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Abstract

Background Fatigue and impaired upright postural control (balance) are the 2 most common findings in people with multiple sclerosis (MS), with treatment approaches varying greatly in effectiveness.

Objectives The aim of this study was to investigate the benefits of implementing a vestibular rehabilitation program for the purpose of decreasing fatigue and improving balance in patients with MS.

Design The study was a 14-week, single-blinded, stratified blocked randomized controlled trial.

Setting Measurements were conducted in an outpatient clinical setting, and interventions were performed in a human performance laboratory.

Patients Thirty-eight patients with MS were randomly assigned to an experimental group, an exercise control group, or a wait-listed control group.

Intervention The experimental group underwent vestibular rehabilitation, the exercise control group underwent bicycle endurance and stretching exercises, and the wait-listed control group received usual medical care.

Measurements Primary measures were a measure of fatigue (Modified Fatigue Impact Scale), a measure of balance (posturography), and a measure of walking (Six-Minute Walk Test). Secondary measures were a measure of disability due to dizziness or disequilibrium (Dizziness Handicap Inventory) and a measure of depression (Beck Depression Inventory–II).

Results Following intervention, the experimental group had greater improvements in fatigue, balance, and disability due to dizziness or disequilibrium compared with the exercise control group and the wait-listed control group. These results changed minimally at the 4-week follow-up.

Limitations The study was limited by the small sample size. Further investigations are needed to determine the underlying mechanisms associated with the changes in the outcome measures due to the vestibular rehabilitation program.

Conclusion A 6-week vestibular rehabilitation program demonstrated both statistically significant and clinically relevant change in fatigue, impaired balance, and disability due to dizziness or disequilibrium in patients with MS.

Footnotes

  • Dr Hebert, Dr Corboy, and Dr Schenkman provided concept/idea/research design, project management, and fund procurement. All authors provided writing. Dr Hebert and Dr Manago provided data collection and data analysis. Dr Corboy provided participants. Dr Schenkman provided facilities/equipment. Dr Corboy and Dr Schenkman provided institutional liaisons. Dr Manago provided clerical support. Dr Corboy and Dr Manago provided consultation (including review of manuscript before submission). The authors thank the Rocky Mountain MS Center, Anschutz Medical Campus, Aurora, Colorado, and the Colorado Chapter of the National Multiple Sclerosis Society for assistance in recruitment for this study.

  • A Colorado Multiple Institutional Review Board approved this study.

  • This study was partially supported by the National Multiple Sclerosis Society, Pilot Project no. PP1501.

  • Trial registration: ClinicalTrials.gov Identifier: NCT01216137.

  • Received November 18, 2010.
  • Accepted March 29, 2011.
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