The effectiveness of Frenkel’s and Swiss ball exercises on improved balance and decreased depression in patients with multiple sclerosis: a comparative study

Document Type : Original Articles


1 Physiotherapist, Lecturer, Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 MD, Associate Professor, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran



Introduction: Multiple sclerosis (MS) is the most common progressive neurological disorder among young adults. This disease damages the myelin sheath of neural axons and consequently creates functional disability. One of the affected areas in MS is the cerebellum. Damage to this structure results in an inability to maintain balance, which in turn leads to a decreased quality of life in affected patients. Therefore, providing low-cost methods without any side-effects seems to be necessary to solve this problem.Materials and Methods: This double-blinded, prospective and quasi-experimental study was carried out between 2009 and 2010 in Isfahan. Two groups of 23 MS patients each was taught to do either Frenkel’s or Swiss ball exercises in 10 sessions under the direct supervision of a physical therapist. Before the initiation and after the completion of treatment sessions, Berg Balance Scale and Beck questionnaire were respectively used for the evaluation of balance and depression. Using SPSS software (version 13), paired-t test and t test were conducted to compare patients in above-mentioned groups in different stages.Results: There was a significant difference between balance ability of patients in both Frenkel’s and Swiss ball groups before and after treatment program (P = 0.00). Depression status of patients in both Frenkel’s and Swiss ball groups also showed a significant difference as it compared before and after the treatment (P = 0.00). Although two groups had no significant difference in balance ability before the treatment (P = 0.18), a significant difference in this ability was indicated as two groups were compared after the treatment (0.01). However, there was no meaningful difference between two groups regarding to the depression status of patients neither before the initiation (P = 0.29) nor after the termination of treatment program (P = 0.30).Conclusion: The study results showed that continuous Frenkel’s and Swiss ball exercises can lead to improved balance and decreased depression in MS patients. Moreover, this study indicated that Frenkel’s exercises are more effective than Swiss ball exercises in improvement of balance in MS patients.Keywords: Multiple sclerosis, Balance, Depression, Frenkles exercises and Swiss ball exercises

  • Receive Date: 21 November 2011
  • Revise Date: 30 March 2023
  • Accept Date: 22 May 2022
  • First Publish Date: 22 May 2022