Effects of Perturbation Training on Balance, Walking, and Lumbar Stabilization in Patients with Multiple Sclerosis: A Pilot Study

Objective: To investigate the effect of perturbation training (PT) on balance, walking, and lumbar stabilization in patients with multiple sclerosis. Methods: Ten patients were given manual PT twice a week for 6 weeks. Romberg (RT), Sharpened Romberg (SR), and single leg stance test (SLST) were performed for static balance. Dynamic balance was assessed with functional reach test (FRT), lateral reach test [dominant (LRT-D) and non-dominant (LFR-ND)], and four square step test (FSST). The Falls Efficacy Scale International (FES-I) was used to evaluate the fear of falling. Timed up and go (TUG) test and pressure biofeedback stabilization were used to assess the functional mobility and lumbar stabilization. Results: The results of SR and SLST were significantly increased after the treatment (p<0.05). However, the RT duration had no differences between pre and post-treatments (p>0.05). Significant differences were found in the values of FRT and LRT-ND. The results of LRT-D and FSST were not changed with the treatment. The fear of falling decreased after the treatment but was not statistically significant (p>0.05). After the treatment, the TUG duration improved in participants (p=0.01). No difference was found in the PBS duration between the pre and post-treatment (p>0.05). Conclusion: This study revealed that manual PT without computerized systems in the clinic may improve static and dynamic balance, walking, and fear of falling. Additionally, the effect of PT on lumbar stabilization in MS was not determined in our study. Major conclusions were limited by the small sample size; however, the observed results may contribute to designing future trials.