New research suggests that personalized balance training, not a one-size-fits-all program, yields the best improvements for people with multiple sclerosis (MS). Turkish scientists found that exercise type should target individual balance challenges to maximize walking endurance and stability. The study, published in Neurological Research, has implications for Thailand’s growing rehabilitation services and the millions living with MS worldwide, including many younger adults and women in Thailand.
MS commonly affects balance and walking, increasing falls and limiting daily life. Traditional guidance often promotes general balance work, but the latest findings show benefits vary by the specific balance problem—standing still, moving, walking fast, or enduring longer distances. A customized plan can better address these distinct needs.
In a 12-week randomized trial, 35 people with MS were assigned to three exercise programs: standard balance exercise (SBE), vestibular exercise (VE), and cervical stabilization exercise (CSE). SBE included classic tasks like toe-to-heel walking and balance boards. VE focused on the vestibular system with movements such as head turning and eyes-closed balance. CSE targeted deep neck and spinal muscles to support posture during movement.
After the program, VE and CSE groups showed significant gains in walking distance, measured by a two-minute walk test, and in forward-reaching balance. The SBE group lagged behind on most measures. Dynamic balance tasks—like the four-square step test and timed up-and-go test—improved most in the CSE group, while VE yielded the best static balance and walking speed. Overall, SBE produced modest walking gains with minimal impact on broader balance.
Six months later, VE participants maintained improvements in functional reach and dynamic stepping, while CSE participants preserved gains in the timed up-and-go test. Importantly, fatigue, a persistent issue for many with MS, decreased more in both VE and CSE groups than in the SBE group. The researchers concluded that vestibular exercises suit static balance impairments, whereas cervical stabilization exercises better address dynamic balance.
These findings matter for Thai patients and the country’s evolving rehabilitation sector. Thai physiotherapists and physicians increasingly advocate personalized mobility programs aligned with these insights. Dr. Teerawat Vorakitti, a neurophysiologist at a leading Bangkok hospital, notes that clinicians are moving beyond blanket advice. “Exercises that challenge the head, neck, and sense of position offer meaningful, lasting benefits for balance and confidence,” he explains.
The study’s limitations include a small sample and focus on individuals without severe disability. More inclusive research is needed to see how these strategies work for advanced MS, a group growing as treatments extend life. Additionally, the supervised regime—three sessions weekly for three months—poses real-world challenges in busy households and rural areas across Thailand.
MS is no longer regarded as exclusively a Western condition. Thailand’s rates are rising, driven by improved diagnosis, lifestyle changes, and environmental factors. Many younger Thai adults now live with relapsing MS, affecting work and family life. Falls carry particular risk in multigenerational Thai homes where space is limited; targeted balance improvement can protect families and support independence.
As rehabilitation medicine evolves, patients and caregivers should consult neurologists and physiotherapists experienced with MS. The Thai Physical Therapy Association has published guidelines recommending targeted balance, vestibular, and cervical stabilization training—echoing the study’s conclusions. A Bangkok MS nurse adds, “Consistency matters as much as technique; keep moving even on days when symptoms feel milder.”
Technology may further empower Thai patients. Wearable sensors and smartphone apps can objectively track balance, endurance, and fall risk, supplementing clinical assessments and enabling remote adjustments by therapists. Home exercise videos in Thai could also help patients practice safely outside clinics.
The core message is clear: tailored movement strategies outperform generic routines for improving balance and confidence in MS. When gait difficulties arise, clinicians should determine whether speed or endurance is the primary issue to craft a precise physiotherapy plan. For families and individuals living with MS, consulting a care team about specific balance challenges and personalized exercises could be a decisive step toward better mobility and quality of life.
Practical steps for Thai readers include seeking a professional balance assessment from a neurologist or certified physiotherapist and exploring whether vestibular or cervical stabilization exercises might become part of a home program. Resources are increasingly available in Thai, and patient groups often share practical routines that fit local living conditions. With the right strategy, meaningful improvements in balance and well-being are within reach—even in hot, demanding Thai days.
Data and insights come from research conducted with MS patients in Turkey and published in Neurological Research. In Thailand, ongoing collaboration between hospitals, the Thai Physical Therapy Association, and MS support groups continues to translate these findings into practical, culturally appropriate care.