Local Vibration in Multiple Sclerosis Patients

Not Applicable

Interventions: Other: Standard physiotherapy program
Other: Standard physiotherapy program+50 Hz local vibration
Other: Standard physiotherapy program+100 Hz local vibration

Brief Summary: Gastrocnemius spasticity is one of the main complaints in Multiple Sclerosis patients.Local muscle vibration is a method used for spasticity inhibition. However, when the studies in the literature are examined; It is noted that local vibration applications for spasticity are usually single sessions and evaluate the acute effect, do not produce functional outputs, there is no consensus on frequency and amplitude and the changes in muscle architecture are not examined. In this study, we aimed to investigate the effect of local vibration applied on spastic gastrocnemius on muscle architectural and functional properties in Multiple Sclerosis patients in addition to the standard physiotherapy program. The study was planned to include 3 groups, 2 treatment and 1 control group. The control group will receive standard physiotherapy, one of the treatment groups will receive 50 Hz local vibration in addition to standard physiotherapy, and other treatment group will receive 100 Hz local vibration in addition to standard physiotherapy. Disease severity, gastrocnemius spasticity, architectural and viscoelastic properties of muscle, ankle proprioception, balance and gait skills will be evaluated before and after 8 weeks treatment program. As a result; effectiveness of local vibration in addition to standard physiotherapy program and whether there is a difference between applications at different frequencies will be examined.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

having any injury or surgery of the lower extremity
having systemic and metabolic disease
having behavioral and cognitive problems that prevent consistence to guidelines given

Arm && Interventions

Group	Intervention	Description
Control Group	Standard physiotherapy program	-
Treatment Group 50 Hz	Standard physiotherapy program+50 Hz local vibration	-
Treatment Group 100 Hz	Standard physiotherapy program+100 Hz local vibration	-

Primary Outcome Measures

Name	Time	Method
Evaluation of Muscle Thickness and Fascicle Length with Ultrasonography	3 minutes	Bilateral Medial Gastrocnemius US evaluations were performed with use of a 5-10 MHz linear probe (Diasus Dynamic Imaging Ltd, Livingston, Scotland,UK). Patients were positioned prone position with their legs and their muscles relaxed for medial gastrocnemius. Muscle Thickness and Fascicle Length would be expressed as centimeters.
Evaluation of Pennation Angle with Ultrasonography	2 minutes	Bilateral Medial Gastrocnemius US evaluations were performed with use of a 5-10 MHz linear probe (Diasus Dynamic Imaging Ltd, Livingston, Scotland,UK). Patients were positioned prone position with their legs and their muscles relaxed for medial gastrocnemius. Pennation Angle would be angularly indicated.

Secondary Outcome Measures

Name	Time	Method
Assessment of single leg balance	3 minutes	Single leg balance test
Assessment of balance	10 minutes	Bertec Balance Check ScreenerTM force platform system (Assessment of limits of stability, anteroposterior and mediolateral sway range)
Assessment of spasticity	5 minutes	Modified Ashworth Scale (minimum score 0 (worse), maximum score 4 (better))
Assessment of viscoelastic properties of muscle	5 minutes	Myoton-3 (assessment of tone, elasticity and stiffness)
Assessment of ankle proprioception	5 minutes	Isokinetic dynamometer (Isomed 2000) (passive ankle joint position sense)
Assessment of gait characterictics	5 minutes	GAITRite Analysis System (assessment of velocity, step length, percentage of gait cycle spent in double and single support, stance phase, swing phase, base of support)

Locations (1): Hacettepe University, Faculty of Physical Therapy and Rehabilitation
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Ankara, Altındağ, Turkey