Clinical trial NCT05682963: Efficacy of Square- Stepping Exercises in Individuals With Multiple Sclerosis
Official title: Effect of Square- Stepping Exercises on Mobility, Balance and Knee Joint Position Sense in Individuals With Multiple Sclerosis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Multiple Sclerosis
Keywords: Multiple Sclerosis
Mobility
Balance
Position Sense
Lead sponsor: Pamukkale University
Sponsor class: OTHER
First posted: 2023-01-12
Enrollment: 34
Sex: ALL
Minimum age (years): 20
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Total of two groups: Square stepping exercise program group and home exercise program group
Primary purpose: TREATMENT

Brief summary: Square stepping exercises can promote correct foot placement, fast and coordinated step patterns, and sensory-motor interaction. The aim of this study is to examine the effect of square stepping exercises on mobility, balance and knee joint position sense in individuals with multiple sclerosis.

Detailed description: Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system that results in neurological disability. Complex gene-environment interactions play a role in the etiology of multiple sclerosis. Multiple sclerosis is more common in women than men, with a ratio ranging from 2:1 to 3:1.

MS is a very heterogeneous disease and it can have very variable clinical signs and symptoms, including motor, sensory, autonomic and cognitive disorders, depending on the region of the central nervous system. Balance and mobility disorders are the leading symptoms of MS. In addition, somatosensory disorders are frequently encountered as the initial symptom. Disorders in position sense, which is one of the components of somatosensory sense, is an important determinant of limitations during dynamic activities such as walking and balance. In order to reduce disability and improve function in individuals with Multiple Sclerosis, square stepping exercises protocol will be given to one group and a home exercise program protocol to the other group. Created by Shigematsu and Okura to improve balance and reduce the risk of falling, the square stepping exercises is performed on a thin exercise mat divided into 40 small squares of 250 cm x 100 cm. There are a number of step patterns that must be followed by the participants. Certain step patterns will be repeated 3-5 times to the participants and the participant will be asked to repeat the same pattern. As a home exercise protocol, a program consisting of frenkel exercises developed by Professor Heinrich Sebastian Frenkel for the treatment of gait, balance and coordination will be applied.

Square stepping exercises can promote correct foot placement, fast and coordinated step patterns, and sensory-motor interaction. The aim of this study is to examine the effect of square stepping exercises on mobility, balance and knee joint position sense in individuals with multiple sclerosis.

Eligibility criteria: Inclusion Criteria:

* Having a disability score of less than 4
* Being between 20-50 years old
* Not having an attack in the last month
* Patients without lower extremity spasticity according to Modified Ashworth Scale (MAS)

Exclusion Criteria:

* Having a neurological disease other than Multiple Sclerosis
* Having an Multiple Sclerosis attack during the study
* Having had orthopedic surgery affecting balance
* Presence of cognitive and psychiatric influences that will affect participation in the study
* Having a cardiovascular or pulmonary history that would inhibit participation in the study
* Have received steroid and/or immunosuppressive therapy in the past four weeks

Primary outcomes:
measure: Timed 25-Foot Walk (T25-FW) Test
timeFrame: 8 weeks
Secondary outcomes:
measure: Five Times Sit to Stand Test
timeFrame: 8 week
measure: Four Step Square Test (FSST)
timeFrame: 8 week
measure: Activity-Specific Balance Confidence Scale
timeFrame: 8 week
measure: Knee Joint Position Sense
timeFrame: 8 week
measure: Expanded Disability Status Scale (EDSS)
timeFrame: 8 week
Other outcomes:
Locations:
city: Denizli
country: Turkey
facility: Pamukkale University Denizli Health Services Vocational School of Higher Education
state: Centre
Study officials:
affiliation: Pamukkale University Denizli Health Services Vocational School of Higher Education
name: Müge İçelli, M.Sc.
role: PRINCIPAL_INVESTIGATOR
References: