Investigation of the Effects of Technology Supported Different Physiotherapy Approaches on Patients With Multiple Sclerosis
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      Multiple Sclerosis (MS) is an autoimmune disease characterized by chronic inflammation,
      demyelination and axonal loss of the central nervous system. The etiology of the disease is
      not known exactly and possible causes are; genetic, vitamin D deficiency, viral,
      environmental and autoimmune factors have been identified. Common findings of MS are in the
      literature; sensory, visual problems, fatigue, urinary retention / incontinence, motor
      problems (inability to walk, upper extremity skills, coordination and balance problems),
      cognitive deficits, tone, speech and swallowing disorders. In the rehabilitation of MS; It is
      seen that balance, coordination, strengthening, aerobic and neurodevelopmental exercise
      methods are used and these approaches have reached moderate / high level evidence in the
      literature. Task-oriented circuit therapy(TOECT), one of the current neurophysiology-based
      approaches; It is a motor learning-based exercise approach based on the theory of dynamic
      systems, one of the theories of motion control, aiming at the acquisition of skills for a
      specific functional activity. When the existing studies are examined, it has been determined
      that there are a limited number of randomized controlled studies examining the effects of
      TOECT and that sufficient evidence cannot be obtained with these studies. In previous
      studies, it has been observed that standardization of exercise approaches applied to the
      control group could not be achieved and the control groups generally included applications
      that could create passive or effect summation compared to the experimental groups. In
      addition, in the literature, TOECT, which includes rehabilitation games to be applied in the
      form of station training, in MS patients; There is no randomized controlled study examining
      the effects on balance, walking, fatigue, trunk and upper extremity functions and kinematics.
      In this direction, the purpose of the research is; To examine the effects of
      technology-supported TOECT and technology-supported home program applied as station training
      on walking, quality of life, fatigue, balance, trunk and upper extremity functions of
      patients with MS, using kinematic and clinical methods. Volunteers who agree to participate
      in the study will be divided into two groups by the block randomization method. Both groups
      will receive exercise training 3 sessions per week (24 sessions in total) for 8 weeks.
      Evaluations will be made before and after 8 weeks treatment
    


Intervention name(s): Technology Supported Task-Oriented Circuit Training; Home-based Telerehabilitation
Intervention type(s): Other; Other
Intervention description(s): Ten workstations, which are frequently used in the literature and determined according to the clinical experience of the research team, have been created. Each workstation will be applied for a total of 1 hour, in the form of 5 minutes of training and 1 minute of rest.
Sit to stand
Standing and trunk training
Standing and lower limb training
Stepping
Walking
Walking with object manipulation
Climbing and descending stairs
Unilateral upper extremity activity training (VR)
Bilateral upper extremity activity training (VR)
Upper extremity reaction time training (VR) Virtual reality games will be played using the USE-IT intelligent physiotherapy game system. The system offers unilateral, bilateral and bimanual upper extremity training to individuals with a 55 inch touch screen and 7 computer games (balloon popping, car washing, plumbing, arithmetic, apartment, drum and matching).; Strengthening, balance and coordination exercises will be sent to the participants via a mobile application. Patients will do the exercises at home and send a notification to their physiotherapist. Intervention will be applied for 1 hour, 3 days a week for 8 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Virtual Reality; Telerehabilitation; Task-oriented Circuit Therapy; Kinematics; Kinematic Analysis