Proposal of an unstable neuromuscular training protocol for a patient with multiple sclerosis: case-report

Abstract

Introduction: Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system, characterized by demyelination and axonal loss, which often results in motor and sensory impairments associated with balance deficits and falls. Neuromuscular training is a therapeutic strategy that can improve coordination and balance, reducing the risk of falls in these patients. This study aimed to describe the proposal of an intervention protocol with emphasis on unstable neuromuscular training for static and dynamic balance in a patient with MS. Materials and Methods: Case study of a 58-year-old woman with primary progressive MS, with difficulties in maintaining an upright position for prolonged periods, performing squats and walking more than 1 km, due to motor control impairments and postural instability. She was initially assessed using the Berg Balance Scale (BBS), the 12-Item MS Walking Scale (12-MSWS), the Hauser Ambulation Index and the Modified Fatigue Impact Scale (MFIS). She underwent an outpatient regimen for five weeks, with physiotherapy sessions twice a week, each lasting one hour, and final reassessment. Results: An increase of 3 points was observed on the BBS, 11 points on the 12-MSWS, 1 level on the Hauser Ambulation Index and 19 points on the MFIS. Conclusion: The results suggest that unstable neuromuscular training may be effective in improving balance and mobility in people with MS. However, studies with larger samples and long-term follow-ups are needed.