Center-based group and home-based individual exercise programs have similar impacts on gait and balance in people with multiple sclerosis : A randomized trial

Background
Group and home-based exercises to improve function in people with multiple sclerosis (MS) are common but have little underpinning evidence.

Objective
To determine the comparative effectiveness of a center-based group versus home-based individual 8-week exercise program to improve gait and balance in people with MS.

Design
Prospective, randomized controlled trial.

Setting
Community center-based and home-based exercise program.

Participants
Fifty people with MS were randomized and completed allocated intervention (n = 26 center, n = 24 home), 47 completed post-assessment and 44 follow-up assessment.

Methods
The center- and home-based groups completed an 8-week progressive functional and balance training exercise program. The center-based groups of four to six were supervised by a physiotherapist. The home-based group was provided with telephone support.

Main Outcome Measurements
The primary outcome was gait speed (10-meter walk test). Secondary outcomes were gait endurance (6-minute walk test) and balance (Berg Balance Scale). Outcome assessments were conducted at baseline, immediately postintervention and at 8-week follow-up.

Results
There was no statistically significant difference between groups in gait speed post training, with a mean difference of 0.01 m/s, 95% CI −0.36 to 0.37. There were no group effects, time effects, or interactions for gait speed, endurance, or balance. In both groups, gait speed improved to a level that met minimal clinically important differences.

Conclusions
Gait speed, endurance, and balance did not statistically improve in either group; however, gait speed changes met minimally important differences.