Document Type : Original Article
Authors
1
Department Of Physical Therapy For Neurology And Neurosurgery, Faculty Of Physical Therapy, Cairo University.
2
Department of Neurology, Faculty of Medicine, Kasr Alainy Cairo University.
3
Department of Physical Therapy for Neurology and Neurosurgery Faculty of Physical Therapy Cairo University
Abstract
Background: Fatigue and balance dysfunction are common and debilitating symptoms of multiple sclerosis (MS), often affecting mobility and independence. These symptoms may be interconnected due to shared neural mechanisms.
Purpose: This narrative review aimed to investigate how central fatigue contributes to impairments in various aspects of balance control, including static, dynamic, anticipatory, and reactive postural responses. Methods: A comprehensive search of Science Direct, PubMed, and Goggle Scholar was conducted using keywords such as multiple sclerosis, fatigue, balance impairment, neurorehabilitation, postural control, central fatigue. The authors also reviewed references from pertinent literature, however only the most recent or comprehensive studies from April 2006 to May 2025 were included, and only English language studies were reviewed due to lack of translation-related sources. Papers such as oral presentations, conference abstracts, unpublished manuscripts and dissertations that were not part of larger scientific
studies were excluded. Results: Evidence suggests that central fatigue negatively affects balance control by disrupting sensory integration, slowing information processing, and reducing neuromuscular efficiency. Although several rehabilitative strategies such as vestibular rehabilitation, aquatic therapy, dual-task training, and non-invasive brain stimulation have shown promise, research remains limited by small sample sizes, inconsistent methodologies, and short follow-up periods. Conclusion: The relationship between fatigue and balance dysfunction in MS is complex and multifactorial. Addressing both symptoms concurrently may enhance functional outcomes. Future research should prioritize standardized assessment tools and long-term, integrative interventions targeting both physical and cognitive
dimensions.
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