Sensory integration balance training in patients with multiple sclerosis

February 21, 2015

There is increasing evidence that impairment of the sensory system in multiple sclerosis contributes to balance and gait disorders. The majority of the disruption of sensation comes from spinal cord lesions. MS spinal lesions have a propensity to affect the posterior portion of the spinal cord. This involves the Posterior column-medial lemniscus pathway (PCML) (also known as the dorsal column-medial lemniscus pathway) that conveys localized sensations of fine touch, vibration, two-point discrimination, and proprioception (position sense) from the skin and joints. It transmits information from the body to the postcentral gyrus of the cerebral cortex (brain).

A recent research article, “Sensory integration balance training in patients with multiple sclerosis: A randomized, controlled trial”, highlights that rehabilitation targeted to this issue may help:

Visual, somatosensory, and vestibular (inner ear) components are integral to maintenance of balance as well as the process of integrating this information. This group wished to focus rehabilitation on central processing deficits. They compared the effects of sensory integration balance training against conventional rehabilitation on balance disorders in a large sample of patients with MS. Both groups of approximately 40 patients underwent individualized treatments with a physical therapist for 50 minutes/day, three days/week for five weeks at the gym of the Neurological Rehabilitation Unit (AOUI Verona). Sessions consisted of graded exercises with three levels of difficulty (changed the surface of what patients stood upon) repeated under three different sensory conditions (taking away visual input). The patients underwent various balance and gait tests during the sessions and at one month follow up. Results show that, as compared with the conventional training, the training performed under different sensory conditions may produce greater improvement in MS patients and for at least one month post-treatment.