Multiple Sclerosis Clinical Trial
Official title:
Investigating the Acute Effect of Fascial Mobilization on Dynamic Walking Parameters in Patients With Multiple Sclerosis: A Crossover Controlled Group Study
Ten patients who were referred to receive physiotherapy and 10 healthy volunteers will be participants of the study.Following the initial evaluation, participants with multiple sclerosis will take the fascial mobilization for their posterior crural muscle group and hamstring distal tendons which connects the crural bones at first day. After the day following the first visit participants will asked to come again and stretching exercises will apply to plantar muscle groups after the evaluation. Every participants will evaluate with the following assessment tools: Modified Ashworth scale will use to evaluation of severity of plantar flexor spasticity. Static and dynamic loading parameters will assess with dynamic pedobarography.
Ten patients who were referred to receive physiotherapy at the neurology department of
Physiotherapy and Rehabilitation of the Faculty of Health Sciences of Hacettepe University,
Ankara with multiple sclerosis and ten voluntary healthy age matched participants will be
the subjects of this study.
Following the initial evaluation, participants with multiple sclerosis will take the fascial
mobilization (FM) for their posterior crural muscle group and hamstring distal tendons which
connects the crural bones at first day. After the day following the first visit participants
will ask to come again and stretching exercises will apply to plantar muscle groups after
the evaluation. In the investigators' study fascial mobilization will use to release plantar
flexor muscles and fascia because it is believed to not aggravate the spasticity and is
widely used in clinical practice. Fascial mobilization will applied regarding the following
strategies.
The patient lied on prone position with knee extension and therapist put the patient's
plantar surface to her femoral region. Achilles, tibialis posterior, perenous longus and
brevis distal tendons, gastrocnemius proximal tendons, hamstring's distal tendons will
mobilize at first stage. The second stage of fascia mobilization includes the deep fascial
mobilization of posterior crural muscle trunks. After that, the skin also gently mobilize.
During fascial mobilization, once the spastic muscles relaxation were appeared, the ankle is
been moved to dorsiflexion gradually. FM will carry out for 15 minutes for each foot.
Same patients will receive also stretching exercises consisted of 30 s stretching and 10 s
resting periods and will carry out for 15 minutes for each foot at second day after the
first evaluation.Fourteen healthy volunteers will receive no interventions.
Assessments will utilize at initially and after FM were applied at first visit. The day
after patients will asked to come again and initially evaluations will repeat before
stretching exercises. After stretching exercises patients will evaluate again with same
tools.
Assessment tools described as following: Modified Ashworth scale will use to evaluate of
severity of plantar flexor spasticity. Static and dynamic loading parameters will be
evaluate with pedobarography.Maximum loading pressure -N/cm2, maximum loading time- ms for;
1st. and 5th metatarsal head, medial and lateral heel and midfoot will be recorded both
while the patients standing and walking.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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