Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT06198972 |
| Other study ID # |
ZIKKKSU |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
November 15, 2023 |
| Est. completion date |
March 15, 2024 |
Study information
| Verified date |
April 2024 |
| Source |
Kahramanmaras Sutcu Imam University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Multiple Sclerosis (MS) is an autoimmune, demyelinating disease that progresses with motor
and sensory loss of the central nervous system and causes disability at different levels.
Although signs and symptoms vary depending on the location of the lesion, findings such as
loss of muscle strength, spasticity, sensory disorders and fatigue cause decreases in walking
function in the majority of patients. Loss of muscle strength and fatigue cause loss of
mobility, causing individuals with MS to be less physically active than healthy adults in the
same age group. As a result, approximately 40% of individuals with MS have walking problems
and approximately 70% of them experience a decrease in daily living activities. Literature
studies frequently include strengthening exercises for lower extremity muscles in MS
patients. However, the results of pelvic pattern exercises, which are the key to lower
extremity movements, are not specified. In this study, which is planned in the light of this
information, the findings obtained from pelvic PNF exercises will serve to fill this gap in
the literature.
Description:
According to the data of the Turkish Neurology Association, it is estimated that there are
approximately 40,000 MS patients in Turkey. The fact that it is the most common neurological
disease in young adults further increases the importance of the need for effective treatment
programs.
Exercise training, which aims to improve the functional losses caused by the disease,
constitutes a very important part of rehabilitation protocols. For example, while the effects
of resistant exercise training have been investigated in athletes and healthy individuals, no
definitive results have been obtained regarding correct and effective exercise approaches in
MS.
The basic principle of proprioceptive neuromuscular facilitation techniques, defined as
facilitating the responses of the neuromuscular mechanism by stimulating the proprioceptors
and briefly expressed as PNF, is based on the principle that physiological movements in the
human body have rotational and oblique characters and that a greater response can be achieved
with movements performed against maximum resistance.
It consists of the pelvis, sacrum, innominate bones (ilium, ischium, pubis) and coccyx. The
vertebral column is directly connected to the lower extremities through the sacroiliac joint
and is a weight-bearing structure. Pelvic patterns are in harmony with lower extremity
patterns. Because the pelvis actually consists of different functional structures and is in
relationship with the lower extremities through the hip joint. Pelvic movements and stability
are necessary for adequate function of both the trunk and lower extremities. The therapeutic
purposes of pelvic patterns are as follows;
- Pelvic movements and stabilization,
- Body stabilization and movements,
- Rotation etc. functional activities,
- To improve lower extremity movements and stabilization Studies conducted on multiple
sclerosis patients indicate that walking patterns differ compared to healthy individuals
of the same age. Therefore, the main aim of MS rehabilitation is to maintain walking
ability and ensure mobility. To this end; Muscle strength, especially proximal muscles,
needs to be increased. Also MS; It is a neurological disease that affects the structures
responsible for maintaining balance, such as muscle strength and tone, sensory
perception, vision and cognition. For this reason, it is reported that balance and gait
control are impaired in approximately 80% of MS patients, increasing the number of falls
of patients. Because MS disease involves many areas such as the cerebral hemisphere,
brainstem and spinal cord, the cause of balance loss may vary from patient to patient.
Balance; It is a response formed jointly by visual, sensory, vestibular systems and
motor responses. It is complex because of the way systems work together. There is no
definitive evidence as to which system is more effective. However, studies have shown
that there is a relationship between loss of muscle strength and decreased walking speed
and balance problems. It is stated that lower extremity muscle strength is effective on
balance because it supports mobility the most and also plays a fundamental role in
sensoriomotor functions.
Literature studies frequently include strengthening exercises for lower extremity muscles in
MS patients. However, the results of pelvic pattern exercises, which are the key to lower
extremity movements, are not specified. In this study, which we planned in the light of this
information, the findings obtained from pelvic PNF exercises will serve to fill this gap in
the literature.
The hypothesis is that pelvic PNF applications will be superior to lower extremity
strengthening exercises in the development of muscle strength, balance and gait in patients
with MS who receive 6-week training.
