BALANCE BASED TORSO WEIGHTING SHOWS IMMEDIATE AND LONG-TERM FUNCTIONAL IMPROVEMENT IN A WOMAN WITH MULTIPLE SCLEROSIS: THE RESULTS OF AN ABA SINGLE SUBJECT STUDY. Gail Widener*; Cynthia Gibson-Horn Physical Therapy, Samuel Merritt College, Oakland, CA UNIQUE: Placing weight on the bodies of people with ataxia to improve function and balance is controversial. In the past, large amounts of weight have been used and were typically placed on the shoulders, waist, or distal extremities. People with Multiple Sclerosis (MS) often have ataxia that affects their ability to balance and move. There is a paucity of information about the effects of placing minimal weight on the trunk to counteract balance dysfunction. PURPOSE: This single subject study was designed to evaluate changes in function, both immediate and long-term, from placing minimal amounts of weight on the torso of a woman with MS. FOUNDATION: Balance based torso weighting (BBTW) is an examination and treatment method in which small amounts of weight are placed on the trunk based on the person's balance dysfunction. The added weight may activate more automatic postural control mechanisms either through increased sensory feedback and/or biomechanical alteration of the center of mass. DESCRIPTION: An ABA design with pre-intervention (baseline), intervention and post-intervention phases was used. Data was collected weekly for each four week phase. The Timed Up and Go test (TUG), Berg Balance Scale (BBS) and a timed 360 degree turn were used to determine the effect of BBTW. During the intervention phase the subject was asked to wear the torso weight at least one hour per day while continuing with their normal daily activities. No additional treatment was given. Testing was performed without torso weighting except during the intervention phase in which it was completed both weighted and unweighted. Subject: The subject was a 267 pound female with primary progressive MS diagnosed in 1998. She presented with ataxic movements of her trunk. After the baseline period, BBTW was performed and revealed a balance dysfunction that was most pronounced in the posterior direction. Two pounds of weight (0.75% body weight) was distributed anteriorly and laterally, on both sides, that stabilized her excessive trunk movement during quiet stance (Romberg position) and improved her balance dysfunction. OBSERVATIONS: The subject reported liking the torso weight and wearing it ten hours a day. She noted an increase in steadiness, improved activity level along with an increase in fatigue. Objectively, the TUG, BBS and timed turn all showed improvements during the four week intervention phase compared to baseline. This improvement was maintained in the post-inervention phase. For example, TUG scores changed from a mean of 37.48 sec. in the baseline phase to a mean of 30.73 sec. and 29.73 sec. in the intervention and post-intervention phases, respectively. Performance was further enhanced to a mean of 26.08 sec. while wearing the torso weight during the intervention phase. CONCLUSIONS: Small amounts of torso weight improved both immediate and long-term performance with this subject with an ataxic presentation. More research is needed to evaluate the use of strategically placed light weights to improve function in individuals with balance dysfunction. FUNDING SOURCE: This work was supported by a Faculty Development Grant from Samuel Merritt College. KEYWORDS: Ataxia, Balance, Light weight Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.