Respiratory Functions, Trunk Control and Mobility Evaluation in Multiple Sclerosis

Study Overview
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Brief Summary
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Respiratory functions and body control are affected in patients with multiple sclerosis (MS). Because of this effect, the dependency of individuals increases in daily living activities and their quality of life decreases. We think that respiratory functions, respiratory muscle strength and trunk control affect vital mobility as well as vital importance for individuals with MS. As a result of the investigations, it is concluded that the literature is insufficient in this area. The aim of this study is to investigate the effects of pulmonary function, respiratory muscle strength and trunk control on functional mobility in individuals with MS and compare with healthy individuals.

Official Title
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Investigation of the Effects of Respiratory Functions and Trunk Control on Functional Mobility in Individuals With Multiple Sclerosis

Conditions
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Physical Therapy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-65 years old Having a definite MS diagnosis Up to 5.5 points on the Scored Disability Status Scale (EDSS) In the last 3 months have not experienced an attack Mini mental test score of 24 and above Acceptance to participate in the study. Exclusion Criteria: Having orthopedic problems The presence of other neurological problems

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Multiple Sclerosis<br>Patients with a clinically definitive diagnosis of MS, 0-5.5 Extended Disability Status Scale range. | |
| Healthy individuals<br>Voluntary healthy individuals with similar age and gender | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 2 Minutes Walking Test | Two Minute Walk Test (2MWT) will be performed to evaluate functional mobility. | baseline | 
| Timed Up and Go Test | Timed Up and Go Test will be performed to evaluate functional mobility. | baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory Functions Test | Challenging vital capacity (FVC), forced expiratory volume in one second (FEV₁), forced expiratory volume in one second to forced vital capacity (FEV₁/FVC), peak flow rate (PEF), forced vital capacity 25-75% speed (FEF25-75%) will be measured by portable spirometry (Spirolab, Medical International Research, Rome, Italy). | baseline | 
| Respiratory Muscle Strength | Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) will be measured using portable, electronic, oral pressure measuring device (Micro Medical MicroMPM, UK). | baseline | 
| Trunk Impairment Scale | Trunk impairment scale assesses static and dynamic sitting balance and trunk coordination. The maximum scores on the static sitting balance, dynamic sitting balance, and coordination subscales are 7, 10, and 6 points, respectively. The total score of Trunk impairment scale ranges between 0 and 23 points, with a higher score representing better trunk control. | baseline | 
| Side Bridge Test (core muscles endurance) | Subjects were asked to lie on their left or right sides and extend their legs straight. Then the subjects lift their hips off the ground and form a straight line with their bodies. The measurements are recorded with a chronometer as seconds. The tests end when the subjects break the test positions. | baseline | 
| Modified Biering-Sorensen test (core muscles endurance) | During the test, the subjects are placed in an exercise bed that extends outwardly from the leading edge of the upper body and ensures that the upper iliac spine is flush with the bench edge. Subjects are asked to raise their arms while maintaining body positions.Measurements are recorded in seconds with a stopwatch. The tests will end when the subjects break the test positions. | baseline | 
| Trunk Flexion Test (core muscles endurance) | Individuals are positioned in such a way that the body is at 60º, knees and hip at a flexion position of 90º. The evaluating physiotherapist supports the feet and fixes the feet on the floor. The measurements are recorded with a chronometer as seconds. The test is terminated when the 60 ° trunk flexion is impaired. | baseline | 
| Prone bridge test (core muscles endurance) | During the test, the subjects place their elbows on the floor as their starting position and open their feet around the width of their thighs. They keep their body straight without bending over their elbows and toes.The measurements are recorded with a chronometer as seconds. The tests end when the subjects break the test positions. | baseline | 
| Sit-ups Test (core muscles power) | The test is initiated when the subjects are told start and they are asked to flex their upper body up from the floor lifting the lower corner of the scapula from the floor.It is recorded how many times the subjects can perform each test for 30 seconds. | baseline | 
| Modified Push-ups Test (core muscles power) | In the push-ups test, the subjects are required to push their lower body until their elbows reach a 90° angle. They are then asked to extend their arms straight to return to the starting position.It is recorded how many times the subjects can perform each test for 30 seconds. | baseline | 
| Lumbopelvic Stability Test | Lumbopelvic stability is assessed using a stabilizer Pressure Biofeedback UnitTM (Chattanooga, Australia). With the participant lying supine on a plinth, the cushion is inflated underneath the participant's lumbar spine to 40 mmHg. Prior to testing, all participants are instructed in the abdominal hollowing manoeuvre that activates Transversus Abdominis muscle, and told to perform and continue the contraction this during subsequent lumbopelvic stability testing while attempting to minimize contraction of rectus abdominis. Scores are recorded as the highest level completed (0-5) with a pressure change no greater than 10 mmHg. | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multiple Sclerosis, Respiratory function, Respiratory muscle strength, Trunk control, Functional mobility