Effects of the Nds-powerball® System on Muscle Strength, Coordination, Fatigue, Functionality and Quality of Life in People With Multiple Sclerosis. A Randomized Clinical Trial

Abstract

Abstract Introduction Clinical impairment of the upper limbs (UL) in patients with multiple sclerosis (MS) is very common. Muscle strength and hand dexterity are critical factors in maintaining functional activities that are the basis for independence and quality of life. Objective Investigate the effects of a training protocol using the NDS-Powerball® system in combination with conventional physiotherapy on muscle strength, coordination, fatigue, functionality, and quality of life in persons with MS over an 8-week period. Materials and Methods A double-blind randomized controlled trial with two intervention groups was conducted. The control group received conventional treatment, while the experimental group received additional UL training using the NDS-Powerball® system. Both groups received the same number of sessions and weeks of intervention. The following outcome measures were used: isometric grip and pinch strength, Box and Block Test (BBT), Nine Hole Peg Test (NHPT), Abilhand scale, Fatigue Severity Scale (FSS), Multiple Sclerosis Impact Scale (MSIS-29), and Likert satisfaction questionnaire for the experimental group. All measures were administered at baseline, after the treatment, and during a 3-week follow-up period. Results 25 patients completed the study (12 persons with MS and 13 healthy control subjects). The experimental group showed significant improvements in coordination and manual dexterity of the more affected UL as measured by the BBT comparing pre- to post-treatment (p = 0.048) and pre-treatment to follow-up (p = 0.001), and on the less affected UP comparing pre-treatment to follow-up (p < 0.001) and post-treatment to follow-up (p = 0.034). The Likert-type satisfaction questionnaire obtained a mean score of 89.10 (± 8.54) out of 100 points. Conclusions An UL treatment protocol using the NDS-Powerball® system, in combination with conventional physiotherapy for 8 weeks resulted in significant improvements in the intra-group analysis for UL coordination and manual dexterity in favor of the experimental group. The experimental group showed excellent satisfaction to the treatment.