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Gait and mobility are among the functions frequently affected in Multiple Sclerosis (MS) and have a negative impact on quality of life. Strength losses in lower limb muscles, ataxia, sensory problems and fatigue are the most important reasons of walking problems in patients with MS. In addition to loss of strength and tonus problems, especially biomechanical disorders can be seen on foot and this problem affects gatin and balance negatively. The stabilizing muscles, defined as the "core" region and enveloping the body like a corset, are active in the context of postural preparation prior to lower extremity movements and stabilize for the limb movements to be performed. The aim of this study was to investigate the effects of spinal stabilization exercises on walking performance, fatigue, plantar pressure distribution, balance, muscle strength and quality of life in patients with Multiple Sclerosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Experimental | Spinal stabilization exercises in addition to home exercise program |
|
| Control Group | Active Comparator | Home exercise program |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physiotherapy - Study group | Other | Study group : In addition to home program spinal stabilization exercises |
|
| Measure | Description | Time Frame |
|---|---|---|
| 6 Minutes Walk Test | Maximum Walking Distance in 6 Minutes | Change from Baseline 6 Minutes Walking Distance at 6 weeks. |
| Modified Borg Scale | Evaluating fatigue between the scores of 0 and 10. "0" means no fatigue at all. "10" means maximal fatigue. | Change from Baseline Fatigue Score at 6 weeks. |
| Plantar Pressure Distribution | Peak pressure values of 10 subregions under the foot | Change from baseline peak pressure and contact area values at 6 weeks |
| Plantar Pressure Distribution | Contact area values of 10 subregions under the foot | Change from baseline peak pressure and contact area values at 6 weeks |
| Multiple Sclerosis Quality of Life Scale | Quality of life assessment with 54 questions about mental and physical health in daily life activities. | Change from baseline mental and physical quality of life scores at 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Muscle strength with hand held dynamometer | Hip Flexors Muscle Strength | Change from baseline muscle strength at 6 weeks |
| Muscle strength with hand held dynamometer | Hip Abductors Muscle Strength |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23917098 | Background | Bethoux F. Gait disorders in multiple sclerosis. Continuum (Minneap Minn). 2013 Aug;19(4 Multiple Sclerosis):1007-22. doi: 10.1212/01.CON.0000433286.92596.d5. | |
| 18951800 | Background | Givon U, Zeilig G, Achiron A. Gait analysis in multiple sclerosis: characterization of temporal-spatial parameters using GAITRite functional ambulation system. Gait Posture. 2009 Jan;29(1):138-42. doi: 10.1016/j.gaitpost.2008.07.011. Epub 2008 Oct 31. |
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| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D020233 | Gait Disorders, Neurologic |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
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Randomized Controlled Trial
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| Physiotherapy - control group | Other | Home exercise program |
|
| Change from baseline muscle strength at 6 weeks |
| Muscle strength with hand held dynamometer | Knee Flexors Muscle Strength | Change from baseline muscle strength at 6 weeks |
| Muscle strength with hand held dynamometer | Knee Extensors Muscle Strength | Change from baseline muscle strength at 6 weeks |
| Muscle strength with hand held dynamometer | Ankle Dorsiflexors Muscle Strength | Change from baseline muscle strength at 6 weeks |
| MiniBESTest | Static and dynamic balance evaluation. This test includes 14 items and maximum score is 28. 28 points means best balance status. | Change from baseline MiniBESTest scores at 6 weeks |
| Dynamic Gait Index | Dynamic balance evaluation especially walking balance. This test includes 8 items and maximum score is 24. Maximum score means best dynamic balance status. | Change from baseline Dynamic Gait Index scores at 6 weeks |
| 20699285 | Background | Freeman JA, Gear M, Pauli A, Cowan P, Finnigan C, Hunter H, Mobberley C, Nock A, Sims R, Thain J. The effect of core stability training on balance and mobility in ambulant individuals with multiple sclerosis: a multi-centre series of single case studies. Mult Scler. 2010 Nov;16(11):1377-84. doi: 10.1177/1352458510378126. Epub 2010 Aug 10. |
| 16540858 | Background | Hides J, Wilson S, Stanton W, McMahon S, Keto H, McMahon K, Bryant M, Richardson C. An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine (Phila Pa 1976). 2006 Mar 15;31(6):E175-8. doi: 10.1097/01.brs.0000202740.86338.df. |
| 22480437 | Background | Freeman J, Fox E, Gear M, Hough A. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial. BMC Neurol. 2012 Apr 5;12:19. doi: 10.1186/1471-2377-12-19. |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |