Internet-based home training is capable to improve balance in multiple sclerosis: a randomized controlled trial

Abstract

Background: Balance disorders are common in multiple sclerosis.

Aim: Aim of the study is to investigate the effectiveness of an Internet-based home training program (e-Training) to improve balance in patients with multiple sclerosis.

Design: A randomized, controlled study.

Setting: Academic teaching hospital in cooperation with the therapeutic riding center Gut Üttingshof, Bad Mergentheim.

Population: Eighteen multiple sclerosis patients (mean EDSS 3,5) took part in the trial. Outcome of patients using e-Training (N.=9) was compared to the outcome of patients receiving hippotherapy (N.=9), which can be considered as an advanced concept for the improvement of balance and postural control in multiple sclerosis.

Methods: After simple random allocation patients received hippotherapy or Internet-based home training (balance, postural control and strength training) twice a week for 12 weeks. Assessments were done before and after the intervention and included static and dynamic balance (primary outcome). Isometric muscle strength of the knee and trunk extension/flexion (dynamometer), walking capacity, fatigue and quality of life served as secondary outcome parameters.

Results: Both intervention groups showed comparable and highly significant improvement in static and dynamic balance capacity, no difference was seen between the both intervention groups. However looking at fatigue and quality of life only the group receiving hippotherapy improved significantly.

Conclusion: Since e-Training shows even comparable effects to hippotherapy to improve balance, we believe that the established Internet-based home training program, specialized on balance and postural control training, is feasible for a balance and strength training in persons with multiple sclerosis.

Clinical rehabilitation impact: We demonstrated that Internet-based home training is possible in patients with multiple sclerosis.