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Effect of Combined Exercise Training in Patients With Multiple Sclerosis

Not Applicable
Not yet recruiting
Conditions
Multiple Sclerosis
Interventions
Other: Exercise
Other: Home program
Registration Number
NCT06595394
Lead Sponsor
Uskudar University
Brief Summary

The aim of this clinical trial is exercise in sarcopenic MS patients to demonstrate the effectiveness of education. The main questions it aims to answer are: -Can exercise training make a change in muscle thickness in sarcopenic MS patients?

--Does exercise training have an effect on balance in sarcopenic MS patients?

- Does exercise training have an effect on the risk of falling in sarcopenic MS patients?

Participants will:

They will continue combined exercise applications 3 days a week for 8 weeks. Evaluations will be made before the application and at the end of the 8 weeks. The data will be analyzed afterwards.

Detailed Description

A significant decrease in physical performance is observed in MS patients. The reasons for this can be changes in muscle contractile structures and symptoms such as sarcopenia. Sarcopenia is a disorder characterized by loss of skeletal muscle mass and decrease in muscle strength and physical performance. Loss of muscle mass seen outside of old age is defined as secondary sarcopenia. In recent years, studies on neurological disorders and their relationship with sarcopenia have increased. Early diagnosis of sarcopenia in neurological patients and implementation of applications aimed at this are important from an early stage. The aim of this study is to examine the effect of exercise training in sarcopenic MS patients. In the study, participants will be applied a combined exercise program 3 days a week for 8 weeks. Parameters such as muscle thickness, balance, and fall risk will be evaluated before and after physiotherapy application including aerobic exercise, balance exercises, and strengthening exercises.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • People diagnosed with MS by a neurologist
  • People with ambulation whose EDSS is 4.5 or below
  • People between the ages of 18-50
  • People who do not exercise regularly and are not included in an exercise program
Exclusion Criteria
  • Having been diagnosed with sarcopenia before MS diagnosis
  • Having had an MS attack within the last 30 days
  • Having any musculoskeletal problems that may affect walking and balance
  • Having a diagnosed psychiatric disease that may affect cognitive status
  • Having a neurological disease other than MS

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Interventional groupExerciseParticipants were given combined exercise training 3 days a week.
Control groupHome programParticipants were followed with a home program 3 days a week.
Primary Outcome Measures
NameTimeMethod
Muscle thickness8 weeks

Ultrasound (US) is an easy-to-use imaging method that provides information about both muscle quality and quantity, with no risk of radiation. Muscle thickness will be assessed with US. Muscle thickness assessed with US has been shown to be consistent with gold standard measurements that assess muscle function and thickness.

Secondary Outcome Measures
NameTimeMethod
SARC -F8 weeks

The SARC-F questionnaire was developed in 2018 for the rapid diagnosis of sarcopenia and the questionnaire was recommended in the EWGSOP2 guide in 2019 to determine possible sarcopenia. According to the EWGSOP2 guide, a score of 4 or more (0-10) from the SARC-F questionnaire is considered significant for sarcopenia.

Hand grip strength measurement8 weeks

Muscle strength assessment, which is one of the indicators of sarcopenia, is done by measuring handgrip strength. The measurement is performed with the JAMAR hand dynamometer upon the recommendation of the American Hand Therapists Association. The current cut-off value of handgrip strength is determined as 17.1 kg for men and 11.9 kg for women.

Bioelectrical impedance analysis8 weeks

Bioelectrical impedance analysis (BIA) device is used to determine body composition. At the end of the measurements, if the appendicular skeletal muscle mass is \<15 in women and \<20 in men according to the cut-off values recommended by EWGSOP2 (European Working Group on Sarcopenia in Older People), this indicates sarcopenia.

Timed Up and Go (TUG)8 weeks

TUG evaluates the functional mobility of patients with the risk of falling. The time it takes for the patient to complete a task is determined with the help of a stopwatch. TUG is an effective and reliable measurement method for the evaluation of functional mobility in patients with MS.

Berg Balance Scale (BBS)8 weeks

BBS was created to assess balance and fall risk. Each question is scored between 0-4 on the 14-item scale. The lowest value obtained from the scale is '0' and the highest value is '56'. According to the total values obtained from the scale; the 0-20 value range indicates severe balance disorder, the 21-40 value range indicates acceptable balance disorder and the 41-56 value range indicates that the patient has good balance.

Fatigue Severity Scale (FSS)8 weeks

The scale consists of 9 questions that allow MS patients to evaluate their last week. All questions are scored between 1-7 and the result is obtained by dividing the total value by 9. A result value greater than 6.1 is a sign of chronic fatigue.

6 Minute Walk Test8 weeks

It is used to evaluate physical performance in people with sarcopenia. The 6MWT can be used safely and easily in the evaluation of impaired functional capacity in outpatient MS patients.

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