Improvement in Participant-Perceived Benefits with Long-Term Torso Weighting in Multiple Sclerosis: A Randomized Controlled Trial

Abstract

Background In prior research, people with multiple sclerosis (MS) and gait and balance limitations improved in standing stability, gait parameters, and fatigability after wearing custom-placed balance-based torso-weights (BBTW) for 2-4 hours daily for 2 weeks. Participant-perceived benefits were mixed, perhaps because of short intervention duration. Purpose Examine the effect of torso weights compared to no weights or sham weights over four 4-week periods. Methods Eleven participants with MS experienced all three conditions with the order of sham versus torso-weighted conditions randomized: no weights, torso/sham-weights, sham/torso-weights, torso-weights. Weighting involved applying light (or sham) weights to a vest-like garment in strategic positions to improve reactive response to manual perturbations. Participants and assessors were blinded to active condition. Gait parameters, Sensory Organization Testing (SOT), and self-reported outcome measures were assessed at baseline and after each 1-month period. Self-report measures included the Activities-Specific Balance Confidence Scale (ABC), Movement Ability Measure Computer-Adaptive Test (MAM-CAT), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale (MSWS-12), and the Multiple Sclerosis Impact Scale (MSIS-29). Changes in measures were compared after each time period using one-tailed t-tests with a p-value of 0.10. Results Statistically significant improvements included better scores after torso-weights compared to no weights in current movement ability (MAM-CAT now), MSIS physical and psychological subscales, and stride width. Other measures trended in the expected direction but did not reach significance. Differences between sham and torso-weight conditions did not reach significance. The interaction between weight order and weight condition was significant only for SOT, with larger improvements for the sham-first vs. weight-first group. Discussion Final torso-weighting resulted in participant-perceived benefits over the no-weight condition. Unexpectedly, scores following sham and torso-weighting periods did not differ, perhaps affected by significant baseline differences between the sham-first and weight-first groups despite randomization. Larger samples may clarify participants' benefits from this promising intervention. In prior research, people with multiple sclerosis (MS) and gait and balance limitations improved in standing stability, gait parameters, and fatigability after wearing custom-placed balance-based torso-weights (BBTW) for 2-4 hours daily for 2 weeks. Participant-perceived benefits were mixed, perhaps because of short intervention duration. Examine the effect of torso weights compared to no weights or sham weights over four 4-week periods. Eleven participants with MS experienced all three conditions with the order of sham versus torso-weighted conditions randomized: no weights, torso/sham-weights, sham/torso-weights, torso-weights. Weighting involved applying light (or sham) weights to a vest-like garment in strategic positions to improve reactive response to manual perturbations. Participants and assessors were blinded to active condition. Gait parameters, Sensory Organization Testing (SOT), and self-reported outcome measures were assessed at baseline and after each 1-month period. Self-report measures included the Activities-Specific Balance Confidence Scale (ABC), Movement Ability Measure Computer-Adaptive Test (MAM-CAT), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale (MSWS-12), and the Multiple Sclerosis Impact Scale (MSIS-29). Changes in measures were compared after each time period using one-tailed t-tests with a p-value of 0.10. Statistically significant improvements included better scores after torso-weights compared to no weights in current movement ability (MAM-CAT now), MSIS physical and psychological subscales, and stride width. Other measures trended in the expected direction but did not reach significance. Differences between sham and torso-weight conditions did not reach significance. The interaction between weight order and weight condition was significant only for SOT, with larger improvements for the sham-first vs. weight-first group. Final torso-weighting resulted in participant-perceived benefits over the no-weight condition. Unexpectedly, scores following sham and torso-weighting periods did not differ, perhaps affected by significant baseline differences between the sham-first and weight-first groups despite randomization. Larger samples may clarify participants' benefits from this promising intervention.