Long-term effects of various exercise training modalities on balance, gait and fatigue in patients with multiple sclerosis: a randomized controlled study.

OBJECTIVE

To investigate the long-term effects of vestibular exercises (VE), cervical stabilization exercises (CSE) and standard balance exercises (SBE) on balance, gait and fatigue in patients with multiple sclerosis.

METHODS

Thirty-five patients were randomly allocated to three groups, performing different exercises three days a week for 12 weeks. Assessments were conducted at baseline, at Week 12 and at a 6-month follow-up using the Functional Reach Test (FRT), Four-Square Step Test (FSST), 2-Minute Walk Test (2MWT), Timed Up and Go (TUG) test, and Fatigue Impact Scale (FIS).

RESULTS

At 12 weeks, both CSE and VE groups improved on FRT and 2MWT, with the CSE group also experiencing improvements on FSST, TUG, and FIS (p < 0.05). The SBE group showed no significant changes. At 6 months, FRT, FSST, and 2MWT improvements persisted in the VE group, while the CSE group-maintained TUG and FIS gains. The VE group had superior FRT at 6 months, while the CSE group showed greater FSST improvements at 12 weeks. The VE group exhibited greater 2MWT improvements than the CSE group at 6 months, while the CSE group had better TUG results at both timepoints. Both CSE and VE groups showed greater reductions in fatigue (FIS) than the SBE group at 6 months.

DISCUSSION: VE provide long-term benefits for balance and gait speed, while CSE enhance gait endurance and postural control during training. Both modalities contribute to long-term fatigue reduction. SBE are less effective, highlighting the need for targeted interventions such as VE and CSE for sustained improvements.