Vestibular rehabilitation has positive effects on balance, fatigue and activities of daily living in highly disabled multiple sclerosis people: A preliminary randomized controlled trial

Article type: Research Article

Authors: Tramontano, Marco^a | Martino Cinnera, Alex^b | Manzari, Leonardo^c | Tozzi, Federico Francesco^{b; d} | Caltagirone, Carlo^{b; e} | Morone, Giovanni^{a; *} | Pompa, Alessandra^f | Grasso, Maria Grazia^f

Affiliations: [a] Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia (Scientific Institute for Research and Health Care), Rome, Italy | [b] IRCCS Santa Lucia Foundation, Rome, Italy | [c] MSA ENT Academy Center, Cassino, Italy | [d] Physiotherapy Degree, Tor Vergata University, Rome, Italy | [e] Department of Systems Medicine, Tor Vergata University, Rome, Italy | [f] Multiple Sclerosis Unit, IRCCS Santa Lucia Foundation, Rome, Italy

Correspondence: [*] Corresponding author: Giovanni Morone, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy. Tel.: +390651501005; Fax: +390651501004; E-mail: g.morone@hsantalucia.it.

Abstract: Background:Balance disorders are present in patients with Multiple Sclerosis and part of these disorders could be of vestibular origin. Vestibular Rehabilitation was found to be effective in improving balance in patients with central vestibular dysfunction. Objective:To investigate the clinical effects of vestibular rehabilitation on balance skills and secondly on fatigue and activity of daily living in highly disabled multiple sclerosis people. Methods:Thirty hospitalized participants with severe multiple sclerosis (EDSS 6-7) were randomly assigned to the experimental group (15 patients -9F-; mean age 50.64±11.73) and the control group (15 patients -8F-; mean age 45.77±10.91). All patients were evaluated before and after treatment with the Expanded Disability Status Scale, Barthel Index Tinetti Balance and Gait scale, Berg Balance Scale, Fatigue Severity Scale, Two Minute Walking Test and Timed 25-foot walk test. Two follow-ups (i.e., at 30 and 60 days after treatment) were carried out with Barthel Index. Results:Significant improvement was found in the experimental group with respect to the control group (p <  0,05) in balance, fatigue perception, activities of daily living and short distance gait. No significant improvements were found for gait endurance as measured by Two Minute Walking Test. Conclusions:Four weeks of Vestibular Rehabilitation training results in less fatigue, improved balance and performance of the activities of daily living in patients with severe Multiple Sclerosis.

Keywords: Multiple sclerosis, vestibular rehabilitation, rehabilitation, balance, fatigue, gait, activities of daily living

DOI: 10.3233/RNN-180850

Journal: Restorative Neurology and Neuroscience, vol. 36, no. 6, pp. 709-718, 2018