Comparison of the effects of vestibular exercise and cervical stabilization exercise training on balance and gait in multiple sclerosis patients

This study was planned to investigate the Comparison of the Effects of Vestibular Exercise and Cervical Stabilization Exercise Training on Balance and Gait in Multiple Sclerosis Patients. 35 Multiple Sclerosis (MS) patients included in the study were divided into three groups by a simple random method. Conventional treatment (electrical stimulation of lower extremity proximal muscles, tens, and muscle strengthening exercises) was given to all groups. Catwhorne-Cooksey exercises were applied to the vestibular group, cervical stabilization exercises to the cervical group, and classical balance exercises to the control group 3 days a week for 12 weeks. The groups were evaluated 4 times: before the treatment, at the 8th week, at the 12th week (the end of the treatment), and at the 6th month. Balance was evaluated the tandem stance test, functional reach test, and four-step square test. Walk was evaluated with the 25-step walk test, the 2-minute walk test, the timed up and go test, and the MS Walking Scale (MSYS-12). Tiredness was evaluated with the fatigue impact scale, dizziness was evaluated with the disability inventory, and depression was evaluated with the Beck Depression Inventory. MS Quality of Life Questionnaire (MSQOL-54) was used for quality of life assessment. Postural sway was evaluated with the Microgate GYKO device. In the left tandem, right tandem, and functional reach test measurement results, improvements were observed in the cervical and vestibular groups at the 8th week and 12th week evaluations, while improvements were observed only in the vestibular group in the 6th month evaluations. In the four-step square test results, improvements were observed in the vestibular group at the 6th month evaluation (p<0.05). In the gait assessment, improvements were observed in the cervical group at the 8th and 12th weeks in the 25-step walking test, while improvements were observed in the cervical and vestibular groups in the 6th month assessments (p<0.05). In the 2-minute walking test, only the cervical group improved at the 8th and 12th weeks (p<0.05). There was no change in the MS gait scale (MSYS-12) with the timed up and go test (p>0.05). In the fatigue effect scale, the vestibular group showed improvements compared to the other groups at the 6th month evaluation (p<0.05). İn the dizziness disability inventory, the vestibular group improved compared to the other groups (p<0.05). İn the Beck depression inventory, the control group showed improvement compared to the other groups (p<0.05). There was no change in quality of life parameters (p>0.05).Anterior- posterior distance in postural sway was similar in groups (p>0.05). in Antero-Posterior length measurements, and in the 12th week and 6th month evaluations, the control group was better than the vestibular and cervical groups (p<0.05). In Medio-Lateral distance measurements, cervical group was better than vestibular and control groups in the 8th week evaluations (p<0.05). Medio-Lateral length measurements before treatment, 8th and 12th weeks were better in the control group than in the vestibular group (p<0.05). In the 12th week evaluations, the control group was better than the vestibular and cervical groups (p<0.05). Mean distance measurements were better in the pre-treatment control group than the vestibular group (p<0.05) and similar to the cervical group (p>0.05). At the 8th week evaluation, the cervical and control groups were better than the vestibular group (p<0.05). In the 6th month evaluations, the control group was better than the vestibular and cervical groups (p<0.05). In the comparison of mean length measurements between the groups at all times, the control group was better than the vestibular and cervical groups (p<0.05). In the surface area measurements, the control group was better than the vestibular group in the 6th month evaluations of the control group. (p<0.05). In patients with Multiple Sclerosis, vestibular exercises for balance and fatigue complaints, cervical stabilization exercises for walking, and classical balance exercises for postural sway complaints provide a holistic approach with conventional treatment and may increase the effect of the intervention. Keywords: Multiple Sclerosis, Balance, Walking, Fatigue, Exercise