Affiliations: [a] Graduate Program in Physical Therapy, University of California San Francisco/San Francisco State University, San Francisco, CA, USA
| [b]
Department of Physical Therapy, Samuel Merritt University, Oakland, CA, USA
Correspondence:
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Corresponding author: Diane D. Allen, 1600 Holloway Avenue, San Francisco, CA 94132, USA. E-mail: [email protected]; ORCID: 0000-0003-1164-391X.
Abstract: BACKGROUND:Balance-based torso-weighting has improved gait and balance performance in people with multiple sclerosis (MS) in a single session with torso-weights on, demonstrating an orthotic effect. Daily use of torso-weighting may promote motor learning and more enduring therapeutic effects but has not yet been studied. PURPOSE:Confirm orthotic effects and compare therapeutic effects of daily torso-weighting versus shape/sham-weighting or no weighting. We hypothesized that daily torso-weighting would result in positive effects on gait and balance, tested without weights. METHODS:Five participants with MS experienced three conditions for 2-4 weeks each: no weights first, then double-blinded randomization to torso-weighting or shape-weighting first then cross-over to the alternate condition. Personalized torso-weighting on a vest-like garment countered individual reactive balance responses following manual perturbations. Postural sway recorded orthotic effects with/without torso-weights while standing on a force plate with eyes open/closed. Clinical measures recorded therapeutic effects while unweighted: gait parameters, 6-Minute Walk Test (6MWT), and Sensory Organization Test (SOT). Weighting conditions were compared using paired t-tests with one-tailed alpha at 0.05. RESULTS:Postural sway decreased significantly with torso-weights. Cadence and step width improved significantly after torso-weighting versus shape-weight periods. Average gait parameters showed no improvement after shape-weight periods. Velocity, 6MWT, and SOT tended to improve with torso-weighting, averaging improvements of+15%,+16%, and+13.8%, respectively. CONCLUSIONS:Findings support both orthotic and therapeutic effects of torso-weighting. Daily use of torso-weights for multiple weeks may promote motor learning of gait parameters and balance. Further research is warranted to examine sensory augmentation as a potential mechanism.
Keywords: Postural control, gait, multiple sclerosis, rehabilitation, motor learning, torso-weighting
