The Effects of Tai Chi and Square Stepping Exercises on Joint Position Sense and Clinical Outcomes in Women With Multiple Sclerosis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 39
- 试验地点
- 1
- 主要终点
- Knee joint position sense
研究概览
简要总结
Tai Chi is an exercise approach consisting of slow and controlled movements, whereas square stepping exercises are an exercise method in which specific step patterns are followed. The aim of this study is to comparatively examine the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels in women with multiple sclerosis.
详细描述
Multiple Sclerosis (MS) is a chronic and demyelinating disease of the central nervous system observed in young adults. As the disease progresses, impairments occur in motor and sensory functions. Somatosensory inputs, such as knee joint position sense, which is particularly critical for balance and postural control, are frequently affected. In addition to these impairments, a decrease in lower extremity muscle strength and fatigue affecting the vast majority of patients restrict participation in activities of daily living.
Within the scope of this study, women diagnosed with MS will be randomized into one of three different intervention arms: a Tai Chi group incorporating postural stability exercises based on the Yang style; a Square Stepping Exercise (SSE) group consisting of coordinated step patterns aimed at improving sensorimotor integration; or a control group in which Frenkel exercises, representing traditional coordination approaches, are applied. Exercise interventions in all groups were planned for 8 weeks, twice a week.
The study aims to comparatively demonstrate the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels, and to develop evidence-based strategies for these parameters in MS rehabilitation
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Willing to participate and provide informed consent.
- •Diagnosed with multiple sclerosis (MS) according to the McDonald diagnostic criteria.
- •Relapsing-remitting MS (RRMS) phenotype.
- •EDSS score < 3.
- •Female, 20-45 years of age.
- •No MS relapse within the past 1 month.
- •No lower-extremity spasticity according to the Modified Ashworth Scale (MAS).
排除标准
- •Any neurological disease other than MS.
- •Experiencing an MS relapse during the study period.
- •History of orthopedic surgery that may affect balance.
- •Cognitive or psychiatric impairment that may interfere with study participation.
- •Cardiovascular or pulmonary history that may prevent participation.
- •Use of medications that may affect clinical assessment (e.g., antipsychotic use; continuous corticosteroid or immunosuppressive use within the past 1 month).
- •Participation in any other exercise program
研究组 & 干预措施
Tai Chi
Participants in this arm will perform a supervised, group-based Tai Chi program. The program consists of selected movements from the Yang-style 24-form taught progressively, with emphasis on controlled weight shifting, postural alignment, and coordinated whole-body movement. Each session includes a warm-up period with general stretching, a main Tai Chi practice component with repeated form practice (with rest breaks as needed), and a cool-down period that includes stretching and controlled breathing techniques.
干预措施: Tai Chi (Behavioral)
Square Stepping Exercise (SSE)
Participants in this arm will receive supervised, group-based Square Stepping Exercise (SSE) performed on a 250 cm × 100 cm mat divided into 40 squares (25 cm each). Participants will practice predefined stepping patterns that include forward, backward, horizontal (lateral), and diagonal steps. Selected patterns will be repeated 3-5 times, followed by the mirrored version for the same number of repetitions. If a participant has difficulty with a pattern, it will be repeated until learned; progression will occur after the participant completes the pattern correctly three consecutive times.
干预措施: Square Stepping Exercise (SSE) (Behavioral)
Home Exercise Program (Frenkel)
Participants in this arm will follow a home-based program consisting of Frenkel Coordination Exercises (FKE), a coordination-focused exercise approach developed to address gait, balance, and coordination. The exercises emphasize slow, accurate, and well-controlled movements, typically supported by visual guidance and repeated practice to improve movement sequencing and coordination.
干预措施: Home-based Frenkel Coordination Exercises (Behavioral)
结局指标
主要结局
Knee joint position sense
时间窗: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Knee joint position sense will be assessed using an electrogoniometer. For standardization, participants will be evaluated in a seated position with back support, with the hip and knee at 90° flexion. A target angle of 30° knee extension (relative to the start position) will be used. When the participant reaches the target angle, she will be asked to hold the position for 5 seconds to learn the angle. The knee will then be returned to the neutral position and the participant will be asked to reproduce the target angle. Measurements will be repeated three times, the mean value will be calculated, and the absolute error (in degrees) will be recorded. Assessments will be conducted in a quiet room with eyes closed, with the joint exposed and barefoot.
次要结局
- Five-Repetition Sit-to-Stand Test (5STS)(Baseline (pre-intervention) and immediately post-intervention (Week 8).)
- Fatigue Impact Scale (FIS)(Baseline (pre-intervention) and immediately post-intervention (Week 8).)
研究者
müge içelli
Lecturer
Pamukkale University