Feasibility of home-based high-intensity balance training in persons with multiple sclerosis: A pretest-posttest study

Objective To examine the feasibility of a home-based high-intensity balance training programme (HBBT-MS) and its preliminary efficacy in individuals with multiple sclerosis (MS). Design A single-group pretest-posttest design. Setting Community. Subjects Twenty-eight individuals with MS (23 female (82%); mean age: 55.2 ± 11.9). Interventions Participants performed the program for 30 minutes per session, 3 days per week for 12 weeks, with the support of a family member to ensure safety while maintaining a high balance challenge. Main measures Feasibility was assessed using four domains of process, resources, management, and scientific outcomes. Physical function (static balance, lower-extremity function, and mobility), dual-tasking, cognitive function (processing speed, verbal memory, and visuospatial memory), and self-reported outcomes (fatigue, dual-task difficulty, ambulation difficulty, and fear of falling) were assessed at baseline and post-intervention. Results Twenty-six out of 28 participants completed both the pretest and posttest (adherence rate: 92.9%). No severe adverse events attributed to this program were reported. There were significant and small-to-medium improvements in static balance ( d = 0.74, p < 0.001), lower-extremity function ( d = 0.70, p < 0.001), and mobility ( d = 0.34, p = 0.004), with no improvement observed in dual-tasking. Participants showed significant and medium improvement in processing speed ( d = 0.71, p = 0.007) and visuospatial memory ( d = 0.55, p = 0.22), but not verbal memory ( d = 0.02, p = 0.22). We observed significant improvements in all self-reported outcomes. Conclusions The HBBT-MS was feasible, safe, and acceptable. Further evaluation using a controlled design is warranted to examine the effectiveness of the programme. Clinical trial registration: clinicaltrials.gov; NCT06412003