Enhancement of balance, and mobility in individuals with multiple sclerosis using visual cue guided multidirectional step training - A pilot study.

BACKGROUND Individuals with multiple sclerosis (MS) often experience limitations in mobility due to impairment of gait and balance. Rehabilitation approaches to improve balance and mobility in individuals with MS are limited. We have developed a novel visual cue guided multi-direction step (MDS) training method to improve balance and mobility in individuals with MS. OBJECTIVE To examine the effect of MDS training on balance, gait, and mobility in individuals with MS. METHODS Five individuals with relapsing- remitting MS participated in the 4-week training involving stepping in eight directions in response to a visual cue. Balance, gait, and mobility were assessed before and after training. RESULTS Training related improvements were seen in the limits of stability (p< .05), spatial and temporal gait parameters (p<.05), and performance of the Tinetti Mobility Assessment (p=.001), 10-Meter Walk test (p<.001), and Four-Square Step test (p<.002). CONCLUSION Balance, gait, and mobility in individuals with MS could be improved after 4 weeks of visual cue guided multi-direction stepping training. Outcomes from this feasibility study could help to refocus conventional rehabilitation strategies aimed at aiding individuals with MS to achieve maximal independence in mobility.