Effects of dual-task balance training on postural performance in patients with Multiple Sclerosis: a double-blind, randomized controlled pilot trial

Objective: To investigate the effects of dual-task balance training on postural performance in patients with multiple sclerosis as compared with single-task balance training. Design: Double-blind, pretest-posttest, randomized controlled pilot trial. Setting: Local Multiple Sclerosis Society. Subjects: A total of 47 patients were randomly assigned to two equal groups labeled as single-task training and dual-task training groups. Interventions: All patients received supervised balance training sessions, 3 times per week for 4 weeks. The patients in the single-task group performed balance activities, alone. However, patients in dual-task group practiced balance activities while simultaneously performing cognitive tasks. Main measures: The 10-Meter Walk Test and Timed Up-and-Go under single-task and dual-task conditions, in addition to Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment were assessed pre-, and post intervention and also 6-weeks after the end of intervention. Results: Only 38 patients completed the treatment plan. There was no difference in the amount of improvement seen between the two study groups. In both groups there was a significant effect of time for dual-10 Meter Walk Test (F-1,F- 36=11.33, p=0.002) and dual-Timed Up-and-Go (F-1,F- 36=14.27, p=0.001) but not for their single-tasks. Moreover, there was a significant effect of time for Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment (P<0.01). Conclusions: This pilot study did not show more benefits from undertaking dual-task training than single-task training. A power analysis showed 71 patients per group would be needed to determine whether there was a clinically relevant difference for dual-task gait speed between the groups.