Correction of postural impairments in children with relapsing-remitting multiple sclerosis

BACKGROUND: Patients with multiple sclerosis who have multifocal lesions of the central nervous system may present various complaints, including loss of balance. Some postural control disorders are detected already at an early stage of the disease. Solving this problem is critical, as it directly causes falls with subsequent injuries and deteriorating quality of life. The Balance Evaluation Systems Test offers benefits over other postural control assessment tests. It enables more personalized therapy, especially in the context of decreased tolerance to physical exercise in patients.

AIM: To implement the Balance Evaluation Systems Test for a detailed assessment of postural control, identifying the markers to be used for the development of individual physical rehabilitation programs, as well as to assess the effectiveness of this approach.

MATERIALS AND METHODS: This single-center, prospective, continuous, controlled, randomized study involved 38 patients from the pediatric neuropsychiatric department of a Russian children’s clinical hospital (mean age: 13–16 years). All of them had a confirmed diagnosis of relapsing-remitting multiple sclerosis. The patients were examined in the pediatric medical rehabilitation department using the Balance Evaluation Systems Test at the beginning and at the end of a therapeutic exercise course conducted on a daily basis for 10 days. The patients were randomized into two groups, 19 persons each. The control group was offered standard balance exercises; in the experimental group, exercises were selected individually for each patient, considering the identified postural control defects.

RESULTS: The treatment resulted in statistically significant changes for patients both in the control and experimental groups (p <0.001). However, when comparing the results after the exercise course between the groups, the experimental group demonstrated more significant changes in postural control (p <0.001).

CONCLUSION: Therefore, the Balance Evaluation Systems Test helps develop a personalized physical rehabilitation program showing more effective results. This provides patients with an opportunity to improve their functional status and reduce the risk of falls and injuries, while delaying the progression of disability and improving the quality of life.