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Conference Focuses on Walking Difficulties and Rehabilitation Strategies in People with MS

January 3, 2019

SUMMARY
  • Nearly 100 clinicians, researchers, engineers and others from around the world gathered in Portland, Oregon for the 8th International Symposium on Gait and Balance in MS. Their goal was to share current knowledge about walking problems and ways to address them through rehabilitation.
  • The presentation summaries (abstracts) from the meeting are published online in the International Journal of MS Care (2018;20(6):298-299).
  • These types of studies can help gather evidence to confirm the benefits of specific rehabilitation approaches so that they may be more broadly disseminated to the community.
 
DETAILS
Background: in walking -- also known as gait -- is one of the most common mobility issues for people with MS. Walking difficulties are related to several factors, including poor balance, spasticity (severe muscle tightness), fatigue and weakness. Gait problems can also put individuals at significant risk for falls and the potentially life-changing consequences of fall-related injuries. Research that uncovers solutions to address gait and balance problems is critical to helping people with MS to live their best lives.
 
The Meeting: Nearly 100 clinicians, researchers, engineers and others from around the world gathered in Portland, Oregon in September for the 8th International Symposium on Gait and Balance in MS. This annual conference is convened by the Oregon Health & Science University MS Center and the MS Center of Excellence West at the VA Portland Health Care System. The purpose of the meeting was to share current research about walking and balance difficulties in MS and rehabilitation strategies to address them.
 
Here are a few highlights:
  • Anna Carling (Örebro University, Örebro, Sweden) and colleagues evaluated the “CoDuSe” balance exercise program in a controlled study involving 121 people with MS, 33 of whom were classified as “fallers” (having fallen one or more times in a seven-week period). The CoDuSe program focuses on building the capacity of the muscles of the torso to help maintain balance, practice doing two tasks simultaneously, and strategies for managing sensory cues. Seven weeks of one-hour sessions, delivered twice each week, improved balance and significantly reduced falls compared to those who hadn’t yet begun the program. The number of “fallers” was reduced to 16.
  • Mark Mañago, PT, DPT, NCS (University of Colorado, Denver) and colleagues conducted a small feasibility study to see whether gait would improve after a program to specifically strengthen muscles in the ankle, hip, and trunk. The eight-week strength training program involved 10 people with MS. Strength improved 23-47% in the targeted muscles, and gait speed and endurance improved significantly. Based on these findings, the team believes that a controlled trial of this program is warranted.
  • Jules Miehm (University of Massachusetts, Amherst) and colleagues tested whether simple physical tests – like an instrument used to detect vibration perception on the sole of the foot, or a test involving rapid foot tapping – would show different results in people with relapsing versus progressive MS whose gait and mobility were similarly unimpaired. They found that people with progressive MS tended to have impaired function on these tests, while those with relapsing-remitting MS did not. These results suggest that testing for vibration perception and rapid foot tap may provide early indicators that a person is developing progression, which may help guide treatment decisions..
 
Next Steps: These types of studies are critical to the development of individualized rehabilitation approaches that can be more broadly disseminated to the MS community. Identifying rehabilitation strategies to improve gait and balance in MS is critical to identifying solutions and improving quality of life for people living with MS. The National MS Society is funding such efforts, including a trial to test a rehabilitation technique that addresses walking and thinking issues, as well as a trial testing an electromechanically-assisted gait training system in people with progressive MS.
 
Read More:
Read more about addressing walking difficulties in MS

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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