Effect of vestibular rehabilitation on trunk kinetic and kinematic parameters in patients with multiple sclerosis
More details
Hide details
Department of Physical Therapy for Neuromuscular Disorders, Faculty of Physical Therapy, Beni-Suef University, New Beni-Suef, Egypt
Faculty of Physical Therapy, Al Ryada University for Science and Technology, Menoufia, Egypt
Department of Biomechanics, Faculty of Physical Therapy, October 6 University, Giza, Egypt
Submission date: 2023-04-04
Acceptance date: 2024-01-25
Publication date: 2024-03-22
Corresponding author
Ahmed Magdy Alshimy   

Lecturer of Physical Therapy for Neurology and its Surgery, Faculty of Physical Therapy, Al Ryada University for Science and Technology, Egypt.
Hum Mov. 2024;25(1):68-74
To investigate the effect of the Cawthorne Cooksey exercise protocol on trunk kinetic and kinematic parameters in MS patients.

Using a randomised controlled study design, 30 ambulatory patients with MS (aged 35–55 years) with relapsing/ remitting disease, hemiparesis, and minimal disability were recruited. Patients were split into two equal groups to undergo four weeks of vestibular rehabilitation. Group I received conventional vestibular rehabilitation along with the Cawthorne Cooksey exercise protocol, and group II (control group) received only conventional vestibular rehabilitation. Patients were assessed using an isokinetic dynamometer (average power, acceleration, and deceleration time) before and after the treatment.

The current study found that there was a significant improvement in the trunk flexors’ average power and a decrease (enhancement) in the acceleration and deceleration times after the treatment (p < 0.05). The effect was more pronounced in group I than in group II.

Cawthorne Cooksey exercise protocol may be an effective way to help people with MS improve their dynamic trunk stability by facilitating trunk movements and muscle power.

García-Muńoz C, Cortés-Vega M-D, Heredia-Rizo AM, Martín-Valero R, García-Bernal M-I, Casuso-Holgado MJ. Effectiveness of vestibular training for balance and dizziness rehabilitation in people with multiple sclerosis: a systematic review and meta-analysis. J Clin Med. 2020;9(2):590; doi: 10.3390/jcm9020590.
Marrie RA, Cutter GR, Tyry T. Substantial burden of dizziness in multiple sclerosis. Mult Scler Relat Disord. 2013;2(1):21–28; doi: 10.1016/j.msard.2012.08.004.
Cattaneo D, Jonsdottir J. Sensory impairments in quiet standing in subjects with multiple sclerosis. Mult Scler. 2009;15(1):59–67; doi: 10.1177/135245850809 6874.
Whelan R, Lonergan R, Kiiski H, Nolan H, Kinsella K, Bramham J, et al. A high-density ERP study reveals latency, amplitude, and topographical differences in multiple sclerosis patients versus controls. Clin Neurophysiol. 2010;121(9):1420–1426; doi: 10.1016/j.clinph. 2010.03.019.
Kutz JW. The dizzy patient. Med Clin North Am. 2010; 94(5):989–1002; doi: 10.1016/j.mcna.2010.05.011.
Tjernström F, Zur O, Jahn K. Current concepts and future approaches to vestibular rehabilitation. J Neurol. 2016;263(1):65–70; doi: 10.1007/s00415-015-7914-1.
Whitney SL, Alghwiri AA, Alghadir A. An overview of vestibular rehabilitation. Handb Clin Neurol. 2016;137: 187–205; doi: 10.1016/B978-0-444-63437-5.00013-3.
Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol. 2011;7(4):184–196; doi: 10.3988/ jcn.2011.7.4.184.
Hain TC. Neurophysiology of vestibular rehabilitation. NeuroRehabilitation. 2011;29(2):127–141; doi: 10.3233/ NRE-2011-0687.
Black FO, Angel CR, Pesznecker SC, Gianna C. Outcome analysis of individualized vestibular rehabilitation protocols. Am J Otol. 2000;21(4):543–551.
Whitney SL, Rossi MM. Efficacy of vestibular rehabilitation. Otolaryngol Clin North Am. 2000;33(3):659– 672; doi: 10.1016/s0030-6665(05)70232-2.
Krebs DE, Gill-Body KM, Parker SW, Ramirez JV, Wernick- Robinson M. Vestibular rehabilitation: useful but not universally so. Otolaryngol Head Neck Surg. 2003; 128(2):240–250; doi: 10.1067/mhn.2003.72.
Larocca NG. Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners. Patient. 2011;4(3):189–201; doi: 10.2165/11591150- 000000000-00000.
Cohen HS. Side-lying as an alternative to the Dix-Hallpike test of the posterior canal. Otol Neurotol. 2004; 25(2):130–134; doi: 10.1097/00129492-200403000- 00008.
Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–1452; doi: 10.1212/WNL. 33.11.1444.
El Mhandi L, Bethoux F. Isokinetic testing in patients with neuromuscular diseases: a focused review. Am J Phys Med Rehabil. 2013;92(2):163–178; doi: 10.1097/ PHM.0b013e31826ed94c.
Bergkvist C, Svensson M, Eriksrud O. Accuracy and Repeatability of Force, Position and Speed Measurement of 1080 Quantum and 1080 Sprint. 1080 Motion AB: Stockholm; 2015.
Barbado D, Lopez-Valenciano A, Juan-Recio C, Montero- Carretero C, van Dieën JH, Vera-Garcia FJ. Trunk stability, trunk strength and sport performance level in judo. PLoS One. 2016;11(9):e0162962; doi: 10.1371/ journal.pone.0156267.
Hoang PD, Cameron MH, Gandevia SC, Lord SR. Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study. Arch Phys Med Rehabil. 2014;95(3):480– 486; doi: 10.1016/j.apmr.2013.09.017.
Fritz S, Lusardi M. White paper: “walking speed: the sixth vital sign”. J Geriatr Phys Ther. 2009;32(2):46–49.
Sosnoff JJ, Weikert M, Dlugonski D, Smith DC, Motl RW. Quantifying gait impairment in multiple sclerosis using GAITRite™ technology. Gait Posture. 2011;34(1): 145–147; doi: 10.1016/j.gaitpost.2011.03.020.
Nilsagĺrd YE, von Koch LK, Nilsson M, Forsberg AS. Balance exercise program reduced falls in people with multiple sclerosis: a single-group, pretest-posttest trial. Arch Phys Med Rehabil. 2014;95(12):2428–2434; doi: 10.1016/j.apmr.2014.06.016.
Journals System - logo
Scroll to top