Balance, eye exercises may help multiple sclerosis patients feel steady

People with multiple sclerosis who do balance and eye movement exercises may feel steadier on their feet and experience less fatigue and dizziness, a small trial suggests.

Multiple sclerosis (MS) is a rare, disabling autoimmune disease that damages the central nervous system. It can lead to fatigue, pain, vision loss and impaired coordination and motor skills.

For the current study, researchers focused on 88 adults with MS who were able to walk 100 meters assisted with a cane if necessary. Half of them were randomly selected to participate in a supervised exercise program, while the rest were put on a waiting list.

At the start of the study, researchers gave all of the participants computer-based balance tests. None of the participants approached scores of 90 out of 100 that are typical for healthy adults without balance issues.

After six weeks, however, average scores rose more for the exercise group. While both groups started with scores around 62-63, those in the exercise group rose to an average of 73, compared with an increase to 66 in the other group.

“It is possible that disability due to MS can be improved or the accumulation of disability lessened by participation in exercise such as (this) program; however, additional research in this area is needed,” said lead study author Jeffrey Hebert of the University of Colorado School of Medicine in Denver.

“The . . . program is most generalizable to ambulatory patients with MS who have some limitations related to balance and fatigue,” Hebert said by email.

In the exercise group, people completed supervised exercises twice a week and received instructions to exercise daily at home for the first six weeks. Then, for the next eight weeks, they got one supervised workout a week plus daily exercises to do at home.

Exercises included balancing on different surfaces and while walking, both with and without head movements and eyes open and closed, as well as eye movement exercises to help improve visual stability.

For the exercise group, the benefits persisted even when they cut back to supervised workouts just once a week. By the end of the study, they had average balance test scores of 75, compared with 65 in the control group.

The people who did the exercises also saw greater improvements in their fatigue and dizziness test scores than the other group.

In addition, researchers found that patients in the exercise group who had lesions in brain regions that are important to balance and eye movement control had greater improvements in balance than people without these lesions.

It’s possible that this finding was due to chance, however, because the study was too small to detect statistically meaningful differences among people within the exercise group, researchers note in Neurology.

Even so, the results suggest that all patients with MS who are able to complete these exercises might benefit, said Susan Bennett, co-author of an accompanying editorial and a researcher at the University at Buffalo in New York.

“Any person experiencing imbalance whether related to MS, inner ear disorder, brainstem injury, weakness or sensory loss in the legs will experience fatigue as the brain has to work harder to process limited information or inaccurate information to maintain an upright posture in standing and during walking,” Bennett said by email.

The study results suggest that with a supervised exercise program, “the majority of people with MS could have an improvement in their balance, which would then reduce fall risk in this population,” Bennett added.