Balance, Sensory Stimulation Exercises Can Improve MS Symptoms, BEEMS Program Shows

Balance, Sensory Stimulation Exercises Can Improve MS Symptoms, BEEMS Program Shows

A specially tailored program focused on balance and eye-movement exercises can help multiple sclerosis (MS) patients improve balance, dizziness, fatigue, and quality of life, according to a study published in the journal Neurology.

The study is titled “Efficacy of Balance and Eye-Movement Exercises for Persons With Multiple Sclerosis (BEEMS).

Balance impairment is a common symptom in patients with MS, and it can limit mobility and affect the ability to work and perform daily tasks. It is known that balance depends to a degree on sensory systems, including vision. Patients with MS often experience vision problems, which can affect their capacity to correct inappropriate movements. In turn, that can lead to further balance issues.

Despite this known association between sensory systems and balance, most rehabilitation strategies to improve balance and gait currently focus on improving strength and nonspecific balance activities.

A team at the University of Colorado School of Medicine developed an intervention program called “Balance and Eye-Movement Exercises for People With Multiple Sclerosis (BEEMS).” This program is based on visual and sensory stimulation combined with balance and movement exercises.

“Most rehabilitation programs to improve balance have focused mainly on strength exercises and balance exercises that are not designed for the specific problems of people with MS,” Jeffrey R. Hebert, PT, PhD, lead author of the study, said in a news release.

“We wanted to see if performing balance and eye movement exercises while processing multiple different sensory information could help people improve their balance and fatigue issues,” Hebert said.

The study (NCT01698086) enrolled 88 patients with MS who were able to walk 100 meters with no more assistance than a cane or other lateral support.

Half of the patients completed the BEEMS program, which consisted of twice-weekly supervised exercises and a daily home exercise plan for six weeks, followed by eight weeks of once weekly supervised exercise sessions and daily home exercises. The exercises consisted of maintaining balance on different surfaces and while walking, with and without head movement, and visual stimulation to promote visual stability.

Participants assigned to the study’s control group were told they were on a waiting list for the program.

After completion of the initial six weeks of the exercise program, participants showed significant improvements in overall assessments of physical and mental health, compared to baseline levels and the control group.

Balance was also improved in these patients. While healthy individuals taking a computer-based balance test scored around 90 or better out of 100, the scores of MS patients undergoing the BEEMS program improved from an average of 63 at the start of the program to an average of 73 after six weeks. The control group scored an average of 62 at the start of the study and 66 after six weeks.

A second evaluation at week 14 of the program showed that patients continued to show significant improvements in balance, overall physical and mental health, fatigue, and dizziness.

“These findings suggest that vestibular [balance] rehabilitation and eye/head/limb coordination under progressively more challenging conditions should be included in physical interventions,” the researchers wrote.

“The BEEMS protocol could be coupled with a functional training program to further enhance improvements of walking and safe participation in daily physical activity,” the team added.

Additional studies directly comparing the beneficial effects of the BEEMS program to other balance training programs are still required, researchers said.

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19 comments

  1. Betty Beem says:

    In 2016 I was fortunate enough to have PT with a person who had also had training in vestibular rehab. The visual exercises made a significant difference in my visual functioning. My neurologist and both opthamologists were very impressed by the gains I had made. My physical therapist was able to adapt some of the exercises so that they are now an integral part of my violin practice. I continue to do my exercises. For years i had only worn tennis shoes with lots of support as I always felt as if I were going to fall off my feet. With a series of exercises designed for my unique needs, I can now walk around bare footed. Little did I realize this was a vestibular problem. I’m a visual learner and probably over rely on visual cues from my environment to navigate the world. I continue to do vestibular exercises. I also incorporate other textures in my routine to further develop my proprio recption skills. This particular therapist has been so outstanding that I have compiled a collection of exercises she assigned me. I have grouped similar exercises and variations together: core, cardio, balance, vestibular, eye exercises,leg strengthening, arm strengthening, stairs, exercise safety, etc. I have also cross indexed many of the exercises as many involve more than one area of focus.

    • BELINDA J. MATTOS says:

      Betty, can you share any of these vestibular exercises or provide a site for them? I am sure I am not the only one who would appreciate it. Thanks for sharing.

    • Sharilyne says:

      Betty, I would love access to eye exercises. My vision has been very compromised for the last few weeks. Brain MRI showed very, very small tumor on my pituitary gland and inflammation. After swelling recedes (IV STEROIDS for 3 days should help)then eye exercise would improve my ability to read and use computer. Thank you.

    • Pam Johnston says:

      I would love to participate in these exercises.
      I live in Marco island Florida, is there anywhere I could go or a Dr or PT I could talk too.?

      • Peggy Starks says:

        Pam I live in Ft Myers and I go to physical therapists at a place called “Fyzical” – call them at 239-561-5616 to see if there’s anything like it on Marco.

  2. tricia talle says:

    Yes Betty, please point us to a place where we can experience the exercises. Are the visual similar to yoga eye exercises? Thanks.

  3. Zuzana says:

    Using a swing improves body-eye-movement coordination. I fixed my vertigo from last relaps just by swinging for a minute few days a week and spinning on roundabout with kids. Give it a try and be careful at the beginning. But your eyes and brain will learn fast. It works!!!!!!!!!!!!!!!!!

  4. Joe Ford says:

    Betty, like all who wrote before, can you share any of these vestibular exercises or provide a site for them? Thank you.

    Reply

  5. BELINDA J. MATTOS says:

    Everyone: I am wondering if Betty Been might be a “BOT”, as she has not responded. It is also interesting that her last name is also the name in he study. So, I sent a message to a Betty Been on Facebook to verify if she is the same person who posted the comment on vestibular exercises, and I am awaiting a response. If I am wrong, I apologize to you, Betty, but we cannot be too careful in the present internet atmosphere.
    That said, I asked my personal trainer about vestibular exercise, and she directed me to the following web site for additional information. Unbeknownst to me, I’d done a few of these exercises with the trainer. I just did not know they were vestibular.
    Here’s the site. I hope this helps. Thanks.
    http://www.steprightstability.com/vestibular-rehabilitation.html

  6. Virginia Cofer says:

    I’ve had the privilege of incorporating an online MS movement practice a friend introduced me to. Look up ‘The MS Gym’ on Facebook – it is a closed group, you will be accepted and can see all the wonderful videos and wisdom from it’s creator, Trevor Wicken.

  7. Karen says:

    Equine therapy has helped my balance and gait issues immensely. I wish it was studied more to give more awareness to its effectiveness!!

  8. Jennifer Stroman says:

    my PT specializes in vestibular training. she has worked with MS and other Neuro diseases. I’ve only has 1 sessions for eval. She started me on a “homework” program. She says MS or neuro patients need vestibular therapy to improve balance and body movements. My insurance only pays for 26 PT sessions a year so she is trying to get me to where I can do alot on my own and only see her weekly. Feel free to message me on FB Jennifer Stroman

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