Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis.

Autor:	Davies BL; Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE., Arpin DJ; Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE., Liu M; Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE., Reelfs H; Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE., Volkman KG; Department of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE., Healey K; Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE., Zabad R; Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE., Kurz MJ; Department of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE. Electronic address: mkurz@unmc.edu.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2016 Dec; Vol. 97 (12), pp. 2095-2101.e3. Date of Electronic Publication: 2016 Jul 01.
DOI:	10.1016/j.apmr.2016.05.024
Abstrakt:	Objective: To evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) who participated in a motor adaptation protocol and a cohort of persons with MS who participated in a therapeutic exercise protocol. Design: A cohort design, where subjects were evaluated before and after a 6-week intervention period. Setting: Clinical laboratory setting. Participants: Individuals (N=42) with relapsing-remitting or secondary progressive MS (Expanded Disability Status Scale [EDSS] scores, 3.0-6.5) were initially screened for eligibility for participation in the study, from which those who fit the inclusion criteria (n=32) were enrolled in the study. Subjects were pseudorandomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the motor adaptation cohort (MAC) (mean age ± SD, 52.6±9y; mean EDSS score ± SD, 5.5±0.9) and 13 individuals in the therapeutic exercise cohort (TEC) (mean age ± SD, 54.0±9y; mean EDSS score ± SD, 5.3±0.9) completed the entire duration of their respective programs. Interventions: Both cohorts completed their therapy twice a day, 5 days each week, for 6 weeks. Each session of the MAC program consisted of balance and gait training that encouraged new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program. Main Outcome Measures: The Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics. Results: Collectively, both treatment groups had improvements in postural balance (P=.001), walking endurance (P=.002), walking speed (P=.004), and step length (P<.001) after therapy. However, there were no statistical differences between the 2 treatment groups for any of the outcome variables (P values >.01). Conclusions: Our exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS. (Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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