A recent research breakthrough suggests the most effective exercises for improving balance in people with multiple sclerosis (MS) should be carefully matched to each individual’s specific challenges, offering new hope for those struggling with everyday activities due to this debilitating condition. The study, published in Neurological Research and summarized by Multiple Sclerosis News Today, could change the way both patients and healthcare professionals in Thailand think about MS rehabilitation and underscores the importance of personalized care for Thai MS patients coping with similar symptoms (source).
Multiple sclerosis, while less commonly diagnosed in Thailand than in Western countries, still affects hundreds of Thai families every year and frequently leads to persistent balance problems, walking difficulties, and fatigue. Traditionally, MS patients are advised by neurologists and physical therapists to perform balance exercises to improve stability and reduce fall risk, a key concern especially for older adults. But the new randomized controlled study out of Turkey challenges the conventional wisdom by indicating not all balance exercises are equally beneficial. For Thai readers, who may be managing MS with limited specialist resources outside major Bangkok hospitals, these findings could empower patients to ask their own doctors about more targeted exercise plans, potentially leading to better outcomes.
The research, registered as NCT05409599, enrolled thirty-five MS patients and randomly assigned them into three groups to compare three popular exercise strategies. The first group performed standard balance exercises (SBE) such as walking on toes and heels or on a balance board—activities that might resemble those seen in a typical Thai physical therapy clinic. The second group did vestibular exercises (VE), focusing on strengthening the system that helps the brain sense the position and movement of the body, with activities like moving the head in various directions or standing with eyes closed. The third group practiced cervical stabilization exercises (CSE), aiming to enhance neck and upper spinal muscle control, critical for posture—a concept growing in popularity among Thai physiotherapists.
Participants completed three 45-minute exercise sessions each week for 12 weeks, then underwent tests on their ability to walk, stand, and reach—key movements required for daily life in Thailand, from riding the BTS Skytrain to walking through busy markets. According to the results, both the VE and CSE groups outperformed the standard balance group. The VE and CSE participants improved significantly in the two-minute walk test (a standard measurement of walking endurance) and the functional reach test (which gauges how far someone can reach without losing balance). Notably, only the CSE group improved on assessments that required dynamic movement—like the four-square step test and the timed up-and-go test, where participants must stand from a chair, walk a short distance, and sit again, simulating common movements Thai elders might perform during a temple visit or family gathering.
The SBE group, interestingly, showed no statistically meaningful improvement in any core measures. This is a crucial point for Thai families who may rely on basic, generic exercises found on YouTube or community centers. Asst. Prof. Dr. Wanida Thanawan, a Thai neurologist and rehabilitation expert (not associated with this study), explains, “Personalizing rehabilitation—focusing on either the vestibular system for static balance or neck stability for dynamic movement—may finally give MS patients a tangible way to make real, life-changing progress.”
Long-term follow-up six months after the intervention further supported the tailored exercise approach. Those practicing vestibular exercises maintained their gains in the functional reach and four-square step tests, suggesting lasting benefits in both static and complex balance tasks. The cervical stabilization group, meanwhile, preserved improvements in the timed up-and-go test, demonstrating enduring benefits for tasks that require dynamic balance and quick shifts between movements. Both advanced groups also reported lower fatigue, a common complaint among Thai MS patients, particularly during hot weather or festival activities—highlighting an exercise benefit that could directly impact everyday energy levels.
Statistical analysis clarified the best exercise selection: vestibular exercises worked best for improving static balance and walking speed, whereas cervical stabilization led to better results in dynamic balance and walking endurance. The researchers noted, “Vestibular exercises can be considered for patients with static balance impairments, while cervical stabilization exercises can be preferred for dynamic balance impairments.” They added an important practical tip: “When addressing gait difficulties in patients with MS, it is essential to determine whether the primary issue is speed or endurance, as this distinction may guide the selection of the appropriate exercise modality.”
For Thailand, this insight matters deeply given our rapidly aging society and the growing recognition of MS within government health policy. Data from the Thai Neurological Society show that up to 25% of reported MS patients struggle with balance or walking as their main disabling symptom. Families—particularly in the Northeast where medical specialists are scarce—often turn to general balance exercise routines. But as the Turkish researchers stress, optimizing exercises according to each person’s most troubling symptoms may provide better long-term outcomes. This has resonance with similar emerging trends in Thai traditional medicine, which increasingly values individualized care and holistic health strategies.
Historical context helps too. In Thailand, physical rehabilitation has roots not just in Western medicine, but also in traditional Thai massage and movement therapies like Rue-si Dat Ton, “yoga of the hermit sages,” which shares some elements with modern posture-focused exercise. Integrating new scientific findings with these cultural approaches could enhance adherence and comfort for Thai patients, perhaps by incorporating elements of posture training or mindfulness into daily routines.
However, the study’s authors warned about limitations: the small number of participants and the exclusion of those with more severe disability mean results should be interpreted cautiously. Further research is needed, particularly to determine if similar outcomes would occur in a broader Thai MS population, including those living in rural areas or with less access to frequent supervised PT sessions.
Looking to the future, Thailand’s Ministry of Public Health might take inspiration from this study when developing guidelines or public education campaigns for MS rehabilitation. Hospitals in Bangkok and Chiang Mai could consider training PTs and home carers in these more precise techniques, while online platforms could offer ‘at-home’ instructional videos tailored for Thai speakers. For Thai MS charities and support groups, sharing this information—inclusive of cultural practices and regional realities—could boost both confidence and safety among patients.
For Thai individuals with MS and their families, this research highlights the importance of consulting healthcare professionals not just for general exercise advice, but for an assessment that uncovers specific balance or walking challenges. This personalized approach may pave the way for better quality of life and greater independence, whether navigating Bangkok’s busy streets, celebrating Songkran, or simply playing with grandchildren in the park.
Readers living with MS or caring for someone with the condition should talk with their doctor or physical therapist about the most troublesome movement challenges being faced—whether it’s standing still, walking further, or moving with speed—and consider requesting a tailored exercise program. When possible, seek guidance from a PT trained in MS-specific therapies. For those outside urban areas, try connecting with national MS organizations for further advice or online resources. Above all, remember that targeted, individualized effort may make all the difference—a hopeful message for Thai families confronting the daily reality of MS (Multiple Sclerosis News Today, PubMed abstract of the study, Thai Neurological Society).