Multiple Sclerosis and Related Disorders · Nov 7, 2025

The effect of aquatic therapy on fatigue and balance in people with multiple sclerosis: An assessor-blind randomized controlled trial

By Tsatsakos G, Grammatikou G, Zogka E et al.

BACKGROUND: Multiple sclerosis (MS) often leads to debilitating fatigue and balance impairments. Aquatic therapy (AT) has been suggested as a beneficial exercise modality for MS symptoms, but evidence from controlled trials is limited. The aim is to evaluate the effect of an AT program on fatigue and balance in people with MS, compared to conventional physiotherapy. METHODS: Twenty-six adults with relapsing-remitting MS (EDSS 1.0-3.5) were randomized to AT (n = 14) or standard physiotherapy (n = 12) for 8 weeks. Fatigue and balance were assessed pre- and post-intervention using the Modified Fatigue Impact Scale (MFIS, total and subdomains) and the Berg Balance Scale (BBS). RESULTS: AT led to significantly greater improvements in balance and fatigue than control group (p < 0.001). The AT group's BBS score increased by ∼2.7 points (to 55.3 ± 1.3), while the control group's BBS decreased by ∼3.6 points (to 50.0 ± 3.1). MFIS total scores decreased by 9.0 points in the AT group versus a 5.5-point increase in the control group. All MFIS subdomains (physical, psychosocial, cognitive) showed significant improvements in the AT group compared to controls (p < 0.001). CONCLUSION: AT was effective in improving both balance and fatigue in people with mild MS, outperforming land-based therapy. These findings support the inclusion of AT in MS rehabilitation programs to alleviate fatigue and balance deficits.

doi.org/10.1016/j.msard.2025.106836Open accessPubMed 41218293Interventions