Investigation of the Effects of Selective Exercise Training in Multiple Sclerosis

Study Overview
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Brief Summary
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Selective exercise programs specific to muscle groups, with the workload to be done in line with the muscle's own structure, can enable more strength to be released with less fatigue in MS, and this increase in strength can increase balance and functional activities. to determine the effects of type training (selective exercise training), eccentric and concentric training on function, balance, fatigue and muscle architecture.

Detailed Description
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Recovery and enhancement of muscle function in MS is one of the main goals in physiotherapy and rehabilitation. In literature studies, it is stated that eccentric and concentric exercises are effective exercise approaches in increasing strength and reducing fatigue. However, the best exercise method is not yet clear in terms of providing better performance adaptation with less fatigue. Considering the architectural features of the lower extremity muscles, it is aimed to increase the angle of pennation with programs that include concentric strengthening of the quadriceps, gastro-soleus and gastrocnemius muscles, which are suitable muscle groups to produce large forces by design. With programs that include eccentric strengthening of the hamstring and tibialis anterior muscles that function in a wide range of motion and have high excursion ability, it is aimed to increase fiber length.

Official Title
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Investigation of the Effects of Selective Exercise Training on Muscle Architecture, Balance, Function and Fatigue in Multiple Sclerosis

Conditions
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Multiple Sclerosis, Exercise

Intervention / Treatment
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* Other: exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between the ages of 18-50, With an Extended Disability Status Scale (EDSS) score of 4 or less, No regular exercise habit Able to walk on the treadmill, No pregnancy, Not receiving corticosteroid treatment in the last month, Fampridine etc. in the last 1 month. not taking medication, Patients who have not received Botox treatment in the last 6 months Exclusion Criteria: patients who do not agree to volunteer

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Selective training<br>selective training on lower extremity for 3 days/week | Other: exercise<br>* exercise training for 8 weeks<br>|
| Experimental: Downhill walking<br>downhill walking training on the treadmill for 2 days/week | Other: exercise<br>* exercise training for 8 weeks<br>|
| Experimental: Uphill walking<br>uphill walking training on the treadmill for 2 days/week | Other: exercise<br>* exercise training for 8 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| muscle architecture parameter 1 | The pennation angle were evaluated with Ultrasound | Change from Baseline at 8th weeks and 12th weeks | 
| muscle architecture parameter 2 | The fiber length were evaluated with Ultrasound | Change from Baseline at 8th weeks and 12th weeks | 
| muscle architecture parameter 3 | The muscle thickness were evaluated with Ultrasound | Change from Baseline at 8th weeks and 12th weeks | 
| Muscle strength | low extremity muscles were evaluated with hand dynamometer | Change from Baseline at 8th weeks and 12th weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| walking fatigue | Walking Fatigue Index | Change from Baseline at 8th weeks and 12th weeks | 
| perceived fatigue | Fatigue Severity Scale | Change from Baseline at 8th weeks and 12th weeks | 
| physical fatigue | Modified Borg Scale before and after 6-minute walking test | Change from Baseline at 8th weeks and 12th weeks | 
| static balance | Single standing tests | Change from Baseline at 8th weeks and 12th weeks | 
| dynamic balance | 4 square step tests | Change from Baseline at 8th weeks and 12th weeks | 
| Functional activities 1 | timed-up go test | Change from Baseline at 8th weeks and 12th weeks | 
| Functional activities 2 | 2-minute walk test | Change from Baseline at 8th weeks and 12th weeks | 
| Functional activities 3 | 25-feet walk test | Change from Baseline at 8th weeks and 12th weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multiple sclerosis, muscle architecture, Eccentric Exercise, Concentric Exercise