Последствия восстановления багажа в равновесии, походки, падения и мобильности в общине у пациентов с множественным склерозом: беспорядочное выборочное контролируемое испытание.
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Mukhtar Shatha, Aljohani Ghala, Bakkar Maysam, Almutairi Naseem, Mazi Aseel, Alsweed Lama, Albadi Majed, Aldhabi Rawan, Khan Fayaz
Аннотация
Оригинал публикации
The effects of trunk rehabilitation on balance, gait, falls, and community mobility in patients with multiple sclerosis: A single-blind randomized controlled trial.
BACKGROUND: Multiple sclerosis (MS) impairs daily living and social engagement, thus reducing people's overall quality of life. Trunk impairment in people with MS is closely linked to balance deficits, gait disturbances, and an increased risk of falls. Targeted trunk rehabilitation may improve these outcomes.
PURPOSE: This study aimed to investigate the effectiveness of dynamic trunk-focused rehabilitation in people with MS (PwMS).
METHODS: A total of 45 PwMS were randomly assigned to either a trunk group or a core group. The trunk group received multiplanar trunk exercises on unstable surfaces combined with dual-task training, while the core group performed traditional core stability exercises. Both groups received conventional therapy in addition to their designated intervention. The primary outcome was the Trunk Impairment Scale (TIS), and secondary outcomes included the Berg Balance Scale (BBS), Timed Up and Go (TUG), Modified Falls Efficacy Scale (MFES), Modified Fatigue Impact Scale (MFIS), Hospital Anxiety and Depression Scale (HADS), and Reintegration to Normal Living Index (RNLI). A two-way mixed model ANOVA test was conducted to assess time-by-group interactions.
RESULTS: The trunk group exhibited significantly greater improvements over time across all outcomes compared to the core group. Significant time-by-group interactions were observed for trunk control (TIS, F = 18.3, P ≤ 0.001), balance (BBS, F = 13.2, P ≤ 0.001), mobility (TUG, F = 3.9, P = 0.05), and community reintegration (RNLI, F = 7.6, P = 0.01). Improvements in fall prevention confidence (MFES, F = 16.4, P ≤ 0.001), fatigue reduction (MFIS, F = 8.3, P = 0.007), and psychological well-being (HADS, F = 4.5, P = 0.04) were also significantly greater in the trunk group compared to in the core group.
CONCLUSION: For PwMS, dynamic trunk-focused interventions incorporating multiplanar movements on unstable surfaces along with dual-task training offer superior benefits over standard core stability exercises. These findings support the incorporation of dynamic trunk rehabilitation as a key component of MS rehabilitation protocols.
CLINICALTRIALS: gov (NCT06447571).