ORCID
0009-0005-5779-7481
Date of Award
2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
First Advisor
Susan L. Kasser
Abstract
Multiple sclerosis (MS) is a chronic neurological disorder of the central nervous system characterized by progressive physical and cognitive deterioration throughout the disease process. The physical and cognitive impairments, independently or interactively, impact physical activity, social participation, and quality of life. Traditionally, balance training conducted in a supervised environment has shown to improve balance and cognitive function. However, participation in center-based exercise programs may be burdensome for some persons with MS due to time constraints and transportation difficulties, suggesting the need for an alternative modality that attenuates participation barriers while eliciting important health benefits. Home-based balance training programs have been developed to address these aforementioned hurdles and promote accessibility. However, our recent meta-analyses revealed that home-based balance training did not significantly improve balance and cognitive function in persons with MS. Thus, we designed a novel home-based high-intensity balance training program (HBBT-MS) that employs a family member of MS as an exercise supporter. As a first step, this study aims to examine its feasibility (Chapter 2), determine its effect on physical, cognitive, and self-reported outcomes (Chapter 3), and qualitatively explore exercise supporters’ experiences around support for the intervention (Chapter 4). This involved a single-group pretest-posttest design. We recruited 28 persons with MS (mean age:55.2, 82.1% Female) and 29 exercise supporters (mean age:54.3, 65.5% Male). Participants performed the HBBT-MS program for 30 minutes per session, 3 days per week for 12 weeks. The program demonstrated high adherence rate (92.9%) and attendance rate (94.4%), with no severe adverse events reported. Most participants with MS and exercise supporters were satisfied with the program contents and support. As to treatment effects, there were significant improvements in static balance (p < 0.001, d = 0.74), lower-extremity function (p < 0.001, d = 0.70), and walking (p = 0.004, d = 0.34). Participants showed significant improvement in cognitive processing speed (p = 0.007, d = 0.71) and visuospatial memory (p = 0.22, d = 0.02), but not verbal memory (p =0.007, d = 0.71). We observed significant but small improvements in self-reported outcomes, including fatigue (p = 0.03, d = 0.30), fear of falling (p = 0.004, d = 0.47), and dual-task difficulty (p = 0.003, d = 0.40). After interviewing 12 exercise supporters, we found that they gained varied benefits and insights through the support experience, with subsequent intention to continue this type of support moving forward. The HBBT-MS was feasible and safe in persons with MS. Participants were also capable of meeting high-intensity exercise doses with the support by exercise supporters. This study also demonstrated promising evidence of positive changes in physical, cognitive, and self-reported outcomes following the intervention. Thus, the successful examination of feasibility in this HBBT-MS can inform designing a larger clinical trial focusing on the efficacy of this modality on health outcomes.
Language
en
Number of Pages
98 p.
Recommended Citation
Bae, Myeongjin, "Home-Based High-Intensity Balance Training With Family Member Support In Persons With Multiple Sclerosis: A Feasibility Single-Group Pretest-Posttest Design" (2025). Graduate College Dissertations and Theses. 2083.
https://scholarworks.uvm.edu/graddis/2083