Effect of CoDuSe Balance Training and Step Square Exercises on Risk of Fall in Multiple Sclerosis

Study Overview
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Brief Summary
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To investigate the effect of CoDuSe balance training and step square exercises on the risk of falls in multiple sclerosis. BACKGROUND: risk of fall & balance disabilities are considered serious problems in multiple sclerosis which results in loss of balance & physical inactivity. ………HYPOTHESES: This study hypothesized that: CoDuSe balance training and step square exercises will have a significant effect on the risk of falling in multiple sclerosis RESEARCH QUESTION: Is there an effect of CoDuSe balance training and step square exercises on risk of fall in multiple sclerosis?

Detailed Description
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Fifty-two patients with multiple sclerosis will participate in this study. The patients will randomly be divided into two equal groups; the control group which received the conventional selected exercise program and the study group received the same exercise training program in addition to CoDuSe balance training and step square exercises, three times per week for four weeks. The Evaluation will done pre and post interventions included: Biodex balance system (Risk falling), Short Physical Performance Battery (SPPB) & Morse Fall Scale.

Official Title
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Effect of CoDuSe Balance Training and Step Square Exercises on Risk of Fall in Multiple Sclerosis

Conditions
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Multiple Sclerosis, Relapsing-Remitting

Intervention / Treatment
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* Other: CoDuSe balance training and step square exercises
* Other: conventional balance training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fifty-two Remitting-relapsing multiple sclerosis RRMS patients, Age will range as (20:40) years old Illness duration not more than 10 years, with no relapses over the past three months, body mass index (25:35) Exclusion Criteria: difficulty to communicate or to understand program instructions any other neurological deficits or orthopedic abnormalities, secondary musculoskeletal complication peripheral vestibulopathy, hepatic, renal, hemopoeitic, thyroid and cardiovascular diseases, cognitive dysfunction, hearing deficits, epilepsy or EEG abnormalities

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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
Interventional Model Description: control group which received conventional selected exercise program in form of static and dynamic balance training exercises and study group received the same exercise training program in addition to CoDuSe balance training and step square exercises, three times per week for four weeks.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br>(CoDuSe) exercise inform of core stability, dual tasking, and sensory strategies the conventional selected exercise program inform of static and dynamic balance training exercises | Other: CoDuSe balance training and step square exercises<br>* The standardized intervention targeted visual, somatosensory, and vestibular aspects of balance and will be included with balance exercises Examples of core stability exercises as follows: in supine position with knees bent, slowly slide one heel forward to straighten leg; and, in four-point kneeling position, slide one foot in a straight line away from the body and lift the leg off the floor. Examples of dual-task exercises as walking while turning one's head and juggling a balloon. Examples of sensory strategies as standing and walking on uneven surfaces and standing with eyes closed.<br>Other: conventional balance training<br>* static and dynamic balance training exercises from sitting, standing and ambulation activities<br>|
| Experimental: control group<br>the conventional selected exercise program inform of static and dynamic balance training exercises | Other: conventional balance training<br>* static and dynamic balance training exercises from sitting, standing and ambulation activities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biodex balance system | fast, accurate Fall Risk Screening and Conditioning Programme | 4 weeks | 
| Short Physical Performance Battery (SPPB) | The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests . It has been used as a predictive tool for possible disability and can aid in the monitoring of function in older people. The Short Physical Performance Battery (SPPB)test is designed to measure functional status and physical performance. | 4 weeks | 
| Morse Fall Scale | The Morse Fall Scale (MFS) is a rapid and simple method of assessing a patient's likelihood of falling A patient who scores under 25 points is considered to be at low risk of falling, a patient who scores between 25-45 points is considered to be at moderate risk of falling, and a patient who scores higher than 45 points is considered to be at high risk of falling. | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CoDuSe, balance, step square exercises, risk of fall, Multiple Sclerosis