An intervention to improve balance in persons with multiple sclerosis

摘要

Vestibular rehabilitation is a treatment that is efficacious in treating peripheral vestibular hypofunctioning disorders(1) and improving balance in elderly patients with postural instability.(2) Postural control disorders in multiple sclerosis (MS)(3) may occur from brainstem and cerebellum lesions that disrupt the integration of signals from the visual, somatosensory, and vestibular systems. When any of these systems are impaired (ostensibly as a result of a demyelinating lesion), a patient may experience dizziness, vertigo, or other sensory dysfunction.(4,5) Postural control impairment in MS is also associated with fatigue, which may be a consequence of movement inefficiency and subsequent greater energy expenditure during everyday life tasks.(6-9) The effect of poor balance on cognitive fatigue is less clear; while some have suggested that the compensatory reallocation of cerebral resources needed to maintain balance may result in cognitive fatigue, this theory requires support beyond correlational evidence.