Multiple Sclerosis
Conditions
Keywords
multiple sclerosis, isokinetic, exercises, joint position sense, kinesiophobia
Brief summary
The investigators evaluated the effects of isokinetic muscle strengthening exercises of the quadriceps and hamstring on muscle strength, joint position sense, pain, kinesiophobia and quality of life in patients with multiple sclerosis.
Detailed description
Objective: To evaluate the effects of isokinetic exercises on muscle strength, knee joint position sense, pain, kinesiophobia, and quality of life in patients with multiple sclerosis. Design: Randomized controlled trial. Setting: Outpatient clinic. Participants: Fifty patients with multiple sclerosis. Interventions: Fifty patients who met the inclusion criteria were randomized to an isokinetic exercise (n:25) or home exercise programme (n:25). Sequentially numbered opaque envelopes were used for randomization. Outcome measures: The outcome measures were the peak torque/body mass index of quadriceps and hamstring muscles at 60°/s and 180°/s velocities, the hamstring/quadriceps ratios at the same velocities, absolute angular errors of the 15°, 45°, and 60° and the mean absolute angular error of joint position sense of the less and more affected knees, and the scores of Multiple Sclerosis Quality of Life-54, Visual Analogue Scale, and Tampa Scale of Kinesiophobia.
Interventions
OTHERexercises
Sponsors
Aksaray University Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This prospective randomized controlled trial aimed to recruit 50 patients with MS from the physical medicine and rehabilitation clinic of Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey. Fifty patients who met the inclusion criteria were enrolled in the study. Fifty patients were randomized to two groups: isokinetic exercise (Group 1) (n=25) and home exercise (Group 2) (n=25). Randomization was completed using sequentially numbered, opaque envelopes by the investigator. All patients gave informed consent before the assessment. The outcome measures were assessed initially and at eighth week after the treatment. Group 1 performed isokinetic concentric quadriceps and hamstring strengthening exercises under supervision and Group 2 performed lower extremity muscle strengthening and balance exercises at home.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* definite relapsing remitting MS and secondary progressive MS diagnosis * mild and moderate MS determined by Kurtzke Expanded Disability Status Scale (EDSS) scores below 6.5 * a disease duration of more than one year.
Exclusion criteria
* having an acute exacerbation within the last three months * intravenous pulse steroid therapy in the last four weeks * grade 3-4 spasticity according to the Modified Ashworth Scale * severe vision impairment * severe fatigue and depression * past knee surgery * other neurologic diseases * systemic diseases * pregnancy * having received an exercise program within the last four weeks.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Isokinetic Muscle Strength Test of the More and Less Affected Knees | At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment | The peak torque/body mass index of the quadriceps and hamstring muscles at 60°/s and 180°/s velocities were measured by an isokinetic dynamometer (Biodex Multijoint Pro 3) in Newton/meter. A definite muscle strength value has not been defined. Literally, healthy controls and patients are compared. Higher scores indicate better muscle strength. |
| Joint Position Sense of the More and Less Affected Knees | At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment | Absolute angular errors of the 15°, 45°, and 60° and the mean absolute angular error of the more and less affected knees were measured by an isokinetic dynamometer (Biodex Multijoint Pro 3) with active-active angular reproduction method. Estimating the target angel procedure was repeated at 45°, 15°, and 60° and for both the more and less affected legs. After the joint position sense testing, three angles estimated by the patients were averaged, and the angular error was calculated for each target angle. Absolute angular error was calculated by averaging the angular errors, regardless of the numbers being negative or positive. The absolute angular error values of the three target angles were averaged to obtain the mean absolute angular errors. A definite angular error value has not been defined. Literally, healthy controls and patients are compared. Higher scores indicate worser joint position sense. |
| Tampa Scale of Kinesiophobia | At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment | Kinesiophobia which is described as fear of movement and physical activity was evaluated using the Tampa Scale of Kinesiophobia, which is a 17-item self-report survey. The range of scores are from 17 to 68 where the higher scores indicate an increasing degree of kinesiophobia. If the total score was above 37 points, the patient was considered to have a high level of kinesiophobia. |
| Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment | This is a multidimensional health-related quality of life measure that combines both generic and multiple sclerosis-specific symptoms in a single instrument. The 54 items are divided into 12 multi-item and 2 single-item scales.Health distress, overall quality of life, emotional well-being, role limitations-emotional and cognitive funtion items' final scores averaged and mental composite score was calculated. Physical function, health perceptions, energy/fatigue, role limitations-physical, pain, sexual function, social function, health distress items' final scores were averaged and physical composite score was obtained.Total score was obtained by averaging the mental and physical composite scores.Final scores can be between 0-100 points for total, mental, physical and pain scores. Higher values indicate better quality of life for total, physical and mental scores and worser pain levels for pain score. |
| Visual Analog Scale | At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment | Pain intensity was evaluated with the Visual Analog Scale. Using a ruler, a 10 cm line was drawn which provided a range of scores from 0-100. Than the patients marked the point that showed their pain intensity on this line. A higher score in Visual Analog Scale indicates greater pain intensity. |
Countries
Turkey (Türkiye)
Participant flow
Recruitment details
This prospective randomized controlled trial aimed to recruit 50 patients with multiple sclerosis from the physical medicine and rehabilitation clinic of Ankara Training and Research Hospital, Health Sciences University, Ankara, Turkey.
Participants by arm
| Arm | Count |
|---|---|
| Isokinetic Exercise The isokinetic dynamometer (Biodex Multijoint Pro 3) was used for isokinetic exercises. The isokinetic exercise program was implemented over eight weeks, twice a week on non-consecutive days under the supervision of a doctor. The number of repetitions undertaken by the patients over the program were as follows: first week 5 at 60°/s and 10 at 180°/s, second week 10 at 60°/s and 15 at 180°/s, third week 15 at 60°/s and 20 at 180°/s, fourth week 20 at 60°/s and 30 at 180°/s, and in the last four weeks 20 at 60°/s and 40 at 180°/s angular velocities. Each block of 10 repetitions were performed as a set.
exercises | 19 |
| Home Exercise The patients undertook lower extremity strengthening and balance exercises three times a week for eight weeks without supervision. They started with three repetitions, which was gradually increased to 10-15. The patients were called two times a week to inquire about exercise continuity and encouraged to undertake the recommended exercises.
exercises | 21 |
| Total | 40 |
Baseline characteristics
| Characteristic | Home Exercise | Total | Isokinetic Exercise |
|---|---|---|---|
| Age, Continuous | 39.95 years STANDARD_DEVIATION 12.25 | 39.60 years STANDARD_DEVIATION 10.63 | 39.21 years STANDARD_DEVIATION 8.81 |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment Turkey | 21 Participants | 40 Participants | 19 Participants |
| Sex: Female, Male Female | 14 Participants | 27 Participants | 13 Participants |
| Sex: Female, Male Male | 7 Participants | 13 Participants | 6 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Isokinetic Muscle Strength Test of the More and Less Affected Knees
The peak torque/body mass index of the quadriceps and hamstring muscles at 60°/s and 180°/s velocities were measured by an isokinetic dynamometer (Biodex Multijoint Pro 3) in Newton/meter. A definite muscle strength value has not been defined. Literally, healthy controls and patients are compared. Higher scores indicate better muscle strength.
Time frame: At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(more affected knee) | 82.46 Newton/meter | Standard Deviation 43.96 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(less affected knee) | 59.87 Newton/meter | Standard Deviation 24.51 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring/Quadriceps(more affected knee) | 0.92 Newton/meter | Standard Deviation 0.58 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring/Quadriceps(more affected knee) | 0.77 Newton/meter | Standard Deviation 0.27 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(more affected knee) | 42.25 Newton/meter | Standard Deviation 25.19 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(less affected knee) | 46.74 Newton/meter | Standard Deviation 17.76 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s hamstring/quadriceps(less affected knee) | 0.63 Newton/meter | Standard Deviation 0.14 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(less affected knee) | 69.25 Newton/meter | Standard Deviation 24.28 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(more affected knee) | 58.87 Newton/meter | Standard Deviation 33.6 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s hamstring/quadriceps (less affected knee) | 0.80 Newton/meter | Standard Deviation 0.19 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(less affected knee) | 110.48 Newton/meter | Standard Deviation 37.2 |
| Isokinetic Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(more affected knee) | 52.42 Newton/meter | Standard Deviation 25.08 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(less affected knee) | 85.87 Newton/meter | Standard Deviation 21 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(more affected knee) | 118.50 Newton/meter | Standard Deviation 45.52 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(less affected knee) | 141.05 Newton/meter | Standard Deviation 31.59 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring/Quadriceps(more affected knee) | 0.65 Newton/meter | Standard Deviation 0.12 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(more affected knee) | 77.70 Newton/meter | Standard Deviation 29.27 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s hamstring/quadriceps(less affected knee) | 0.61 Newton/meter | Standard Deviation 0.12 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(more affected knee) | 51.38 Newton/meter | Standard Deviation 23.24 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(less affected knee) | 82.87 Newton/meter | Standard Deviation 23.11 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring/Quadriceps(more affected knee) | 0.66 Newton/meter | Standard Deviation 0.19 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(less affected knee) | 56.85 Newton/meter | Standard Deviation 19.74 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(more affected knee) | 73.62 Newton/meter | Standard Deviation 23.53 |
| Isokinetic Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s hamstring/quadriceps (less affected knee) | 0.69 Newton/meter | Standard Deviation 0.19 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring/Quadriceps(more affected knee) | 0.94 Newton/meter | Standard Deviation 0.58 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(less affected knee) | 123.02 Newton/meter | Standard Deviation 53.8 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(less affected knee) | 72.85 Newton/meter | Standard Deviation 29.02 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s hamstring/quadriceps(less affected knee) | 0.61 Newton/meter | Standard Deviation 0.14 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(less affected knee) | 71.06 Newton/meter | Standard Deviation 32.01 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(less affected knee) | 53.73 Newton/meter | Standard Deviation 22.55 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s hamstring/quadriceps (less affected knee) | 0.76 Newton/meter | Standard Deviation 0.22 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(more affected knee) | 100.16 Newton/meter | Standard Deviation 47.85 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(more affected knee) | 67.00 Newton/meter | Standard Deviation 30.87 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring/Quadriceps(more affected knee) | 0.71 Newton/meter | Standard Deviation 0.22 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(more affected knee) | 57.18 Newton/meter | Standard Deviation 30.59 |
| Home Exercise Baseline | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(more affected knee) | 46.19 Newton/meter | Standard Deviation 22.2 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring/Quadriceps(more affected knee) | 0.71 Newton/meter | Standard Deviation 0.22 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s hamstring/quadriceps (less affected knee) | 0.74 Newton/meter | Standard Deviation 0.18 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(less affected knee) | 56.76 Newton/meter | Standard Deviation 21.21 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(less affected knee) | 127.83 Newton/meter | Standard Deviation 54.35 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(more affected knee) | 62.03 Newton/meter | Standard Deviation 29.38 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Quadriceps PT/BMI(less affected knee) | 76.54 Newton/meter | Standard Deviation 28.73 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s hamstring/quadriceps(less affected knee) | 0.62 Newton/meter | Standard Deviation 0.12 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring/Quadriceps(more affected knee) | 0.85 Newton/meter | Standard Deviation 0.48 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 180°/s Hamstring PT/BMI(more affected knee) | 48.08 Newton/meter | Standard Deviation 23.38 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(more affected knee) | 72.80 Newton/meter | Standard Deviation 31.55 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Quadriceps PT/BMI(more affected knee) | 108.06 Newton/meter | Standard Deviation 48.83 |
| Home Exercise After Treatment | Isokinetic Muscle Strength Test of the More and Less Affected Knees | 60°/s Hamstring PT/BMI(less affected knee) | 78.40 Newton/meter | Standard Deviation 31.21 |
Primary
Joint Position Sense of the More and Less Affected Knees
Absolute angular errors of the 15°, 45°, and 60° and the mean absolute angular error of the more and less affected knees were measured by an isokinetic dynamometer (Biodex Multijoint Pro 3) with active-active angular reproduction method. Estimating the target angel procedure was repeated at 45°, 15°, and 60° and for both the more and less affected legs. After the joint position sense testing, three angles estimated by the patients were averaged, and the angular error was calculated for each target angle. Absolute angular error was calculated by averaging the angular errors, regardless of the numbers being negative or positive. The absolute angular error values of the three target angles were averaged to obtain the mean absolute angular errors. A definite angular error value has not been defined. Literally, healthy controls and patients are compared. Higher scores indicate worser joint position sense.
Time frame: At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of less affected knee | 5.56 degree | Standard Deviation 2.78 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of lmore affected knee | 4.94 degree | Standard Deviation 3.06 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of less affected knee | 6.26 degree | Standard Deviation 4.7 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of more affected knee | 4.61 degree | Standard Deviation 3.79 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of less affected knee | 6.41 degree | Standard Deviation 3.61 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of more affected knee | 4.73 degree | Standard Deviation 3.81 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of less affected knee | 3.40 degree | Standard Deviation 3.08 |
| Isokinetic Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of more affected knee | 6.02 degree | Standard Deviation 4.99 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of more affected knee | 4.21 degree | Standard Deviation 2.95 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of less affected knee | 5.86 degree | Standard Deviation 3.95 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of lmore affected knee | 4.38 degree | Standard Deviation 1.94 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of more affected knee | 4.17 degree | Standard Deviation 2.52 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of less affected knee | 3.39 degree | Standard Deviation 3 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of more affected knee | 0.74 degree | Standard Deviation 4.04 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of less affected knee | 3.87 degree | Standard Deviation 4.28 |
| Isokinetic Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of less affected knee | 4.39 degree | Standard Deviation 2.32 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of less affected knee | 4.55 degree | Standard Deviation 4.78 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of less affected knee | 5.93 degree | Standard Deviation 5.26 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of more affected knee | 4.96 degree | Standard Deviation 4.05 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of less affected knee | 6.23 degree | Standard Deviation 4.36 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of more affected knee | 5.80 degree | Standard Deviation 5 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of more affected knee | 4.18 degree | Standard Deviation 6.67 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of less affected knee | 5.70 degree | Standard Deviation 3.19 |
| Home Exercise Baseline | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of lmore affected knee | 5.76 degree | Standard Deviation 5.35 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of less affected knee | 5.32 degree | Standard Deviation 4.07 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 15° joint position sense of more affected knee | 5.27 degree | Standard Deviation 3.82 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of lmore affected knee | 4.99 degree | Standard Deviation 3.59 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | mean absolute angular error of less affected knee | 5.03 degree | Standard Deviation 2.65 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of less affected knee | 4.94 degree | Standard Deviation 3.04 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of more affected knee | 3.47 degree | Standard Deviation 3.92 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 60° joint position sense of less affected knee | 3.76 degree | Standard Deviation 4.73 |
| Home Exercise After Treatment | Joint Position Sense of the More and Less Affected Knees | 45° joint position sense of more affected knee | 5.46 degree | Standard Deviation 4.62 |
Primary
Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score
This is a multidimensional health-related quality of life measure that combines both generic and multiple sclerosis-specific symptoms in a single instrument. The 54 items are divided into 12 multi-item and 2 single-item scales.Health distress, overall quality of life, emotional well-being, role limitations-emotional and cognitive funtion items' final scores averaged and mental composite score was calculated. Physical function, health perceptions, energy/fatigue, role limitations-physical, pain, sexual function, social function, health distress items' final scores were averaged and physical composite score was obtained.Total score was obtained by averaging the mental and physical composite scores.Final scores can be between 0-100 points for total, mental, physical and pain scores. Higher values indicate better quality of life for total, physical and mental scores and worser pain levels for pain score.
Time frame: At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Isokinetic Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (total) | 52.20 score on a scale | Standard Deviation 17.98 |
| Isokinetic Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (physical) | 50.79 score on a scale | Standard Deviation 17.02 |
| Isokinetic Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (mental) | 53.59 score on a scale | Standard Deviation 20.71 |
| Isokinetic Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (pain) | 54.52 score on a scale | Standard Deviation 26.9 |
| Isokinetic Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (physical) | 54.69 score on a scale | Standard Deviation 18.31 |
| Isokinetic Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (mental) | 59.33 score on a scale | Standard Deviation 21.81 |
| Isokinetic Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (pain) | 58.57 score on a scale | Standard Deviation 30.1 |
| Isokinetic Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (total) | 57.00 score on a scale | Standard Deviation 18.95 |
| Home Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (mental) | 64.11 score on a scale | Standard Deviation 20.41 |
| Home Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (physical) | 58.64 score on a scale | Standard Deviation 19.81 |
| Home Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (pain) | 71.74 score on a scale | Standard Deviation 28.52 |
| Home Exercise Baseline | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (total) | 61.38 score on a scale | Standard Deviation 18.54 |
| Home Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (pain) | 67.83 score on a scale | Standard Deviation 29.94 |
| Home Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (physical) | 56.69 score on a scale | Standard Deviation 22.1 |
| Home Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (total) | 59.39 score on a scale | Standard Deviation 20.93 |
| Home Exercise After Treatment | Multiple Sclerosis Quality of Life-54 Total Score, Physical and Emotional Composite Scores, and Pain Subscale Score | MSQoL-54 (mental) | 62.07 score on a scale | Standard Deviation 22.78 |
Primary
Tampa Scale of Kinesiophobia
Kinesiophobia which is described as fear of movement and physical activity was evaluated using the Tampa Scale of Kinesiophobia, which is a 17-item self-report survey. The range of scores are from 17 to 68 where the higher scores indicate an increasing degree of kinesiophobia. If the total score was above 37 points, the patient was considered to have a high level of kinesiophobia.
Time frame: At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Isokinetic Exercise Baseline | Tampa Scale of Kinesiophobia | 42.42 score on a scale | Standard Deviation 5.48 |
| Isokinetic Exercise After Treatment | Tampa Scale of Kinesiophobia | 40.57 score on a scale | Standard Deviation 7.25 |
| Home Exercise Baseline | Tampa Scale of Kinesiophobia | 40.33 score on a scale | Standard Deviation 6.37 |
| Home Exercise After Treatment | Tampa Scale of Kinesiophobia | 40.33 score on a scale | Standard Deviation 7.72 |
Primary
Visual Analog Scale
Pain intensity was evaluated with the Visual Analog Scale. Using a ruler, a 10 cm line was drawn which provided a range of scores from 0-100. Than the patients marked the point that showed their pain intensity on this line. A higher score in Visual Analog Scale indicates greater pain intensity.
Time frame: At baseline (10 minutes before the start of the treatment) and 8 weeks after start of the treatment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Isokinetic Exercise Baseline | Visual Analog Scale | 40.78 score on a scale | Standard Deviation 34.16 |
| Isokinetic Exercise After Treatment | Visual Analog Scale | 36.68 score on a scale | Standard Deviation 36.66 |
| Home Exercise Baseline | Visual Analog Scale | 41.66 score on a scale | Standard Deviation 31.11 |
| Home Exercise After Treatment | Visual Analog Scale | 42.14 score on a scale | Standard Deviation 29.13 |