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Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial [with consumer summary]
Ozgen G, Uzumcugil Karapolat H, Akkoc Y, Yuceyar N
European Journal of Physical and Rehabilitation Medicine 2016 Aug;52(4):466-478
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Balance disorders are among the most common problems encountered by patients diagnosed with multiple sclerosis (MS). AIM: The purpose of this randomized, controlled trial was to investigate the effects of customized vestibular rehabilitation (VR) on balance, functional capacity, quality of life, and depression in patients with MS. DESIGN: This study was designed as a prospective, randomized, controlled trial. SETTING: The study was carried out in a single tertiary referral center. POPULATION: Forty consecutive patients referred with a diagnosis of MS were randomized into two groups: an exercise group (n = 20) and a control group (n = 20). METHODS: The experimental group underwent customized vestibular rehabilitation and the wait-listed control group received the usual medical care. All of the patients were assessed with objective balance tests (Romberg Test, Tandem Romberg Test, Foam Romberg Test, Static Posturography, Six-Meter Walk Test, Five Times Sit-to-Stand Test, Berg Balance Scale, Timed Up and Go Test, Functional Gait Assessment, and Dynamic Gait Index), subjective balance parameters (Activities-Specific Balance Confidence Scale and Dizziness Handicap Inventory), and functional capacity (Six-Minute Walking Test), quality of life (Multiple Sclerosis Quality of Life-54), and depression (Beck Depression Inventory) scales. RESULTS: At the end of the trial, the exercise group exhibited significant changes in most of the evaluated parameters compared to the control group (except the Tandem Romberg with eyes closed and the Foam Romberg, standing with eyes open (p < 0.05)). No significant differences were observed in any of the parameters in the control group (p > 0.05). The intergroup comparisons of differences indicated significant recoveries in favor of the exercise group in all of the evaluated parameters (p < 0.05). CONCLUSION: This study confirms the effects of customized vestibular rehabilitation programs on balance, quality of life, and functional capacity in patients with MS.

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