Balance Targeted Exercises for Individuals With MS

Study Overview
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Brief Summary
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The purpose of this study is to examine the effects of a postural adjustment, targeted training program on balance ability and postural responses anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA) in individuals with MS

Official Title
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The Effect of a Targeted Exercise Program on Balance and Postural Responses in Patients With Multiple Sclerosis (MS)

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Behavioral: Balance targeted exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be18 to 70 years of age. Medical diagnosis of MS confirmed by a neurologist. Ability to stand independently without any aid for at least 3 minutes. A Patients determined disease steps (PDDS) score of 5 or lower. Normal or corrected-to-normal vision. English or Spanish speaking. Exclusion Criteria: MS-related exacerbation or medication change in the past two months. Presence of concurrent neurological or orthopedic disorders. Unable to perform the experimental tasks.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Balance targeted exercises group<br>participants in this group will receive the balance targeted exercises for up to 6 weeks | Behavioral: Balance targeted exercises<br>* 6-week exercise program, 3 sessions per week (2 sessions in person, 1 session of home exercises. Participants will receive a booklet with information about the home exercises and will receive a text message reminder), each session will last 60 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in balance ability as measured by the BESTest | The Balance Evaluation Systems Test (BESTest) will be used to measure balance ability. Items are scored from 0 (severe impairment) to 3 (no impairment), with a total score of 108. A higher score suggests better balance ability. | Baseline, 6 weeks (post intervention) | 
| Change in reaction time | Measure in seconds | Baseline, 6 weeks (post intervention) | 
| Change in movement velocity | Measure in degree per second | Baseline, 6 weeks (post intervention) | 
| Change in endpoint excursion percentage | measure of endpoint excursion in a percentage out of a100 | Baseline, 6 weeks (post intervention) | 
| Change in directional control percentage | measure of directional control in a percentage out of a100 | Baseline, 6 weeks (post intervention) | 
| Change in maximum excursion percentage | measure of maximum excursion in a percentage out of a100 | Baseline, 6 weeks (post intervention) | 
| Change in muscle responses latency as measured by MCT | The Motor Control test (MCT) measures the subject's ability to generate a motor response latency to a sudden surface translation in a forward and backward direction at three different magnitudes (small, medium, and large). Latency: The time-lapse between the perturbation onset and the subject response for each limb. The latency is reported in milliseconds. | Baseline, 6 weeks (post intervention) | 
| Change in postural muscles responses latency as measured by Electromyography (EMG) | Postural muscles responses onset latency in seconds | Baseline, 6 weeks (post intervention) | 
| Change in APA as measured by microvolts | Postural muscles APA measured in microvolts | Baseline, 6 weeks (post intervention) | 
| Change in CPA as measured by microvolts | Postural muscles CPA in microvolts | Baseline, 6 weeks (post intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in balance confidence as measured by ABC | The Activities Specific Balance Confidence (ABC) scale is a self-report questionnaire of a subject's perceived level of balance confidence. It measures the subject's confidence in performing various ambulatory activities without falling. There are 16 items scored using a scale(0-100) with higher scores indicating more confidence in performing the tasks. A total score is reported by dividing the total ABC score by 16. | Baseline, 6 weeks (post intervention) | 
| Change in quality of life as measured by the MSQoL-54 | Multiple Sclerosis Quality of Life - 54 (MSQoL-54) is a self-report questionnaire measuring subject perceived of quality of life. In total, it contains 54 items with a total score ranging from 0-100, with higher scores indicating a better quality of life | Baseline, 6 weeks (post intervention) |