EFFECT OF PROGRESSIVE RESISTANCE TRAINING COMBINED WITH NEUROMUSCULAR ELECTRICAL STIMULATION ON BALANCE AND FUNCTIONAL MOBILITY IN INDIVIDUALS WITH MULTIPLE SCLEROSIS: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Abstract

Background
Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder characterized
by inflammation, demyelination, and progressive neurodegeneration within the central
nervous system. Balance impairment, muscle weakness, gait dysfunction, and reduced
functional mobility are among the most disabling manifestations of MS, contributing
substantially to falls, loss of independence, and diminished quality of life. Exercise-based
rehabilitation has emerged as a cornerstone of physiotherapy management, with progressive
resistance training and neuromuscular electrical stimulation (NMES) demonstrating
promising effects on neuromuscular performance. However, evidence describing the isolated
effects of resistance training combined with NMES on balance outcomes in ambulatory
individuals with MS remains limited.
Objective
To evaluate the effectiveness of progressive resistance training combined with
neuromuscular electrical stimulation in improving balance and functional mobility among
ambulatory individuals with multiple sclerosis.
Methods
This secondary analysis utilized data from participants allocated to the resistance training
with NMES arm of a randomized controlled trial conducted in the study instituton.
Ambulatory individuals with clinically diagnosed multiple sclerosis underwent supervised
progressive resistance training combined with NMES. Balance and mobility were evaluated
before and after the intervention using the Berg Balance Scale (BBS), Timed Up and Go
Test (TUG), Functional Reach Test (FRT), and Dynamic Gait Index (DGI). Pre- and post-
intervention scores were analyzed using appropriate statistical tests with statistical
significance set at p < 0.05. The trial and intervention details are derived from your study
protocol.
Results
Participants demonstrated improvements in all clinical outcome measures following the
intervention. Mean Berg Balance Scale scores increased from 44.8 to 50.8, Functional Reach
Test values increased from 22.8 cm to 28.8 cm, Dynamic Gait Index scores improved from
18.2 to 21.2, while Timed Up and Go duration decreased from 15.3 seconds to 11.7 seconds
following treatment. These findings indicate improvements in postural stability, dynamic
balance, gait performance, and functional mobility after progressive resistance training
combined with NMES.
Conclusion
Progressive resistance training combined with neuromuscular electrical stimulation appears
to be an effective physiotherapy intervention for improving balance and functional mobility
in ambulatory individuals with multiple sclerosis. Larger multicentre studies with long-term
follow-up are warranted to confirm these findings.