To investigate the effect of CoDuSe balance training and step square exercises on the risk of falls in multiple sclerosis. BACKGROUND: risk of fall & balance disabilities are considered serious problems in multiple sclerosis which results in loss of balance & physical inactivity.

………HYPOTHESES:

This study hypothesized that:

CoDuSe balance training and step square exercises will have a significant effect on the risk of falling in multiple sclerosis

RESEARCH QUESTION:

Is there an effect of CoDuSe balance training and step square exercises on risk of fall in multiple sclerosis?

Fifty-two patients with multiple sclerosis will participate in this study.

The patients will randomly be divided into two equal groups; the control group which received the conventional selected exercise program and the study group received the same exercise training program in addition to CoDuSe balance training and step square exercises, three times per week for four weeks.

The Evaluation will done pre and post interventions included:

Biodex balance system (Risk falling), Short Physical Performance Battery (SPPB) & Morse Fall Scale.

Inclusion Criteria:

• Fifty-two Remitting-relapsing multiple sclerosis RRMS patients,
• Age will range as (20:40) years old
• Illness duration not more than 10 years,
• with no relapses over the past three months,
• body mass index (25:35)

Exclusion Criteria:

• difficulty to communicate or to understand program instructions
• any other neurological deficits or orthopedic abnormalities,
• secondary musculoskeletal complication
• peripheral vestibulopathy, hepatic, renal, hemopoeitic, thyroid and cardiovascular diseases, cognitive dysfunction,
• hearing deficits, epilepsy or EEG abnormalities