Rehabilitation to Improve Gaze and Postural Stability in People With Multiple Sclerosis: A Randomized Clinical Trial.
Brian J Loyd, Annie Fangman, Daniel S Peterson and 4 others
PMID 36113117WHAT IT FOUND
Neither vestibular gaze training nor standard strength and aerobic exercise was superior for reducing dizziness in people with MS.
Both groups improved significantly and maintained gains at 10 weeks. Choose the exercise type based on patient preference and accessibility.
Key findings
01There was no statistically significant difference between the vestibular training group and the strength/aerobic exercise group in the primary outcome (Dizziness Handicap Inventory) at 6 weeks.
02Both groups showed significant improvements in dizziness, balance confidence, and gait assessment scores from baseline to 6 weeks.
03Improvements in dizziness and balance measures were generally maintained at the 10-week follow-up for both groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used an active control group (SAE) rather than a no-treatment control, so it cannot determine if either exercise program is better than doing nothing. The sample size was small (n=41), which may have limited the ability to detect subtle differences between groups. There was substantial heterogeneity in the MS population, which may have masked potential benefits for specific subgroups. Daily physical activity levels and prior function were not measured, so it is unclear if outside activity influenced results.
Declared interests
The study was funded by the National Multiple Sclerosis Society, which had no role in the design, conduct, analysis, or writing of the study. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the lack of difference between groups as evidence that exercise does not work. Both groups improved significantly. The null finding means that specialized vestibular training is not superior to standard strength and aerobic exercise for these outcomes, not that neither is effective.