Ali Ahmed S, Darwish Moshera H, Shalaby Nevin M, Abbas Rami L, Soubhy Habiba Z
Department of Physical Therapy for Neuromuscular Disorders - Faculty of Physical therapy - Cairo University - Egypt; Department of Physical Therapy - Faculty of Health Sciences - Beirut Arab University - Lebanon.
Department of Physical Therapy for Neuromuscular Disorders - Faculty of Physical therapy - Cairo University - Egypt.
Mult Scler Relat Disord. 2021 May;50:102866. doi: 10.1016/j.msard.2021.102866. Epub 2021 Feb 23.
Balance and ataxic symptoms are commonly encountered in people with multiple sclerosis (PwMS). Many intervention approaches have been proposed to address balance in PwMS. The purpose of this study was to investigate the efficacy of adding core stability versus task oriented trainings on traditional approaches on balance in ataxic PwMS.
Forty five ataxic relapsing-remitting PwMS from both sexes were randomly assigned into three identical groups. Control group (CG) treated with conventional balance exercise program; study groups I (GI) and II (GII) received respectively additional training using core stability exercises and task oriented trainings. Outcome measures recorded pre and post study period included stability index (SI), anterior posterior stability index (APSI), and mediolateral stability index (MLSI) using Biodex stability system in addition to the Berg balance scale (BBS).
Post treatment, the results indicated significant improvement in (SI) and (APSI) (p<0.05), and non-significant improvement (p>0.05) in (MLSI) and BBS in CG. In GI and GII there was a significant improvement in all balance measures (p<0.05). Comparison of post treatment results between groups indicated a significant improvement of GII compared to CG in all study measures, GI showed non- significant difference in all balance measures compared to the CG(P>0.05).
In PwMS balance rehabilitation should be multimodal; core stability exercises and task-oriented training in addition to conventional balance training are effective to improve balance and should be considered as an essential part of the training program for balance rehabilitation in ataxic PwMS. Task-oriented training in addition to conventional balance rehabilitation seem to be a favorable approach.
平衡和共济失调症状在多发性硬化症患者（PwMS）中很常见。已经提出了许多干预方法来解决PwMS患者的平衡问题。本研究的目的是调查在传统方法基础上增加核心稳定性训练与任务导向训练对共济失调型PwMS患者平衡能力的疗效。
45名患有共济失调型复发缓解型多发性硬化症的男女患者被随机分为三个相同的组。对照组（CG）接受传统的平衡训练计划；研究组I（GI）和II（GII）分别接受额外的核心稳定性训练和任务导向训练。在研究前后记录的结果指标包括使用Biodex稳定性系统测量的稳定性指数（SI）、前后稳定性指数（APSI）和内外侧稳定性指数（MLSI），以及伯格平衡量表（BBS）。
治疗后，结果表明CG组的（SI）和（APSI）有显著改善（p<0.05），（MLSI）和BBS无显著改善（p>0.05）。在GI组和GII组中，所有平衡指标均有显著改善（p<0.05）。组间治疗后结果比较表明，与CG组相比，GII组在所有研究指标上均有显著改善，GI组与CG组在所有平衡指标上均无显著差异（P>0.05）。
在PwMS患者中，平衡康复应采用多模式；除传统的平衡训练外，核心稳定性训练和任务导向训练对改善平衡有效，应被视为共济失调型PwMS患者平衡康复训练计划的重要组成部分。除传统的平衡康复训练外，任务导向训练似乎是一种有利的方法。
