Comparing the effect of Cawthorne–Cooksey and Frenkel exercises on balance in patients with multiple sclerosis: a randomized controlled trial

Abstract

Objective: To evaluate the effect of Cawthorne–Cooksey and Frenkel exercises on balance in patients with multiple sclerosis. Design: It was a three-arm parallel randomized controlled trial study. Setting: Outpatient clinic. Subjects: Patients with multiple sclerosis. Interventions: Subjects in the intervention groups completed a 12-week program consisted of Cawthorne–Cooksey or Frenkel exercises. The control group only received routine care. Main measures: The outcome measure was the Berg Balance Scale. Results: Seventy-two patients completed the study. At the end of the intervention, there was a statistically significant improvement in Berg Balance Scale in the Cawthorne–Cooksey group (n = 24) in comparison with the other two groups (P = 0.001). In the Frenkel group (n = 23), the improvement was statistically greater than the changes in the control group (n = 25), but it did not appear to be clinically significant. The Berg Balance Scale score increased to 8.9 in the Cawthorne–Cooksey group and 2.3 in the Frenkel group, while it decreased to 1.2 in the control group. When comparing inter-group changes, Berg Balance Scale showed significant improvements in favor of the Cawthorne–Cooksey group after the intervention (P < 0.05). Conclusion: This study demonstrated that in comparison with Frenkel and the control groups, a program of Cawthorne–Cooksey exercise is more effective in improving balance in patients with multiple sclerosis.