Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA.
Department of Physical Therapy, Clarke University, Dubuque, IA, USA.
Mult Scler Relat Disord. 2017 Oct;17:224-229. doi: 10.1016/j.msard.2017.08.013. Epub 2017 Aug 21.
Deficit in balance control is a common and often an initial disabling symptom of multiple sclerosis (MS). We investigated the role of short-term training in improvement of anticipatory postural adjustments (APAs) and its effect on subsequent control of posture in individuals with MS.
A pre-post feasibility study involved eight individuals with relapsing-remitting MS who participated in the laboratory tests before and after a single training session consisting of throwing a medicine ball. The outcome measures including electromyographic activity of trunk and leg muscles and center of pressure displacements were recorded and analyzed during the anticipatory and compensatory phases of postural control.
The training resulted in enhancement of the generation of APAs seen as significantly earlier onset of leg and trunk muscle activity prior to the bilateral arm flexion task (p < 0.05). Significantly early activation of postural muscles was also observed prior to the predictable external perturbation, the task that was not a part of training, indicating the transfer of the effect of the single training session. Postural control during the balance restoration phase was improved after training (p < 0.05).
The observed training-related improvements of balance control suggest that focused rehabilitation could be effective in improving postural control. Consequentially, this could enhance mobility and quality of life in the individuals with MS.
平衡控制缺陷是多发性硬化症（MS）的常见且常为初始致残症状。我们研究了短期训练在改善预期姿势调整（APAs）中的作用，及其对 MS 患者随后姿势控制的影响。
一项前后可行性研究纳入了 8 名复发缓解型 MS 患者，他们在单次训练后进行了实验室测试，训练内容包括投掷药球。在姿势控制的预期和补偿阶段，记录和分析了躯干和腿部肌肉的肌电图活动以及身体重心的位移。
训练导致 APA 的产生增强，表现为在双侧手臂弯曲任务之前，腿部和躯干肌肉活动的起始明显提前（p < 0.05）。在可预测的外部干扰之前，也观察到了姿势肌肉的明显早期激活，而该任务不是训练的一部分，这表明单次训练的效果可以转移。训练后平衡恢复阶段的姿势控制得到改善（p < 0.05）。
观察到的与训练相关的平衡控制改善表明，有针对性的康复可能有效改善姿势控制。因此，这可以提高 MS 患者的移动能力和生活质量。
