Effects of vestibular rehabilitation on MS-related fatigue: Randomized control trial

Fatigue and impaired balance (upright postural control) are the most common symptoms reported in the Multiple Sclerosis (MS) population. Traditional rehabilitation treatment approaches have limited support for treatment of MS-related fatigue. Balance training has been reported to improve upright postural control in the MS population. Investigation of the possible cause and effect relationship between improvement in upright postural control and resultant improvement in self-reported fatigue has not been tested. Purpose. To assess the influence a novel rehabilitation program has on upright postural control and self-report fatigue in patients with MS. Design. 14-week single blinded, Randomized Control Trial. Methods. Thirty patients with confirmed diagnosis of MS were randomly allocated into one of three groups: Experimental, Exercise Control and Control. Subjects in the Experimental and Exercise Control Groups underwent a 6-week, 12-session Intervention Phase followed by a 4-week Follow-up Phase. The Experimental Group received balance and eye movement training (vestibular rehabilitation) and the Exercise Control received standard rehabilitation care. Both groups received energy conservation education. The Control Group received no intervention during the 14 weeks. Results. Within-group analyses of the Experimental Group showed significant improvement in upright postural control and fatigue. The Experimental Group had significantly greater improvement in upright postural control and fatigue than the other groups. Conclusion. This study supports the effectiveness of Vestibular Rehabilitation for the treatment of impaired upright postural control and fatigue in patients with MS. This approach to treatment resulted in clinically meaningful improvements in upright postural control and fatigue. Importance. The results of this study demonstrate the effectiveness of Vestibular Rehabilitation in the MS population, and perhaps other disorders that involve upright postural control and fatigue complaints.