=0.001 respectively). For 10MTW improvement was significant after three months (p=0.029), but not after six. For TUG it was not significant after three and six months. Conclusions: Gait and balance improved after four weeks with inpatient physiotherapy. Short and long-term improvement was demonstrated.