Effects of motor-motor and motor-cognitive tasks on balance in patients with multiple sclerosis.

Background: Dual tasking is frequently impaired in Multiple Sclerosis (MS), substantially impairing quality of life (QoL). We aimed to examine the effects of motor-motor and motor-cognitive tasks on balance in highly mobile patients with relapsing-remitting MS (RRMS), with mild disability.

Methods: Thirty-eight patients and 34 controls were included. Steady Stance Test (SST), Berg Balance Scale (BBS) and Activities-specific Balance Confidence Scale (ABC) were used to evaluate the balance. Expanded Disability Status Scale (EDSS), Mini-mental State Examination (MMSE), Beck Depression Inventory (BDI) and Fatigue Impact Scale (FIS) were used to evaluate disability, cognitive impairment, depression and fatigue, respectively.

Results: BBS and ABC scores were significantly different between the groups. Also, balance was significantly impaired in patients. Eyes-open left single stance test was the most efficient test to reveal the balance impairment in RRMS patients independent of dual-task. Physical component of FIS affected this test independent of age and BMI. Visual input significantly increased the stance durations in majority of SST, especially in tough stance positions with reduced balance area. However, visual input during dual-tasking impaired the balance. In addition, eyes-closed left tandem stance test with MM dual task significantly improved the balance in patients. BBS was significantly correlated with EDSS(r: -0.336), ABC(r: 0.688), FIS physical subgroup(r: -0.614) and FIS social subgroup(r: -0.475).

Conclusion: Dual-tasking improves balance and increases QoL in patients with RRMS. Eyes closed balance treatment with motor-dual task could be beneficial.