A new study is shedding light on how people with multiple sclerosis (MS) can best improve their balance—a vital concern for many living with this complex neurological disease. According to Turkish researchers, the most effective balance exercises for MS patients may vary depending on each individual’s specific difficulties, and a personalized approach could be crucial. These findings, published in the journal Neurological Research, promise to refine treatments and physical therapy strategies for over 2 million people worldwide living with MS—including thousands here in Thailand, where MS rates are on the rise, especially among younger adults and women.
Balance problems and difficulties with walking are among the most common and disabling symptoms in MS, often leading to falls, reduced independence, and limitations in daily life. Traditional advice has typically encouraged patients to perform general balance exercises, but, as this study highlights, “one-size-fits-all” may not be ideal. Instead, different kinds of balance-focused exercises yield different benefits depending on whether a patient struggles with standing still, moving around, walking quickly, or sustaining endurance over longer distances.
The randomized controlled trial enrolled 35 people diagnosed with MS, each assigned to one of three exercise regimes for 12 weeks: standard balance exercise (SBE), vestibular exercise (VE), and cervical stabilization exercise (CSE). SBE comprises classic moves like walking on toes and heels or balancing on a board. VE targets the body’s internal “gyroscope”—the vestibular system—with movements like turning the head or balancing with eyes closed. Meanwhile, CSE strengthens deep neck and spinal muscles vital for posture and stability during movement.
Key findings after the three-month program were striking. Both the VE and CSE groups improved significantly in walking distance (measured by the two-minute walk test) and balance while reaching forward (functional reach test), whereas the SBE group did not. Participants in the CSE group also posted better results on dynamic balance tasks—including the four-square step test and the timed up-and-go test—while VE proved best for static balance and walking speed. Notably, general SBE exercises lagged behind both VE and CSE across nearly all measures, producing only modest gains in walking ability with little impact on overall balance.
Six months after the intervention, the researchers observed that those who had undergone vestibular exercises maintained their gains in functional reach and dynamic step tests. Meanwhile, cervical stabilization participants preserved improvements in the timed up-and-go assessment. Crucially, both VE and CSE groups reported lower fatigue—a persistent and often disabling complaint among MS patients—at long-term follow-up, compared to little change in the SBE group. As the researchers put it, “Vestibular exercises can be considered for patients with static balance impairments, while cervical stabilization exercises are best for dynamic balance impairments.”
These insights have important implications for Thai readers living with MS and for the country’s growing rehabilitation and neurological care sectors. Physical therapists and physicians in Thailand increasingly recognize the need to personalize mobility programs—a trend in line with these findings. Dr. Teerawat Vorakitti, a neurophysiologist at Chulalongkorn Hospital, notes, “For years, our standard advice was to keep patients moving, but we now realize there’s merit in targeting weaknesses. Exercises that challenge the head, neck, and sense of position can offer distinct, lasting benefits for balance and confidence.”
The study had limitations—notably its small sample size and focus on patients without severe disability. The authors emphasized the need for more inclusive research to determine how these strategies might benefit people with advanced MS, a demographic that is also growing as treatment extends life expectancy. Furthermore, all exercises were supervised three times a week for three months; translating these protocols into busy daily routines or community settings poses real-world challenges, especially in rural or under-resourced parts of Thailand.
Multiple sclerosis has historically been viewed as a “Western disease,” but rates are increasing in Thailand, possibly due to better diagnosis, changing lifestyles, or environmental factors. Many younger Thai adults now live with relapsing MS, impacting family life and employment. The burden of frequent falls is especially acute in extended Thai households, where several generations may share compact homes; thus, interventions that can reduce this risk will resonate with many families.
As rehabilitation medicine evolves, experts urge patients and caregivers to consult with physiotherapists familiar with neurological conditions. The Thai Physical Therapy Association has published guidelines for MS management, recommending targeted balance, vestibular, and cervical stabilization training—mirroring this new research’s approach. Dr. Supaporn Wongsa, a Bangkok-based MS nurse, adds, “โปรดอย่าละเลยการออกกำลังกายแม้ในวันที่อาการดูเหมือนจะดีขึ้น—consistency matters as much as technique.”
Looking forward, advances in technology could bring new tools to Thai patients. Wearable sensors and smartphone apps are emerging that can objectively track progress in balance, endurance, and fall risk, supplementing clinic-based assessments and helping therapists fine-tune advice remotely. Tailored home exercise videos, available in Thai, are another promising resource.
In the end, the message is clear: for balance and confidence in MS, tailored movement strategies are more effective than generic routines. “When addressing gait difficulties in patients with MS, it is essential to determine whether the primary issue is speed or endurance,” the researchers note, underlining the importance of individualized physiotherapy plans. For those living with MS and their families, a conversation with their care team about specific balance challenges—and the right exercises to target them—could be the single most important step to improved mobility and quality of life.
For Thai readers with MS or caring for someone affected, practical steps include consulting a neurologist or certified physiotherapist for an assessment of specific balance needs, and exploring whether vestibular or cervical stabilization exercises could form part of a tailored home program. Resources are increasingly available in Thai, and patient support groups often share tips and exercise routines that fit local lifestyles. Above all, remember: with the right strategy, meaningful improvements in balance and well-being are within reach—แม้ในวันที่อากาศร้อนหรือเหนื่อยล้า.
For further reading, see the original study published in Neurological Research (link). For MS support and therapy resources in Thailand, consult the Thai Multiple Sclerosis Society or the Physical Therapy Association of Thailand.