The Effects of Vestibular Exercise and Cervical Stabilization Exercise Training on Balance and Gait in MS Patients

Study Overview
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Brief Summary
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The population of this research consists of individuals between the ages of 18-65 with MS disease. MS patients to be included in the study will be directed by the Neurology outpatient clinic of Sanko University Hospital. All volunteers who agreed to participate in this randomized controlled pretest-posttest design study and met the sample criteria will be included in the study.Individuals who agree to participate will be divided into three groups by simple random method and closed envelope method. Vestibular exercise training group will be formed as Group 1 and Cervical stabilization exercise training group as Group 2, control group, and Group 3 as control group.Functional reach test, tandem stand test, 25 step walking test scale form, Multiple Sclerosis Quality of Life Scale form ( MSQOL-54),Fatigue Impact Scale,Beck depression inventory, MS walking scale (msys-12), dizziness disability inventory, four step square test, timed sit and stand test , 2 minutes walking test be performed before and after treatment,

Detailed Description
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Group 1: Vestibular exercise training will be given in addition to conventional treatment (including TENS, electrical stimulation and normal joint range of motion exercises) for 12 weeks. Cawthorne-Cooksey Exercises will be given as a treatment protocol for vestibular exercise training. Group 2 :Cervical stabilization exercise training will be given in addition to conventional treatment (including Tens, electrical stimulation and normal range of motion exercises) for 12 weeks. Cervical stabilization training improves the sense of cervical proprioception as well as strength and endurance, thereby reducing joint position sense error. Cervical stabilization exercises and training, consisting of 3 stages with increasing difficulty level, will be applied. Group3: Classical balance exercise training will be given to the control group in addition to conventional treatment (including Tens, electrical stimulation and normal range of motion exercises) for 12 weeks. These exercises were selected among the exercises routinely used in balance rehabilitation in the literature and clinic. Balance exercise program: walking on tiptoe and heel, walking straight and diagonally on the line, standing on a balance board, supine/prone rolling on the rehabilitation ball, pelvis control in the sagittal and frontal planes on the rehabilitation ball, prone balance on the rehabilitation ball, walking on mats of different softness , was created from side walking exercises.

Official Title
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Comparison of the Effects of Vestibular Exercise and Cervical Stabilization Exercise Training on Balance and Gait in Multiple Sclerosis Patients

Conditions
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Multiple Sclerosis, Vestibular, Exercises

Intervention / Treatment
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* Other: Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: be diagnosed with MS Not having received physiotherapy-oriented treatment in the last 1 year not have had an attack in the last 1 month and not be in the attack period Exclusion Criteria: having systemic diseases such as hypertension, heart disease, diabetes mellitus, hyperlipidemia, malignancy individuals whose ambulation is not independent Those who have undergone any surgery in the last 6 months

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 |
| --- | --- |
| Active Comparator: Vestibular Exercises<br>Cawthorne-Cooksey Exercises applied to 1st group for 3 days/week for 12 weeks | Other: Exercises<br>* Exercises<br>|
| Active Comparator: Cervical Stabilization Exercises<br>cervical stabilization Exercises applied to 1st group for 3 days/week for 12 weeks | Other: Exercises<br>* Exercises<br>|
| Active Comparator: Balance Exercises<br>classical balance Exercises applied to 1st group for 3 days/week for 12 weeks | Other: Exercises<br>* Exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Static Balance | functional reach test | 12 weeks | 
| Gait speed | 25-step walking test | 12 weeks | 
| Dizziness | dizziness disability inventory | 12 weeks | 
| Dinamic Balance | tandem stance test | 12 weeks | 
| Dinamic Balance | 4 square step test | 12 weeks | 
| Endurance | 2-minute walk test | 12 weeks | 
| Coordination | timed sit and stand test | 12 weeks | 
| Postural swing | GYKO | 12 weeks | 
| Walkiing difficulty | Multiple Sclerosis Walking Scale-12 (MSYS-12) | 12 Weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fatigue | fatigue impact scale | 12 weeks | 
| Depression | beck depression inventory | 12 weeks | 
| MSQ54 İnventory | quality of life | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multiple Sclerosis, vestibular exercises, cervical stabilization, gait