Investigation of the Effects of Motor Imagery and Action Observation Training in Individuals With Multiple Sclerosis

Study Overview
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Brief Summary
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It was planned to examine the effects of motor imagery and action observation training applied in addition to standard rehabilitation in individuals with Multiple Sclerosis on walking, fatigue, trunk control and muscle oxygenation.

Official Title
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Investigation of the Effects of Motor Imagery and Action Observation Training on Walking, Fatigue, Trunk Control and Muscle Oxygenation in Individuals With Multiple Sclerosis

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Other: Motor Imagery training
* Other: Action Observation training
* Other: standard rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being between the ages of 18-65 Having a definite diagnosis of MS Expanded Disability Status Scale (EDSS) score of 4.0 and below (it is determined routinely by the physician during the examination) Not having an attack in the last 3 months Exclusion Criteria: Having another musculoskeletal, cardiovascular, pulmonary, metabolic, or neurological disease severe enough to preclude participation in the study. Having severe vision and hearing problems Presence of severe cognitive impairment detected by the physician at a level that prevents the tests from being performed.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motor Imagery Group<br>Individuals included in this group will receive 20 minutes of motor imagery training in addition to 40 minutes of standard rehabilitation. Patients will be trained 3 days a week for 6 weeks. | Other: Motor Imagery training<br>* Individuals included in this group will receive 20 minutes of motor imagery training in addition to 40 minutes of standard rehabilitation.<br>Other: standard rehabilitation<br>* 40 minutes of standard rehabilitation.<br>|
| Experimental: Action Observation Group<br>Individuals included in this group will receive 20 minutes of action observation training in addition to 40 minutes of standard rehabilitation. Patients will be trained 3 days a week for 6 weeks. | Other: Action Observation training<br>* Individuals included in this group will receive 20 minutes of action observation training in addition to 40 minutes of standard rehabilitation.<br>Other: standard rehabilitation<br>* 40 minutes of standard rehabilitation.<br>|
| Other: Control Group<br>Individuals included in this group will receive only 40 minutes of standard rehabilitation. Patients will be trained 3 days a week for 6 weeks. | Other: standard rehabilitation<br>* 40 minutes of standard rehabilitation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6 Min Walking Test | It will be used to measure walking capacity. Before the test is applied, necessary information will be given to the individuals and they will be asked to walk as fast as possible for 6 minutes on the 30-meter track. | 6 week | 
| Timed Up and Go Test | It will be used to assess the functional mobility of individuals. Individuals will be asked to stand up without support from the chair they are sitting in, and to return from the designated area after walking a distance of 3 meters and sit back on the chair without support. | 6 week | 
| Dynamic Gait Index | It is a scale that evaluates gait balance in MS patients. It examines the balance in completely different walking situations, including daily life activities such as turning the head while walking, taking a step over an obstacle, climbing and descending stairs. | 6 week | 
| Multiple Sclerosis Walking Scale-12 | It is a scale used to measure walking capacity. | 6 week | 
| RehaGait® (Hasomed, Magdeburg, Germany) Gait Analysis | The device gives about the time-distance characteristics and kinematic data of the gait. | 6 week | 
| Fatigue Severity Scale | It is a scale that evaluates the extent to which fatigue affects the daily functions of MS patients. | 6 week | 
| Trunk Impairment Scale | It is used to evaluate trunk control. | 6 week | 
| Assessment of the Endurance of Core Muscles | The McGill protocol will be applied to assess the endurance of the core muscles. This protocol consists of a combination of 4 tests; modified Biering-Sorenson test, trunk flexor endurance test, right and left lateral bridge (lateral plank) tests. | 6 week | 
| Assessment of the Strength of Core Muscles | It will be evaluated with Sit-ups and Modified Push-ups tests. | 6 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinesthetic and Visual Imagery Questionnaire | It is a tool used to assess individuals' imagery levels. | 6 week | 
| Movement Imagery Questionnaire-3 | It is a tool used to assess individuals' imagery levels. | 6 week | 
| Mental Stopwatch | Mental stopwatch is a method that enables the objective measurement of motor imagery by examining the time difference between the physical execution of the movement (Movement Execution Time, MET) and the mental visualization of the same movement (Movement Imagery Time, MIT). | 6 week | 
| Measurement of Muscle Oxygenation | It will be measured over the Quadriceps muscle with the MOXY Monitor Device (saturation, Hb values). The Moxy muscle oxygen monitor is a lightweight (42 g) and small (dimensions: 61 × 44 × 21 mm) device that measures regional blood flow and oxygenation by placing it on the skin non-invasively with near infrared spectroscopy (NIRS). | 6 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Walking, Multiple Sclerosis, Motor Imagery Training, Action Observation Training, Fatigue, Trunk Control, Muscle Oxygenation