Long-term effect of CoDuSe program on balance, fall risk, and gait in patients with multiple sclerosis

Background: Patients with Multiple Sclerosis (MS) frequently suffer from balance and gait difficulties. Objective: This study aims to investigate the long-term effects of a combined Core Stability, Dual-task, and Sensory Exercise (CoDuSe) program and standard exercise routine on balance, fall risk, and gait performance in patients with MS, compared to a standard exercise program alone. Methods: Thirty-nine patients with MS were randomized into a study group (n = 19) that received CoDuSe balance training in addition to a specified exercise program and a control group (n = 20) that received only the specified exercise program. Both groups of patients trained for 8 weeks at 60 min per session, 2 days a week. All patients were evaluated at pretreatment, week 9, week 16, and week 24 following the rehabilitation regimen. The Berg Balance Scale Test (BBST), the Biodex Balance System (BBS; specifically, the Overall Stability Index [OSI]), the timed 25-foot walk test (T25FW), and the 12-item MS walking scale (MSWS-12) were used to assess static and dynamic balance, the fall risk index test, gait speed, and walking ability, respectively. Results: The study group showed significant improvements compared to the control group in all outcome measures (p <.001). BBST scores improved the most in week 16 (ES = 0.66), while OSI and MSWS-12 improved significantly by week 9 (ES = 0.76, 0.34, respectively). T25FW demonstrated notable enhancements in weeks 9 and 16 (ES = 0.33). These findings highlight the sustained benefits of CoDuSe on balance, fall risk, and gait in patients with MS. Conclusion: The CODuSe program, when combined with a standard exercise routine, has a long-lasting effect on balance, fall risk (up to 24 weeks), and gait ability (up to 16 weeks) in patients with MS. Clinical Trial Registration: Iranian Trial Registration (IRCT20210909052421N4).