Monitoring Intensity During Balance Training in Persons With Multiple Sclerosis (BALANCE-MS)

September 14, 2026 updated by: Jens Bansi, Klinik Valens

Monitoring Intensity During Balance Training in Persons With Multiple Sclerosis - a Randomized Feasibility Study

Balance training is recommended to improve gait stability and mobility. However, there are currently no clearly defined methods for controlling the intensity (challenge) of balance training. This research project aims to determine whether balance training for individuals with multiple sclerosis (MS), individually tailored to the level of difficulty and exertion, is feasible and possible within an inpatient rehabilitation setting. Participants will be randomly assigned to one of two groups: either they will complete group training focusing on strength, endurance, and balance in addition to their regular therapy program, or they will receive individually tailored balance training. Both groups will undergo an initial assessment followed by seven training sessions, each lasting approximately 45-60 minutes. Before discharge, the initial assessments will be repeated. These assessments include completing questionnaires, performing gait tests, balance tests, and a short cognitive test. Interviews will also be conducted with patients and therapists. These are intended to help better assess the feasibility of the training and to gain more insight into the experiences with the training.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Canton of St. Gallen
      • Valens, Canton of St. Gallen, Switzerland, 7317
        • Recruiting
        • Rehabilitation Centre Valens
        • Principal Investigator:
          • Jens Bansi, PhD
        • Contact:
        • Contact:
        • Sub-Investigator:
          • Isa Slotboom, MSc
        • Sub-Investigator:
          • Laura Engler, MSc

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients with a definite MS diagnosis according to 2024 revised McDonald criteria;
  • Hold an Expanded disability status (EDSS) between 2.0-6.5;
  • An inpatient stay of at least three weeks at the ;
  • Aged 18 years and older;
  • Have sufficient knowledge of the German language (spoken and written).

Exclusion Criteria:

  • Cognitive impairment indicated by a score of <21 on the Montreal Cognitive Assessment (MoCA);
  • Severe osteoporosis;
  • Fractures and/or other surgical interventions;
  • Presence of any other condition that would substantially influence balance;
  • Alcoholism;
  • Participation in another study;
  • Pregnancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Balance training
The balance training is performed three times per week over a period of three weeks with sessions lasting 45-60 minutes. The intervention is designed to meet the individual needs of pwMS and allows for challenging tasks, while guaranteeing safety by a harnass. During the first training session the appropriate exercise levels that target the adequate intensity are determined (baseline value). Moderate to high-intensive BT in this study is defined as a score of 7-9 points on the rate of perceived stability (RPS) scale and to fulfill the moderate to high-intensive characteristics on the therapists' scale. The intensity of each exercise (level of challenge during the exercise) is monitored and documented for both the therapists and pwMS. According to this feedback, progression is performed by systematically by in- or decreasing difficulty of the exercises.
The balance training is performed three times per week over a period of three weeks with sessions lasting 45-60 minutes. The intervention is designed to meet the individual needs of pwMS and allows for challenging tasks, while guaranteeing safety by a harnass. During the first training session the appropriate exercise levels that target the adequate intensity are determined (baseline value). Moderate to high-intensive BT in this study is defined as a score of 7-9 points on the rate of perceived stability (RPS) scale and to fulfill the moderate to high-intensive characteristics on the therapists' scale. The intensity of each exercise (level of challenge during the exercise) is monitored and documented for both the therapists and pwMS. According to this feedback, progression is performed by systematically by in- or decreasing difficulty of the exercises.
Active Comparator: Sporttherapy
The control group performs a standardized group training session (usual care, UC) that consists of strength, endurance, coordination, balance and mobility exercises. This training is part of standard care at the Rehabilitation Clinic Valens and is therefore not personalized for each participant. The training is performed three times per week over a period of three weeks with sessions lasting 45-60 minutes.
The control group performs a standardized group training session (usual care, UC) that consists of strength, endurance, coordination, balance and mobility exercises. This training is part of standard care at the Rehabilitation Clinic Valens and is therefore not personalized for each participant. The training is performed three times per week over a period of three weeks with sessions lasting 45-60 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Balance capacity
Time Frame: From enrollment to the end of treatment at 3 weeks.
Balance capacity measured by the Mini Balance Evaluation system Test (Mini-Best). Measured with a score from 0-28, a higher score indicates a better balance capacity.
From enrollment to the end of treatment at 3 weeks.
Cognitive processing speed
Time Frame: From enrollment to the end of treatment at 3 weeks.
Cognitive processing speed is measured with the Symbol Digit Modalities Test (SDMT). Participants receive a sheet with a key of nine numbers (1-9) and symbols shown in pairs. In boxes below only the symbols are shown, and the participants must report the correct corresponding number. The number of correct answers made within 90 seconds is assessed. The oral form of the SDMT is used due to its non-sensitivity to motor disabilities of the upper extremities. Higher scores indicate higher cognitive processing speed.
From enrollment to the end of treatment at 3 weeks.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mobility
Time Frame: From enrollment to the end of treatment at 3 weeks.
Mobility measured by the Timed Up and Go Test (TUG). Measurement in seconds, a lower time indicates a better functional mobility.
From enrollment to the end of treatment at 3 weeks.
Complex walking ability
Time Frame: From enrollment to the end of treatment at 3 weeks.
Complex walking ability measured by the Six Spot Step Test (SSST). Measurement in seconds for all trials and for the trials with the dominant and non-dominant leg, a lower time indicates a better complex walking ability.
From enrollment to the end of treatment at 3 weeks.
Fatigue
Time Frame: From enrollment to the end of treatment at 3 weeks.
Fatigue measured with the Fatigue Scale for Motor and Cognitive Function (FSMC) Questionnaire. A total score [20-100] and a motor and cognitive subscores [each 10-50] are calculated, a higher score indicates a higher fatigue.
From enrollment to the end of treatment at 3 weeks.
Walking endurance
Time Frame: From enrollment to the end of treatment at 3 weeks.
Walking endurance measured with the 6 Minute Walking Test. Within this test the total distance [m], the 2 minute distance [m], and the steps [Number] and time [s] needed for 10 meters are measured.
From enrollment to the end of treatment at 3 weeks.
Fear of falling
Time Frame: From enrollment to the end of treatment at 3 weeks
Fear of falling is measured with the Falls Efficacy Scale-International (FES-I). Participants must answer 16 different questions regarding their fear of falling during activities of daily life. For each item the level of fear is assessed on a 4-point scale (from 1="not at all" to 4="very"). Scores range from 16-64, with higher scores indicating a higher fair of falling during daily activities.
From enrollment to the end of treatment at 3 weeks
Health related quality of life
Time Frame: From enrollment to the end of treatment at 3 weeks
Health related quality of life is measured with the Patient Reported Outcomes Measurement Information System-10 (PROMIS-10). They score each item on a 5-point scale and rate their pain from 0 to 10. The score is summarized to a mental and a physical health score, each from 0-20. With low scores indicating poor perceived health related quality of life.
From enrollment to the end of treatment at 3 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Jens Bansi, PhD, Klinik Valens

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 6, 2026

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

September 1, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 4, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 14, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • BALANCE-MS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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