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The effectiveness of upper extremity focused neuromuscular exercise training in early stage people with MS will be investigated. People with MS enrolled in the study will be randomly assigned to three groups: Neuromuscular Exercise Group (NEG), Conventional Exercise Group (CEG), and Control Group (CG). All three groups will be assessed with primary and secondary outcome measures at baseline, week 8, and week 12. NEG, CEG, and CG will be initially assessed for upper extremity function, cognitive function, lower extremity function, grip strength, proximal muscle strength, sensation, coordination, fatigue, postural sway, and core muscle strength and endurance. Then, NEG will receive clinically supervised upper extremity focused neuromuscular exercise training with a minimum of 60 minutes of session time, 2 days a week for 8 weeks. This exercise training includes steps for postural control, weight transfer, proximal and distal muscle strengthening, proprioception, coordination and reaction speed. Similarly, CEG will receive clinically supervised traditional upper extremity exercise training, twice a week for 8 weeks, with a minimum of 60 minutes of session time. This exercise training includes strengthening with the band and manuel dexterity exercises. In both groups, stretching and mobility exercises will be added to the warm-up and cool-down exercises before and after the program. During this process, CG will be on the waiting list. At the end of 8 weeks, all three groups will be re-evaluated. After the exercise training, follow-up will be done and evaluations will be repeated in the 12th week. This study will provide evidence on the effects of upper extremity-focused neuromuscular exercise training on physical and cognitive functions in early-stage people with MS compared to traditional treatment approaches.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NEG | Experimental | Upper Extremity Focused Neuromuscular Exercise Training |
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| CEG | Active Comparator | Traditional Upper Extremity Exercise Training |
|
| CG | No Intervention | Control Group |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neuromuscular Exercise Training | Other | This group will receive neuromuscular exercise training with 60-75 minute sessions per day, 2 days a week, for 8 weeks. Warm-up Program - 5 minutes Postural Control-Weight Transfer - 10-15 minutes Strength Training - 30-35 minutes Proprioception - Coordination - Reaction Speed 10-15 minutes Cool-down Program - 5 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Nine Hole Peg Test | To assess unilateral function of the upper extremity | At the beginning, at the end of 8 weeks and 12 weeks |
| Minnesota Manual Dexterity Test | To assess bilateral upper extremity function | At the beginning, at the end of 8 weeks and 12 weeks |
| Manual Ability Measure-36 | To assess upper extremity function. A higher score indicates better hand function. | At the beginning, at the end of 8 weeks and 12 weeks |
| Timed 25-Foot Walk | To assess lower extremity function | At the beginning, at the end of 8 weeks and 12 weeks |
| Symbol Digit Modalities Test | To assess cognitive function | At the beginning, at the end of 8 weeks and 12 weeks |
| Hand Dynamometer | To assess hand grip strength | At the beginning, at the end of 8 weeks and 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Hand Held Dynamometer | To assess elbow muscle strength | At the beginning, at the end of 8 weeks and 12 weeks |
| Biodex Balance System | To assess postural sway |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Uğur Ovacık | Contact | +90 444 1 428 | ovacikugur@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Uğur Ovacık | Istanbul Aydın University | Principal Investigator |
| Ela Tarakcı | Istanbul University - Cerrahpasa | Study Director |
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| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D009043 | Motor Activity |
| 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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| Conventional Exercise Training | Other | This group will be given traditional strength exercise training consisting of 60-75 minute sessions per day, 2 days per week for 8 weeks. Warm-up Program - 5 minutes Strength Training - 30-35 minutes Manuel Dexterity - 15-20 minutes Cool-down Program - 5 minutes |
|
| At the beginning, at the end of 8 weeks and 12 weeks |
| Laser-pointer Assisted Angle Reproduction Test | To assess of shoulder proprioception | At the beginning, at the end of 8 weeks and 12 weeks |
| Finger Tapping Test | To assess upper extremity coordination | At the beginning, at the end of 8 weeks and 12 weeks |
| Fatigue Severity Scale | To assess fatigue severity. A high score indicates high fatigue severity. | At the beginning, at the end of 8 weeks and 12 weeks |
| Plank | To assess core muscle endurance | At the beginning, at the end of 8 weeks and 12 weeks |
| Curl-up | To assess core muscle strength | At the beginning, at the end of 8 weeks and 12 weeks |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D001519 | Behavior |