SUMMARY
- A research team funded by the National MS Society found that a program of exercises focusing on balance, including eye and head movements and walking, improved balance, fatigue, cognition, dizziness and quality of life in people with MS significantly more than an untreated control group.
- The researchers plan future studies to confirm these benefits.
- The team (Jeffrey R. Hebert, PT, PhD, University of Colorado School of Medicine, Aurora, and others) report their findings in Neurology (2018;90:1-11).
DETAILS
Background: In people with MS the immune system damages parts of the brain and spinal cord. The specific effects of this damage depend on what parts of the nervous system are affected. Portions of the brain known as the cerebellum and brainstem process signals from various systems of the body including sensory, visual and inner ear (vestibular system) which all contribute to controlling balance and coordinating movements. Damage to these areas can cause problems with balance, which may be severe enough to cause falls.
With grant funding from the National MS Society, Jeffrey Hebert, PT, PhD, MSCS, and team investigated the effectiveness of Balance and Eye-Movement Exercises for People with Multiple Sclerosis (BEEMS), a vestibular rehabilitation program that his team designed.
This Study: The study involved 88 people with MS who were able to walk 100 meters using at most a cane or other device on one side. The participants completed assessments measuring balance, fatigue, cognition, dizziness and quality of life. A neurologist examined MRI scans to determine whether participants had disease activity in the cerebellum or brainstem.
Participants were randomly assigned to one of two groups. One group completed supervised exercises twice a week and were given instructions for exercising every day at home for six weeks; then they completed one supervised exercise session plus the daily exercises at home for eight weeks. The BEEMS exercise program includes three components: balancing on different surfaces; walking, both with and without head movements and with eyes open and closed; and eye movement exercises. In the second group, participants were placed on a waiting list for the program. All participants were tested after six weeks and again at 14 weeks.
Results: In all, 76 participants completed the study. Results measured at six weeks showed that BEEMS participants improved in their balance significantly more than those in the control group. BEEMS participants also showed greater improvements in fatigue, cognition, dizziness, and quality of life. The improvements were sustained at 14 weeks.
Improvements were more pronounced after six weeks in the BEEMS participants who had shown disease activity in the cerebellum or brainstem. This was not the case at 14 weeks.
The team (Jeffrey R. Hebert, PT, PhD, University of Colorado School of Medicine, Aurora, and others) report their findings in
Neurology (
2018;90:1-11).
Next Steps: Dr. Hebert and colleagues plan further studies to confirm these benefits so that the program could be made available in the future. They note that future investigations should establish how long improvements can be sustained, and the necessity of supervised exercise. Also, teleconferencing may provide a strategy for delivering the BEEMS program in a cost-effective, long-term manner.
In the meantime, people who wish to explore balance/eye movement exercises should consult with their MS healthcare provider, local rehabilitation facilities or hospitals to see whether this type of training is available.
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