The Effect of Multiple-Task Training in Patients With Multiple Sclerosis

Study Overview
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Brief Summary
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The Activities of Daily Living requires the ability to perform multiple activities at the same time, not just the motor or cognitive activity. When many tasks are performed at the same time, the attention capacity is effectively used and attention is shared according to the difficulty and priority of the tasks. There is evidence that patients with Multiple Sclerosis (MS) have reduced performance during multitasking. In this study, the investigators aim to investigate the effect of multitasking training on balance, mobility, upper extremity performance and cognitive functions in patients with MS.

Detailed Description
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Patients with MS between 0-1,5 score according to the Extended Disability Status Scale (EDSS) will be included in the study. The balance, mobility, upper extremity performance, the cognitive function will be evaluated twice. The study was designed as a prospective, randomized controlled study. The patients will be randomly assigned to three groups, the multi-task training (MT) group, the single task training (ST) group, and control group. The training will be twice a week for 6 weeks. Statistical analyses will be performed using the SPSS software version 15 (SPSS Inc. Chicago, IL, USA). The pre-training and post-training measurements of groups will be compared with the Wilcoxon Test. The significance level was set at p< 0.05

Official Title
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The Effect of Multiple-Task Training on Physical and Cognitive Functions in Patients With Multiple Sclerosis

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Other: Multi-task training
* Other: Single task training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants who are ambulatory and volunteer to participate to the study, in a stable phase of the disease, without relapses in the last 3 month, with an EDSS between 0-1,5. Exclusion Criteria: Participants who have orthopedic, vision, hearing, or perception problems Patients who have any cardiovascular or pulmonary disease in which exercise is contraindicated

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Single task training<br>The exercise program consisting of 10 different motor tasks will be implemented in a single task training group. | Other: Single task training<br>* An exercise program consisting of 10 different motor tasks will be implemented in a single task training group.<br>|
| Experimental: Multi-task training<br>In the multitasking training group, a second motor task in the first two weeks, a cognitive task in the third and fourth week, both motor and cognitive tasks in the last two weeks will be added to these 10 different motor tasks. | Other: Multi-task training<br>* In the multitasking training group, a second motor task in the first two weeks, a cognitive task in the third and fourth week, both motor and cognitive tasks in the last two weeks will be added to these 10 different motor tasks.<br>|
| No Intervention: Control group<br>The control group will be taught relaxation exercises and will be asked to perform the exercises at home. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mobility | Timed Up and Go Test | ten minutes] | 
| Modified Sensory Organization Test | The Modified Sensory Organization Test, which is performed using computerized posturography, measures postural sway in response to 4 different sensory conditions is measured using a force platform. | Fifteen minutes] | 
| Upper extremity function | 9-Hole Peg Test | ten minutes | 
| cognitive function | The Brief Repeatable Battery of Neuropsychological Tests | thirty minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Activity | International Physical Activity Questionnaire- Long version | ten minutes | 
| Fatigue Impact | Fatigue impact scale consists of forty questions and evaluates the effects of fatigue on the 3 dimensions of daily life activities; cognitive function, physical function and psychosocial function. Each question is graded between 0 (no problem) and 4 (maximum problem). | five minutes | 
| Fatigue Severity | In the Fatigue Severity Scale (FSS), participants are asked to rate their fatigue level between 1 and 7 in the 9 statements (including motivation, exercise, physical functioning, carrying out duties, and interfering with work, family, or social life) during the last week. | Five minutes | 
| Balance Confidence | Activities-specific Balance Confidence (ABC) is a scale in which the patient rates his perceived level of confidence while performing 16 daily living activities. | five minutes | 
| Neuropsychological Questionnaire | Multiple Sclerosis Neuropsychological Questionnaire - MSNQ | one minute | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Balance, Multiple sclerosis, Multi-task training, Mobility, Cognition, Upper extremity function