Reflex Locomotion Therapy for Balance, Gait, and Fatigue Rehabilitation in Subjects with Multiple Sclerosis.

María Carratalá-Tejada,Alicia Cuesta-Gómez,Rosa Ortiz-Gutiérrez,Francisco Molina-Rueda,Laura Luna-Oliva,Juan Carlos Miangolarra-Page

doi:10.3390/jcm11030567

Abstract

This study evaluates the effects of a rehabilitation program based on reflex locomotion therapy (RLT) on balance, gait, and fatigue in patients with multiple sclerosis (MS). Twenty-three patients diagnosed with MS participated in this study. Reversal design was carried out. The assessment tools included the Berg Balance Scale (BBS), the Performance Oriented Mobility Assessment (POMA), the Fatigue Severity Scale (FSS) and the instrumental analysis of the gait recorded by Vicon Motion System®. We analyzed spatio-temporal parameters and kinematic variables of the hip, knee, and ankle joints. Additionally, the Client Satisfaction Questionnaire (CSQ-8) was administrated. We did find a significant improvement in balance and gait tools after the RLT period. Regarding instrumental analysis, the statistical analysis of spatio-temporal parameters showed a significant improvement in stride length, double support, and velocity after the RLT period. Concerning kinematic parameters, the analysis showed improvements in hip and knee range of motion (ROM) after RLT period. RLT could improve gait and balance in patients with MS. The patients reported a high level of satisfaction with the therapy received.

Highlights

Multiple sclerosis (MS) is a progressive disease with a fluctuating and unpredictable course
We excluded subjects who over the previous six months and during the research had suffered a worsening of symptoms, had required hospitalization, corticoid therapy, either intravenous or oral, botulinum toxin, or experienced any other situation that could potentially hamper their participation in the study
The sample comprised a total of 23 patients (EDSS between 4 and 6), of whom 27 were initially assessed

Summary

Introduction

Multiple sclerosis (MS) is a progressive disease with a fluctuating and unpredictable course. The disease is characterized by the accumulative effect of multiple injuries at numerous levels. These variables depend on each patient and their stage of the disease. MS can cause sensory (40%), pyramidal (40%), cerebellar (25%), and visual symptoms (20%) [2]. The level of disability is scored using the Expanded Disability Status Scale (EDSS), a useful scale for measuring neurological disability (pyramidal, cerebellar, brainstem, sensory, bowel, bladder, visual, and cerebral functions) [4]. It is considered that a certain level of recovery regarding these disorders is associated with an overall improvement in the functional autonomy and quality of life [5]

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