Masters Thesis

Effects of aquatic exercise on balance outcomes in individuals with multiple sclerosis

Balance deficiencies are common amongst individuals with Multiple Sclerosis (MS). Poor balance may lead to decreased physical activity and increased risk of injury through falls. Aquatic exercise has been shown to improve balance in individuals with MS. This study aims to objectively investigate the effects of aquatic exercise on balance outcomes in individuals with MS. Methods: 12 participants with MS were recruited and randomly assigned to either the intervention (aquatic exercise) or control group. The intervention group received 50-minutes aquatic exercise, twice a week for 10 weeks. Each session included a warm-up, balance, gait and strength training, and cool-down. Biomechanical balance tests were administered on a computerized posturographic equipment. Balance outcomes were measured twice, pre- and post-intervention, for both groups including: The Sensory Organization Test (SOT), Motor Control Test (MCT), Adaptation Test (ADT), Sit-to-Stand (STS) and Step-Up/Over (SUO). Secondary outcome measurements of pain and fatigue were measured through the Brief Pain Inventory (BPI) and the Modified Fatigue Impact Scale (MFIS). For statistical analysis, mixed model ANOVA was used for between-group comparison. A paired t-test and effect size calculations were used for within-group comparison, Results: In between-group comparison, no significant group interaction was found for any outcome measures. In within-group comparison, no significant improvements were found for either group. However, the positive trend for the STS (weight transfer time) d=0.52, SUO (impact index) d=0.46, ADT (sway energy) d=0.42, SOT (equilibrium score) d=0.55, BPI d=0.40 and MFIS d=0.53 were found to be clinically meaningful in the aquatic group. Conclusion: Balance, pain and fatigue showed trends of improvement in individuals with MS following a 10-week aquatic exercise program. Aquatic exercise may provide an effective therapeutic option. This study outcome with aid clinicians, rehabilitators, and researchers when developing aquatic interventions for individuals with MS.

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