THE EFFECT OF BALANCE TRAINING ON THE LEVEL OF PHYSICAL ACTIVITY IN PATIENTS WITH MULTIPLE SCLEROSIS
DOI:
https://doi.org/10.31891/pcs.2025.1(1).111Keywords:
multiple sclerosis, physical therapy, physical activity, balance, rehabilitation, neuromuscular activationAbstract
Multiple sclerosis is a neuroinflammatory disease that leads to progressive neurodegeneration and a wide range of functional system disorders, and is the most common non-traumatic neurological cause of disability in young people. Reduced physical activity is one of the common consequences of multiple sclerosis, which worsens the prognosis for secondary complications and disability. Balance disorders are among the factors that lead to a decrease in physical activity in multiple sclerosis, but there is a lack of research on the effectiveness of different methods of balance training on physical activity in this population. The aim of the study: to evaluate the effect of different methods of balance training on physical activity in patients with multiple sclerosis. Material and Methods: 57 patients with multiple sclerosis participated in the study and were randomized into two groups: the intervention group (29 people) and the comparison group (28 people). The intervention group implemented a physical therapy program using the neuromuscular activation method, while the comparison group used conventional balance exercises. The study participants were examined twice: the first time - before the start of physical therapy, the second time - 21 days after the start of the intervention. The International Physical Activity Questionnaire was used to assess the outcome indicators. Evaluation of the effectiveness of the physical therapy program using the neuromuscular activation technique demonstrated a statistically significant larger effect size for the physical activity index in the intervention group compared to the group in which conventional balance exercises were used, and also contributed to more pronounced clinically significant changes in the physical activity index in patients with multiple sclerosis.
References
Dendrou, C. A., Fugger, L., & Friese, M. A. (2015). Immunopathology of multiple sclerosis. Nature reviews. Immunology, 15(9), 545–558. https://doi.org/10.1038/nri3871
Proschinger, S., Kuhwand, P., Rademacher, A., Walzik, D., Warnke, C., Zimmer, P., & Joisten, N. (2022). Fitness, physical activity, and exercise in multiple sclerosis: a systematic review on current evidence for interactions with disease activity and progression. Journal of neurology, 269(6), 2922–2940. https://doi.org/10.1007/s00415-021-10935-6
Alkahtani, R. F., Alhinti, M. F., AlRashid, M. H., Alomar, A. A., Alrumaih, S. S., Alkanhal, A. F., AlHarbi, A. A., & AlAbdulSalam, A. M. (2023). Physical activity assessment among patients with multiple sclerosis in Saudi Arabia. Neurosciences (Riyadh, Saudi Arabia), 28(4), 243–249. https://doi.org/10.17712/nsj.2023.4.20230024
Walton, C., King, R., Rechtman, L., Kaye, W., Leray, E., Marrie, R. A., Robertson, N., La Rocca, N., Uitdehaag, B., van der Mei, I., Wallin, M., Helme, A., Angood Napier, C., Rijke, N., & Baneke, P. (2020). Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Multiple sclerosis (Houndmills, Basingstoke, England), 26(14), 1816–1821. https://doi.org/10.1177/1352458520970841
Kędra, E., & Wilusz, J. (2016). Jakość życia chorych na stwardnienie rozsiane. Higher School’s Pulse, 10, 21–24. 10.5604/20812021.1208708
Torkildsen, Ø., Myhr, K. M., & Bø, L. (2016). Disease-modifying treatments for multiple sclerosis - a review of approved medications. European journal of neurology, 23 Suppl 1(Suppl 1), 18–27. https://doi.org/10.1111/ene.12883
Khan, F., & Amatya, B. (2017). Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews. Archives of physical medicine and rehabilitation, 98(2), 353–367. https://doi.org/10.1016/j.apmr.2016.04.016
Goldberg, Y., Fainstein, N., Zaychik, Y., Hamdi, L., Segal, S., Nabat, H., Touloumi, O., Zoidou, S., Grigoriadis, N., Hoffman, J. R., Katz, A., Ben-Hur, T., & Einstein, O. (2021). Continuous and interval training attenuate encephalomyelitis by separate immunomodulatory mechanisms. Annals of clinical and translational neurology, 8(1), 190–200. https://doi.org/10.1002/acn3.51267
Xie, Y., Li, Z., Wang, Y., Xue, X., Ma, W., Zhang, Y., & Wang, J. (2019). Effects of moderate- versus high- intensity swimming training on inflammatory and CD4+ T cell subset profiles in experimental autoimmune encephalomyelitis mice. Journal of neuroimmunology, 328, 60–67. https://doi.org/10.1016/j.jneuroim.2018.12.005
Kalb, R., Brown, T. R., Coote, S., Costello, K., Dalgas, U., Garmon, E., Giesser, B., Halper, J., Karpatkin, H., Keller, J., Ng, A. V., Pilutti, L. A., Rohrig, A., Van Asch, P., Zackowski, K., & Motl, R. W. (2020). Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course. Multiple sclerosis (Houndmills, Basingstoke, England), 26(12), 1459–1469. https://doi.org/10.1177/1352458520915629
Hao, Z., Zhang, X., & Chen, P. (2022). Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients-A Network Meta-Analysis of Randomized Controlled Trials. International journal of environmental research and public health, 19(12), 7175. https://doi.org/10.3390/ijerph19127175
Learmonth, Y. C., & Motl, R. W. (2021). Exercise Training for Multiple Sclerosis: A Narrative Review of History, Benefits, Safety, Guidelines, and Promotion. International journal of environmental research and public health, 18(24), 13245. https://doi.org/10.3390/ijerph182413245
Stuifbergen, A. K., Blozis, S. A., Harrison, T. C., & Becker, H. A. (2006). Exercise, functional limitations, and quality of life: A longitudinal study of persons with multiple sclerosis. Archives of physical medicine and rehabilitation, 87(7), 935–943. https://doi.org/10.1016/j.apmr.2006.04.003
Kuspinar, A., Rodriguez, A. M., & Mayo, N. E. (2012). The effects of clinical interventions on health-related quality of life in multiple sclerosis: a meta-analysis. Multiple sclerosis (Houndmills, Basingstoke, England), 18(12), 1686–1704. https://doi.org/10.1177/1352458512445201
Madsen, L. T., Dalgas, U., Hvid, L. G., & Bansi, J. (2019). A cross-sectional study on the relationship between cardiorespiratory fitness, disease severity and walking speed in persons with Multiple Sclerosis. Multiple sclerosis and related disorders, 29, 35–40. https://doi.org/10.1016/j.msard.2019.01.024
Sharif, K., Watad, A., Bragazzi, N. L., Lichtbroun, M., Amital, H., & Shoenfeld, Y. (2018). Physical activity and autoimmune diseases: Get moving and manage the disease. Autoimmunity reviews, 17(1), 53–72. https://doi.org/10.1016/j.autrev.2017.11.010
Latimer-Cheung, A. E., Martin Ginis, K. A., Hicks, A. L., Motl, R. W., Pilutti, L. A., Duggan, M., Wheeler, G., Persad, R., & Smith, K. M. (2013). Development of evidence-informed physical activity guidelines for adults with multiple sclerosis. Archives of physical medicine and rehabilitation, 94(9), 1829–1836.e7. https://doi.org/10.1016/j.apmr.2013.05.015
Kinnett-Hopkins, D., Adamson, B., Rougeau, K., & Motl, R. W. (2017). People with MS are less physically active than healthy controls but as active as those with other chronic diseases: An updated meta-analysis. Multiple sclerosis and related disorders, 13, 38–43. https://doi.org/10.1016/j.msard.2017.01.016
Casey, B., Coote, S., Galvin, R., & Donnelly, A. (2018). Objective physical activity levels in people with multiple sclerosis: Meta-analysis. Scandinavian journal of medicine & science in sports, 28(9), 1960–1969. https://doi.org/10.1111/sms.13214
Corrini, C., Gervasoni, E., Perini, G., Cosentino, C., Putzolu, M., Montesano, A., Pelosin, E., Prosperini, L., & Cattaneo, D. (2023). Mobility and balance rehabilitation in multiple sclerosis: A systematic review and dose-response meta-analysis. Multiple sclerosis and related disorders, 69, 104424. https://doi.org/10.1016/j.msard.2022.104424.
World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191-2194. doi: 10.1001/jama.2013.281053.
McCoy C. E. (2017). Understanding the Intention-to-treat Principle in Randomized Controlled Trials. The western journal of emergency medicine, 18(6), 1075–1078. https://doi.org/10.5811/westjem.2017.8.35985
The International Physical Activity Questionnaire (IPAQ). [Electronic resource]. Аvailable at: https://sites.google.com/view/ipaq/home?authuser=0 (date of access: 07.04.2025).
Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., O'Brien, W. L., Bassett, D. R., Jr, Schmitz, K. H., Emplaincourt, P. O., Jacobs, D. R., Jr, & Leon, A. S. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Medicine and science in sports and exercise, 32(9 Suppl), S498–S504. https://doi.org/10.1097/00005768-200009001-00009
Multiple sclerosis in adults: management NICE guideline (2022). [Electronic resource]. Аvailable at: www.nice.org.uk/guidance/ng220 (date of access: 20.03.2025).
Neurac. Redcord. [Electronic resource]. Аvailable at: https://www.redcord.com/neurac (date of access: 20.03.2025).
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