Cortical Excitability, Multiple Sclerosis
Conditions
Keywords
Galvanic Vestibular Stimulation, Hand Dexterity, Multiple Sclerosis, Transcranial magnetic Stimulation, Cortical excitability
Brief summary
This study will be conducted to investigate the following: 1. The impact of implementing GVS in MS rehabilitation on cortical excitability. 2. The influence of GVS on upper limb function in patients diagnosed with MS. Patients will be randomly assigned to a control group (Conventional Physical Therapy program = CPT) and a study group (Galvanic Vestibular Stimulation = GVS in addition to the conventional program) subsequently. CPT will perform moderate intensity aerobic training (arm ergometer) and task oriented hand manipulation training, while GVS will receive Galvanic Vestibular Stimulation will be added to the conventional physical Therapy program.
Interventions
galvanic current generated by Gymna DUO 200 and delivered through conductive medium (electrode gel) by two small carbon rubber electrodes 3 cm 2 each bilaterally over two mastoid processes for 30 minutes, two times per week for 12 weeks .
DEVICEMovAlyzeR® software from Neuroscript
MovAlyzeR® movement analysis software from Neuroscript turns a pen tablet or mouse into a high-quality system for examining movements by a pen, mouse or finger. Hence, it can train and analyze hand dexterity and handwriting using pen tablets such as sentence parameters.
DEVICEBODYFIT Mini Portable Pedal Home Exerciser (cyclic ergometer)
stationary upper body pedaling as a moderate intensity aerobic training
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
1. Patients with ataxic RRMS type of both genders will be recruited. The last MS relapse occurred at least 3 months prior to the study. 2. Patients' age will range from 20 to 45 years old. 3. Ambulant Patients who meet the level less than or equal to 5 on EDSS will be recruited. 4. Patients' score on Mini Mental State Examination should be \> 26. 5. Mild or no spasticity (grade 1 or 1+) according to Modified Ashworth Scale. 6. All patients must at least hold Primary stage certificate of education from one of the Egyptian educational authorities. 7. All patients can independently sign consent form
Exclusion criteria
* Patients will be excluded if they have: 1. Moderate to severe auditory or visual or cognitive impairment. 2. Coexistence of other neurological diagnoses of Central or Peripheral Nervous system (e.g. cerebrovascular stroke, vestibulopathy or polyneuropathy). 3. History of any problems that hinder conduction of aerobic training or magnetic stimulation (e.g. deep venous thrombosis, shunts and pacemakers).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cortical changes | 15 minutes | central motor conduction time is the time taken for neural impulses to travel through the central nervous system on their way to the target muscles. |
| Upper Limb motor dexterity | 15-20 minutes | Nine hole peg test 9 HPT |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Advanced dexterity (Handwriting analysis) by MovAlyzeR® software | 15-20 minutes | — |
| Balance | 15-20 minutes | Berg Balance scale (BBS) of 14 items graded on 5 scoring system 0= worst and 4= the best ( total 0 = worst performance - Total 56 = Best performance). The lower your score, the more at risk you are for losing your balance. In general, Berg balance scale scores are interpreted as such: 0 to 20: A person with a score in this range will likely need the assistance of a wheelchair to move around safely. |
| Fatigue | 15-20 minutes | Fatigue Severity Scale (FSS)is 9-item questionnaire, scored on a 7 point scale with 1 = strongly disagree and 7= strongly agree. The minimum score = 9 and maximum score possible = 63. Higher the score = greater fatigue severity. |
Countries
Egypt
Outcome results
None listed