Balance Improves with Exercise in Patients with Multiple Sclerosis

Specific exercises may help to improve balance for patients with multiple sclerosis (MS), according to a new study published by Neurology.
Patients with MS may experience a host of adverse events that correlate with the part of the nervous system damaged. Patients may experience balance and movement issues related to damage of the cerebellum and brainstem, which control signals from systems of the body including sensory, visual, and inner ear. This damage may cause patients to fall and injure themselves.
In the new study, the authors explored the efficacy of a vestibular rehabilitation program called Balance and Eye-Movement Exercises for People with MS (BEEMS).
Included in the trial were 88 patients with MS who were able to walk 100 meters using a walking device. Patients underwent assessments that quantified balance, fatigue, cognition, dizziness, and quality of life. Neurologists evaluated MRI scans to determine disease activity in the cerebellum or brainstem.
Patients were randomized into 1 of 2 cohorts: one group completed supervised exercises twice per week and were given instructions to exercise every day at home for 6 weeks. These individuals then completed 1 supervised exercise session plus daily exercises at home for 8 weeks. The second group was placed on a waiting list.
The BEEMS program included activities such as balancing on different surfaces, walking with and without head movements and with eyes open and closed, and eye movement exercises.
The authors noted that the assessment at 6 weeks showed that patients in the BEEMS cohort had significantly improved measures of balance compared with patients in the control group, according to the study.
Additionally, patients in the exercise group had improvements in fatigue, cognition, dizziness, and quality of life.
These improvements were found to persist through 14 weeks, according to the study.
The authors found that the improvements at 6 weeks were even more profound among BEEMS patients who previously had MS-related damage to the cerebellum or brainstem; however, these results did not remain true at 14 weeks, according to the study.
“BEEMS improved multiple outcomes regardless of whether brainstem/cerebellar lesions were present, supporting the generalizability of BEEMS for ambulatory people with MS who have at least minimally impaired balance and fatigue,” the authors wrote.
The researchers plan to confirm the benefits of the BEEMS study for patients with MS. Further studies should also determine how long the improvements last and the requirement of supervised exercise, according to the study. The authors hypothesize that telehealth platforms may be able to provide a cost-effective, long-term solution for delivering the program.
The authors concluded that patients who wish to start balance and eye movement exercises should consult with their physician. 

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