Home Based Functional Balance Intervention (FBI) for Physical and Cognitive Symptoms of Multiple Sclerosis
Aims: Aim 1: Examine the effect of the FBI (Intervention Group) on physical function in PwMS compared to a stretching program (Control Group). Hypothesis 1: After four months of training, the FBI group will show significantly greater improvements in physical function compared to the stretching group. Aim 2: Examine the effect of the multicomponent FBI on cognitive function in PwMS compared to the stretching program. Hypothesis 2: After four months of training, the FBI group will show significantly greater improvements in cognitive function compared to the stretching group. Aim 3: Examine the effects of the multicomponent FBI compared to the Control Group among PwMS on measures of daily living (dual-task performance, balance confidence, community mobility, and quality of life). Hypothesis 3: After four months of training, the FBI group will show significantly greater improvements in measures of daily living compared to the stretching group. All assessment sessions will be conducted virtually via Zoom. All measures collected during the initial screening, pre-training assessment, training progression, and mid- and post-training assessment sessions will be administered either via Zoom with a Helper Buddy present or through survey links sent to participants via the UIC REDCap system. The training sessions will be performed independently by the participants in the presence of a Helper Buddy. The investigators will recruit 75 people with multiple sclerosis (PwMS) for this study. Eligible participants will be randomized to either the FBI (Intervention) or stretching (Control) group, followed by an onboarding session with a designated Helper Buddy. Training will occur twice weekly for four months. Based on the anticipated attrition rate, the investigators aim for 40 PwMS to complete the post-training assessments and finish the study.
‣ Telephone Screening Inclusion Criteria:
• Age 40-90 years.
• Self-reported diagnosis of Multiple Sclerosis.
• On stable disease-modifying therapy for ≥6 months.
• No PT/OT balance-related therapy in the past 6 months.
• Able to stand from a chair independently (with or without hand support).
• Score 25-75% on the 12-item MS Walking Scale.
• No other neurological, cardiopulmonary, musculoskeletal, or systemic conditions affecting standing/walking.
• English speaking.
• Willing to complete all study procedures including Zoom sessions.
⁃ Has reliable internet access.
⁃ Has a helper buddy available for all sessions.
⁃ Possible mild cognitive impairment based on self-report.
‣ Initial Screening Inclusion Criteria:
• Moderate disability: ePR-EDSS score 4.0-6.5.
• Mild cognitive impairment: MoCA 18-25, or Jak/Bondi criteria for those scoring 26-30.
• Physically inactive or moderately active (Godin score \<24).
• Cardiovascular safety parameters within acceptable limits.
• No global aphasia (Mississippi Aphasia Screening Test ≥71 percent).
• Berg Balance Scale score ≥40/56.
• Able to walk 1 block with or without an assistive device.
‣ Helper Buddy Inclusion Criteria:
• Age ≥18 years.
• Lives within close proximity to the participant.
• No self-reported major medical conditions limiting safety assistance.
• English speaking.
• Able to attend all training and assessment sessions.
• Able to assist with basic safety, positioning, and communication with the research team.
• Has internet access and can use Zoom.