Researchers study weighted vests for stability in MS

[ActiveMSers]

Physiotherapy Research International

Changes in standing stability with balance‐based torso‐weighting with cerebellar ataxia: A pilot study

Gail L. Widener Nicole Conley Sarah Whiteford Jason Gee Anthony Harrell Cynthia Gibson‐Horn Valerie Block Diane D. Allen
First published: 20 November 2019 https://doi.org/10.1002/pri.1814

Abstract

Objectives
People with cerebellar ataxia have few options to improve the standing stability they need for function. Strategic placement of light weights on the torso using the balance‐based torso‐weighting (BBTW) method has improved stability and reduced falls in people with multiple sclerosis, but has not been tested in cerebellar ataxia. We examined whether torso‐weighting increased standing stability and/or functional movement in people with cerebellar ataxia.

Methods
Ten people with cerebellar ataxia and 10 matched controls participated in this single‐session quasi‐experimental pilot study. People with ataxia performed the Scale for the Assessment and Rating of Ataxia (SARA) prior to clinical testing. All participants donned inertial sensors that recorded postural sway; stopwatches recorded duration for standing and mobility tasks. All participants stood for up to 30 s on firm and foam surfaces with eyes open then eyes closed, and performed the Timed Up and Go (TUG) test. Light weights (0.57–1.25 kg) were strategically applied to a vest‐like garment. Paired t tests compared within‐group differences with and without BBTW weights. Independent t tests assessed differences from controls. All t tests were one‐tailed with alpha set at .05.

Results
Duration of standing for people with ataxia was significantly longer with weighting (p = .004); all controls stood for the maximum time of 120 s with and without weights. More severe ataxia according to SARA was moderately correlated with greater improvement in standing duration with BBTW (Pearson r = .54). Tasks with more sensory challenges (eyes closed, standing on firm surface) showed less body sway with weighting. Duration for the TUG was unchanged by torso‐weighting in people with ataxia.

Conclusion
Strategic weighting improved standing stability but not movement speed in people with ataxia. BBTW has potential for improving stability and response to challenging sensory conditions in this population. Future studies should further examine gait stability measures along with movement speed.

FULL ARTICLE (FREE):
https://onlinelibrary.wiley.com/doi/....1002/pri.1814

[ActiveMSers]

A Combination of Core Exercise and Balance-Based Torso Weighting for Women with Multiple Sclerosis

Source: International Journal of MS Care . 2020, Vol. 22 Issue S2, p73-74. 2p.
Author(s): Stephenson, Jeannie B.; Haladay, Douglas E.; Carey, Stephanie L.; Beckstead, Jason W.; Robertson, Derrick

Abstract:

Background: Multiple sclerosis (MS) is a neurodegenerative disease that often results in fatigue and balance and walking impairment. Core exercise has been shown to reduce fatigue and improve balance and walking in people with MS. However, no studies have investigated the effects of a combination of core exercise and balance-based torso weighting (BBTW).

Objectives: The purpose of this study was to investigate whether the combination of BBTW plus core exercise leads to greater improvement in self-reports of fatigue, balance confidence, and walking ability compared to core exercise alone in women with MS. Methods: Eighteen women with MS (Expanded Disability Status Scale score 3.0-5.0) were randomly assigned to 1 of 2 groups: core exercise (CE) or BBTW plus core exercise (BBTW + CE). Subjects completed 3 questionnaires at baseline and after a 6-week intervention period: Modified Fatigue Impact Scale (MFIS), Activities-Specific Balance Confidence Scale (ABC Scale), and the MS Walking Scale (MSWS-12). All subjects participated in a Pilates-based CE program once a week with a physical therapist along with a daily home exercise program. In addition to the CE, 1 group also participated in the BBTW protocol. This involved fitting subjects with a vest worn on the torso and application of small weights to the vest at baseline followed by biweekly sessions to adjust weights and gradually increase wearing time up to 6 hours daily.

Results: Following the 6-week intervention period, both groups demonstrated positive change indicating improvements in self-reported fatigue, balance confi- dence, and walking ability. The percent change for each measure was as follows: MFIS: CE group = 14.1% decrease, BBTW + CE group = 19.9% decrease; ABC Scale: CE group = 9.7% increase, BBTW + CE group 15.6% increase; and MSWS-12: CE group: 11.9% decrease, BBTW + CE group = 19.3% decrease. Despite these improvements, none of the change in scores exceeded the MDC95 estimates for each measure (MFIS = 49%, ABC = 20%, MSWS-12 = 53%).

Conclusions: Core exercise with or without BBTW led to decreased self-perceived fatigue and improved balance confidence and walking ability, however, the percent change for both groups did not exceed MDC95 estimates. The percent change in perceived fatigue, balance, and walking was greater in the BBTW + CE group. The balance wear vest may provide individuals with added truncal proprioceptive input and recruitment of core stabilizers, however, the mechanism of improvement needs to be further investigated.