Incorporating Balance, Resistance, and Aerobic Training into Therapy Sessions with a Patient who has MS: A Case Report

Background: Many of the symptoms associated with multiple sclerosis can negatively affect a person’s ability to move and can in turn decrease their overall quality of life. Physical rehabilitation is considered one of the most effective ways to treat mobility deficits in those with multiple sclerosis. Case Description: The patient was a 66 year old woman with multiple sclerosis whose main impairment was general unsteadiness. She had recently experienced a fall which resulted in a left wrist fracture. The patient was referred to physical therapy for gait instability and left wrist pain. Intervention Strategies: The patient underwent three months of physical therapy with focuses initially placed on both static and dynamic balance training as well as wrist treatment. An additional emphasis on strength training and aerobic training were incorporated into the patient’s therapy sessions one month into treatment. Outcome Measures: Main outcome measures collected during this case study included manual muscle testing of the lower extremities, a Berg Balance Scale, a Dynamic Gait Index, and an Activities-specific Balance Confidence Scale. A Twelve Item Multiple Sclerosis Walking Scale, 2 minute walk test, and peak torque values of knee extension and knee flexion were also collected but were unable to be further measured. Discussion: The purpose of this case report was to describe the strategies used to incorporate aerobic, resistance, and balance training into therapy sessions of an individual with MS, and to evaluate the response that the patient had to these interventions. The patient showed clinically significant improvements in both static and dynamic balance. Measurements related to the patient’s strength and endurance were unable to be collected.