Effects of Mat and Reformer Pilates Training on Postural Adjustments, Balance, and Walking in Patients With Multiple Sclerosis
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- Gait kinematics
研究概览
简要总结
Our study aims to investigate the effects of core stability-based Mat Pilates and Equipment-Based Pilates training on anticipatory postural adjustments (APA), balance, and gait in individuals with Multiple Sclerosis (MS). Participants diagnosed with MS will be randomly assigned to Mat Pilates, Equipment-Based Pilates, or a control group. Both Pilates programs will be conducted twice a week for eight weeks.
Assessments will be conducted before and after the training period. Anticipatory postural adjustments (APA) will be evaluated using electromyography (EMG) electrodes placed on the Erector Spinae and Tibialis Anterior muscles while participants take a step. Biomechanical responses related to APAs, specifically center of pressure displacement, will be measured using a force platform (Biodex® BioSway).
Core endurance will be assessed using the lateral bridge test, Modified Biering-Sorensen test, trunk flexion test, and prone bridge test, while core strength will be evaluated through sit-ups and push-ups. Balance will be measured using posturography. The Activities-Specific Balance Confidence (ABC) Scale will assess confidence in performing daily activities requiring balance. Functional mobility will be evaluated using the Timed Up and Go (TUG) test. Spatiotemporal gait parameters and variability will be analyzed with the BTS® G-WALK system. The Multiple Sclerosis Quality of Life Questionnaire (MSQOL-54) will assess quality of life.
This study is unique in that, unlike previous Pilates studies, it will be the first to examine the effects of different Pilates methods on APAs, which are crucial for both locomotor activities and postural stability in individuals with MS. Additionally, it will be the first study to evaluate two commonly used Pilates techniques in terms of their impact on balance and gait.
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
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of Multiple Sclerosis by a specialist physician
- •Having a disability level between 0-4.5 according to the Expanded Disability Status Scale (EDSS)
- •Being between the ages of 18-65
- •Not having had an attack in the last 3 months
- •Mini-Mental Test score > 25
排除标准
- •Having another neurological disorder
- •Having orthopedic, cardiovascular, and pulmonary problems that may affect the research results
- •Having vision, hearing, and perception problems
- •Having a disease that may affect the immune system, such as infection, cancer
研究组 & 干预措施
Mat Pilates
In Mat Pilates training, exercise balls and elastic bands will be used. The exercises will be done with 10 repetitions for the first 4 weeks, and with 20 repetitions for the last 4 weeks. The difficulty level of the exercises will be increased in the following weeks according to the patient's condition.
干预措施: Mat Pilates (Other)
Reformer Pilates
In the Reformer Pilates group, the difficulty level of the exercises will be provided by different positions, and the springs' resistance will be increased.
干预措施: Reformer Pilates (Other)
Control group
The control group will perform the relaxing exercise at home.
结局指标
主要结局
Gait kinematics
时间窗: 8 weeks
Measurement Tool: BTS G-WALK sensor system Parameters Assessed: Walking speed (m/s) Cadence (steps/min) Step length (m) Step time (s) Stance time (s) Swing time (s) Double support time (s) Single support time (%) Pelvic angle changes (degrees) Procedure: Participants will walk naturally over a 7-meter course while spatiotemporal parameters are recorded.
Anticipatory postural adjustments (APA)
时间窗: 8 weeks
Measurement Tool: Biodex-BioSway™ Portable Balance System Parameters Assessed: Maximum posterior displacement (cm), maximum lateral displacement (cm) Procedure: Participants will take a step following an auditory cue. The magnitude, duration, and latency of medio-lateral and anterior-posterior APAs, as well as the magnitude and speed of the first step, will be recorded separately.
Neuromuscular activation
时间窗: 8 weeks
Measurement Tool: Wireless surface EMG sensors Muscles Assessed: Erector spinae (µV), Tibialis anterior (µV) Procedure: EMG amplitude will be recorded at the onset of APAs, following SENIAM project (Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscles) guideline.
Core stability
时间窗: 8 weeks
Core stability will be evaluated in terms of endurance and strength. Core endurance will be measured using the McGill Protocol, which includes the Modified Biering-Sorensen trunk extension test, lateral bridge test, trunk flexion test, and prone bridge test. The results will be recorded in seconds. Core strength will be assessed using sit-ups and modified push-ups, where participants will be asked to complete as many repetitions as possible within 30 seconds.
Postural stability
时间窗: 8 weeks
Measurement Tool: Portable Balance System Parameters Assessed: Total stability index Anterior-posterior stability index Medio-lateral stability index Procedure: Tests performed for 30 seconds (both feet stance) and 10 seconds (single leg stance), repeated three times. Average values will be reported.
次要结局
- Balance Confidence(8 weeks)
- Mobility(8 weeks)
- Fatigue severity(8 weeks)
- Quality of life(8 weeks)