Neural Mobilization on Multiple Sclerosis

Multiple Sclerosis Clinical Trial

Official title:

Effect of Neurodynamic Mobilization Exercises on Pain, Muscle Strength and Manual Dexterity in Multiple Sclerosis Patients

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06153264
• Other study ID #: ipek.kirmaci
• Status: Recruiting
• Phase: N/A
• Start date: September 15, 2023
• Est. completion date: July 15, 2024

Study information

• Verified date: December 2023
• Source: Kahramanmaras Sutcu Imam University
• Contact: Zekiye Ipek Katirci Kirmaci
• Phone: +90 544 261 82 85
• Email: ipekkatirci[@]hotmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Current treatments for pain in MS patients include the use of non-pharmacological interventions such as electrotherapy and exercise, as well as pharmacological treatments. Neurodynamic mobilization exercises are an intervention that aims to restore homeostasis in and around the nervous system by activating the nervous system itself or the structures surrounding the nervous system. Neurodynamic mobilization facilitates movement between neural structures and their environment through manual techniques and exercise. Human and animal studies reveal that neurodynamic mobilization reduces intraneural edema, improves intraneural fluid distribution, reduces thermal and mechanical hyperalgesia, and reverses increased immune responses following a nerve injury.

Description:

Multiple Sclerosis (MS) is a chronic neurological disease characterized by local inflammation, gliosis and demyelination in the central nervous system (CNS). It is characterized by demyelinating plaques seen in the brain and medulla spinalis. Many different symptoms can be seen depending on the affected areas in the CNS. One of the common symptoms in these patients is pain. Approximately 50% of patients complain of pain at some point in their lives, and in 20% of them, pain is one of the initial symptoms. Pain may originate from the musculoskeletal system; It may also develop due to inflammation and upper motor neuron damage and may have a neuropathic character. As a result, pain in MS negatively affects patients' physical, emotional functions and quality of life. Current treatments for pain in MS patients include the use of non-pharmacological interventions such as electrotherapy and exercise, as well as pharmacological treatments. Neurodynamic mobilization exercises are an intervention that aims to restore homeostasis in and around the nervous system by activating the nervous system itself or the structures surrounding the nervous system. Neurodynamic mobilization facilitates movement between neural structures and their environment through manual techniques and exercise. Human and animal studies reveal that neurodynamic mobilization reduces intraneural edema, improves intraneural fluid distribution, reduces thermal and mechanical hyperalgesia, and reverses increased immune responses following a nerve injury. As a result of this study, it is thought that the determination of effective treatment methods for pain, which is a common symptom of MS patients, will increase the patient's muscle strength and dexterity. The aim of the study is to examine the effects of neurodynamic mobilization exercises on pain, muscle strength and dexterity in Multiple Sclerosis patients.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 40
• Est. completion date: July 15, 2024
• Est. primary completion date: June 15, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

1. Being diagnosed with MS according to McDonald 2010 diagnostic criteria

2. Being between the ages of 18-65

3. Volunteering to participate in the study

Exclusion Criteria:

1. Being under 18 years of age and over 65 years of age

2. Having a history of trauma within the last year

3. Having alcohol and substance addiction

4. Having diabetes mellitus

5. Having another known neurological disease

6. Being pregnant

Related Conditions & MeSH terms

• Multiple Sclerosis
• Sclerosis

Intervention

Other:
• neurodynamic mobilization exercise
Upper extremity neurodynamic mobilization exercises and upper extremity strengthening exercises will be applied 10 repetitions a day, 3 days a week for 6 weeks.
• strengthening exercises
upper extremity strengthening exercises will be applied 10 repetitions a day, 3 days a week for 6 weeks

Locations

Country	Name	City	State
Turkey	Kahramanmaras Sutcu Imam University	Kahramanmaras

Sponsors (1)

Lead Sponsor	Collaborator
Kahramanmaras Sutcu Imam University

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Visual Analog Scale	It is a scale used to determine the severity of pain and to clinically monitor pain.0 worst score/10 best score	Baseline and after 6 weeks
Primary	Leeds Assessment of Neuropathic Symptoms and Signs Scale	It is a multidimensional scale based on the analysis of short-term survey data that can be applied to the patient at the bedside and is especially used to differentiate between neuropathic and nociceptive pain. The scale is scored between 0 and 24 points, and a A score higher than 12 points indicates neuropathic pain.	Baseline and after 6 weeks
Secondary	Muscle strength	Upper extremity muscles will be evaluated using a digital dynamometer (Knect).	Baseline and after 6 weeks
Secondary	Manual Ability Measure-36	In this survey, in order to evaluate manual dexterity, it is questioned how difficult it is to perform 36 activities determined to represent daily living activities without the use of assistive devices. Items are rated on a 4-point Likert-type scale from 0 (almost never performed) to 4 (easy). Scores on the 36 items were summed to create a raw total score, and then the raw scores were converted to transformed manual ability measures, which range from 0 to 100	Baseline and after 6 weeks
Secondary	Nine hole peg test	It is a validated test in MS where manual dexterity is measured in seconds based on performance. A lower time is better score.	Baseline and after 6 weeks