Effects of spinal stabilization and local vibration on postural control in people with ataxic multiple sclerosis: An assessor-blind, randomized controlled pilot trial

Abstract

Objectives: To evaluate the effects of spinal stabilization training (SST) combined with local vibration (LV) on postural control and to explore potential differences between LV application areas in people with ataxic multiple sclerosis (MS). Design: Randomized controlled, assessor-blind pilot trial with three parallel groups. Setting: Neurorehabilitation outpatient clinic. Participants: Thirty people with MS and clinical signs of ataxia who were ambulatory were randomly allocated to three parallel groups. Intervention: All participants received SST three times per week for 8 weeks. Two intervention groups received additional LV applied either to the gastrosoleus muscles or to the paraspinal muscles. The third group received only SST without vibration. Main outcome and Measures: The primary outcome was balance performance measured by the Berg Balance Scale (BBS). Secondary outcomes included limits of stability, postural sways, ataxia severity, core endurance, and spatiotemporal gait parameters. Results: All groups showed significant improvements in postural control measures (p < 0.05). Paraspinal LV was accompanied by greater improvements in balance performance, as indicated by greater increases in BBS compared to Gastrosoleus LV (p < 0.05). Gastrosoleus LV was accompanied by changes in mobility-related parameters, including improved step length, movement velocity, and reduced gait variability (p < 0.05). Conclusion: SST appears to improve postural control in people with ataxic MS. The addition of LV may further enhance specific balance and gait parameters, with benefits varying by application site. This multimodal approach may offer clinically relevant guidance for optimizing individualized rehabilitation strategies in this population.