School of Medicine-Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA.
Phys Ther. 2011 Aug;91(8):1166-83. doi: 10.2522/ptj.20100399. Epub 2011 Jun 16.
Fatigue and impaired upright postural control (balance) are the 2 most common findings in people with multiple sclerosis (MS), with treatment approaches varying greatly in effectiveness.
The aim of this study was to investigate the benefits of implementing a vestibular rehabilitation program for the purpose of decreasing fatigue and improving balance in patients with MS.
The study was a 14-week, single-blinded, stratified blocked randomized controlled trial.
Measurements were conducted in an outpatient clinical setting, and interventions were performed in a human performance laboratory.
Thirty-eight patients with MS were randomly assigned to an experimental group, an exercise control group, or a wait-listed control group.
The experimental group underwent vestibular rehabilitation, the exercise control group underwent bicycle endurance and stretching exercises, and the wait-listed control group received usual medical care.
Primary measures were a measure of fatigue (Modified Fatigue Impact Scale), a measure of balance (posturography), and a measure of walking (Six-Minute Walk Test). Secondary measures were a measure of disability due to dizziness or disequilibrium (Dizziness Handicap Inventory) and a measure of depression (Beck Depression Inventory-II).
Following intervention, the experimental group had greater improvements in fatigue, balance, and disability due to dizziness or disequilibrium compared with the exercise control group and the wait-listed control group. These results changed minimally at the 4-week follow-up. Limitations The study was limited by the small sample size. Further investigations are needed to determine the underlying mechanisms associated with the changes in the outcome measures due to the vestibular rehabilitation program.
A 6-week vestibular rehabilitation program demonstrated both statistically significant and clinically relevant change in fatigue, impaired balance, and disability due to dizziness or disequilibrium in patients with MS.
疲劳和直立姿势控制（平衡）受损是多发性硬化症（MS）患者最常见的两种发现，治疗方法的有效性差异很大。
本研究旨在探讨实施前庭康复计划对减少 MS 患者疲劳和改善平衡的益处。
这是一项为期 14 周的单盲、分层分组随机对照试验。
测量在门诊临床环境中进行，干预在人体性能实验室中进行。
38 名 MS 患者被随机分配到实验组、运动对照组或候补对照组。
实验组进行前庭康复，运动对照组进行自行车耐力和伸展运动，候补对照组接受常规医疗护理。
主要测量指标为疲劳（改良疲劳影响量表）、平衡（姿势描记术）和行走（六分钟步行测试）。次要测量指标为因头晕或失衡导致的残疾（头晕障碍量表）和抑郁（贝克抑郁量表-II）。
干预后，实验组在疲劳、平衡和因头晕或失衡导致的残疾方面的改善明显优于运动对照组和候补对照组。这些结果在 4 周随访时变化不大。限制：该研究受到样本量小的限制。需要进一步研究以确定与前庭康复计划相关的结果测量变化的潜在机制。
为期 6 周的前庭康复计划在 MS 患者的疲劳、平衡受损和因头晕或失衡导致的残疾方面显示出统计学显著和临床相关的变化。
