Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Collections
    • Subjects A-Z
    • Residents & Fellows
    • Patient Pages
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Collections
    • Subjects A-Z
    • Residents & Fellows
    • Patient Pages
  • Podcast
  • CME
    • Article CME
    • Podcast CME
  • About
    • About the Journals
    • Contact Us
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

February 27, 2018; 90 (9) Article

Efficacy of Balance and Eye-Movement Exercises for Persons With Multiple Sclerosis (BEEMS)

Jeffrey R. Hebert, John R. Corboy, Timothy Vollmer, Jeri E. Forster, Margaret Schenkman
First published January 31, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005013
Jeffrey R. Hebert
From the Department of Physical Medicine and Rehabilitation (J.R.H., J.E.F., M.S.) and Department of Neurology (J.R.H., J.R.C., T.V.), University of Colorado School of Medicine, Aurora.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John R. Corboy
From the Department of Physical Medicine and Rehabilitation (J.R.H., J.E.F., M.S.) and Department of Neurology (J.R.H., J.R.C., T.V.), University of Colorado School of Medicine, Aurora.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Timothy Vollmer
From the Department of Physical Medicine and Rehabilitation (J.R.H., J.E.F., M.S.) and Department of Neurology (J.R.H., J.R.C., T.V.), University of Colorado School of Medicine, Aurora.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeri E. Forster
From the Department of Physical Medicine and Rehabilitation (J.R.H., J.E.F., M.S.) and Department of Neurology (J.R.H., J.R.C., T.V.), University of Colorado School of Medicine, Aurora.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Margaret Schenkman
From the Department of Physical Medicine and Rehabilitation (J.R.H., J.E.F., M.S.) and Department of Neurology (J.R.H., J.R.C., T.V.), University of Colorado School of Medicine, Aurora.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Efficacy of Balance and Eye-Movement Exercises for Persons With Multiple Sclerosis (BEEMS)
Jeffrey R. Hebert, John R. Corboy, Timothy Vollmer, Jeri E. Forster, Margaret Schenkman
Neurology Feb 2018, 90 (9) e797-e807; DOI: 10.1212/WNL.0000000000005013

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Comment

Downloads
292

Share

  • Article
  • Figures & Data
  • Info
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To determine whether a multifaceted vestibular-related rehabilitation program (Balance and Eye-Movement Exercises for Persons with Multiple Sclerosis; BEEMS) improves balance in persons with MS and whether there are differences in outcomes based on brainstem/cerebellar lesion involvement.

Methods A 2-arm, examiner-blinded, stratified (involvement vs no involvement of brainstem/cerebellar structures), randomized controlled trial was implemented. Eighty-eight participants were allocated to BEEMS or no treatment control. Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) measured balance control. The Dizziness Handicap Inventory (DHI), Modified Fatigue Impact Scale (MFIS), and Short Form-36 Health Status Questionnaire (SF-36) were also administered. Linear mixed models were used to investigate the primary and secondary aims.

Results From baseline to 6 weeks, BEEMS participants experienced greater improvements compared to control participants in CDP-SOT composite (model-estimated difference in change 4.9, 95% confidence interval 1.39–8.38, p = 0.006), DHI total (−13.5, −17.7 to −7.25, p < 0.0001), MFIS total (−11.4, −15.7 to −7.0, p < 0.0001), SF-36 Mental (5.6, 2.43–8.71, p = 0.0006), and SF-36 Physical (3.5, 1.12–5.81, p = 0.004) scores and from baseline to 14 weeks in CDP-SOT composite (8.3, 4.73–11.9, p < 0.0001), DHI total (−13.9, −19.3 to −8.62, p < 0.0001), MFIS total (−12.3, −16.7 to −7.79, p < 0.0001), SF-36 Mental (3.9, 0.70–7.16, p = 0.02), and SF-36 Physical (3.2, 0.79–5.62, p = 0.01) scores. From baseline to 6 weeks, BEEMS participants with brainstem/cerebellar lesion involvement experienced greater improvements compared to those without in CDP-SOT composite (5.26, 0.34–10.2, p = 0.04) and MFIS total (−7.6, −14.0 to −1.33, p = 0.02) scores.

Conclusion BEEMS improved multiple outcomes regardless of whether brainstem/cerebellar lesions were present, supporting the generalizability of BEEMS for ambulatory people with MS who have at least minimally impaired balance and fatigue.

Clinical trials.gov identifier NCT01698086.

Classification of evidence This study provides Class I evidence that BEEMS training improves dynamic posturography-based balance, dizziness, fatigue, and quality of life in persons with MS.

Glossary

BEEMS=
Balance and Eye-Movement Exercises for People With Multiple Sclerosis;
CDP-SOT=
Computerized Dynamic Posturography-Sensory Organization Test;
DHI=
Dizziness Handicap Index;
DVAT=
Dynamic Visual Acuity Test;
GST=
Gaze Stabilization Test;
MFIS=
Modified Fatigue Impact Scale;
MS=
multiple sclerosis;
PDQ=
Perceived Deficits Questionnaire;
SF-36=
Short Form-36 Health Status Questionnaire;
T25FW=
Timed 25-Foot Walk;
VOR=
vestibulo-ocular reflex

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Class of Evidence: NPub.org/coe

  • Editorial, page 403

  • Received March 5, 2017.
  • Accepted in final form November 8, 2017.
  • © 2018 American Academy of Neurology
View Full Text

AAN Members: Sign in with your AAN member credentials (e-mail or 6-digit Member ID number)

Non-AAN Member subscribers: Sign in with subscriber credentials

Log in using your username and password

Forgot your user name or password?

Purchase access

AAN members must change their passwords on the AAN site

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All contributors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within the last 8 weeks.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All contributors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Author contributions
    • Study funding
    • Disclosure
    • Acknowledgment
    • Footnotes
    • References
  • Figures & Data
  • Info

Related Articles

  • An intervention to improve balance in persons with multiple sclerosis

Topics Discussed

  • Class I
  • Clinical trials Randomized controlled (CONSORT agreement)
  • Autoimmune diseases

Alert Me

  • Alert me when this article is cited
  • Alert me if a correction is posted
  • Alert me when eletters are published
Advertisement
Neurology: 92 (8)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2019 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise