Multiple Sclerosis
Conditions
Keywords
multiple sclerosis, aerobic exercise, virtual reality, fatigue, cognition
Brief summary
Multiple Sclerosis (MS) is the second most common neurological disorder in young adults after trauma. Treatments developed today can slow progression and reduce symptoms. Exercise therapy is a useful rehabilitation practice in MS to manage symptoms, restore function, optimize quality of life, ensure well-being and increase participation in daily life activities. In this study, it is planned to investigate the acute effects of conservative and virtual reality (VR)-based aerobic exercise applications and standard exercises that frequently form the rehabilitation programs of individuals with MS in clinics. For this purpose, patients with MS who met the inclusion criteria were given two-week intervals; Conservative aerobic exercise, virtual reality-based aerobic exercise and standard exercise practices will be performed. With the data obtained from this study, it is aimed to investigate the safety of aerobic exercises performed using VR tools that can be used in telerehabilitation applications, which are thought to have a very important place in MS rehabilitation in the future, in terms of acute body temperature increase, cognitive and physical fatigue caused by conservative methods and fNIRS cortical effects of VR-based aerobic exercise applications. It will be possible to prove it with objective methods such as.
Interventions
Traditional aerobic exercise will be continued with an arm ergometer, at moderate intensity, for 30 minutes.
OTHERVR Based Aerobic Exercise
In the virtual reality-based aerobic exercise training, the game called Beat Saber will be played with Oculus Quest 2 virtual reality for 30 minutes.
OTHERConventional Exercise
The conventional exercise program will be modified with stabilization, balance and strengthening exercises, taking into account the functional status of the participants.
Sponsors
Acibadem University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed as Relapsing Remitting MS by neurologist according to the McDonald Criteria. * 18-55 years old. * EDSS score \< 4.5 * Mini mental examination test score ≥ 24 * No MS attack in the last 6 months. * No visual or vestibular deficits. * Signed the written consent form.
Exclusion criteria
* Having previous full immersive VR experience. * Having an additional neurological disease. * Spasticity in any muscle of the upper extremity \> 3, according to MAS. * Continuing the active physical therapy and rehabilitation program.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Energy Spent | For 30 minutes during the entire exercise | Sense Wear Pro3 Armband by Body Media Inc. (USA): It will be used to calculate the energy spent during exercises. This device is a 2-axis monitor with multiple sensors such as a galvanic skin response sensor to evaluate skin electrical resistance changes and a skin temperature sensor to evaluate temperature changes. The device will be worn on the individuals' right arm triceps muscle throughout the exercises and will be used to calculate the energy spent during the exercises. |
| Cortical Activity | During preintervention cognitive tasks, for 30 minutes during the entire exercise, during postintervention cognitive tasks | Functional Near Infrared Light Spectroscopy (fNIRS): fNIRS is an optical system that uses near-infrared (NIR) light in the assessment of brain activity by measuring light absorption differences in changes in oxy-hemoglobin and deoxy-hemoglobin concentrations. The modified Beer-Lambert law is used to convert and calculate light intensity measurements obtained from the brain into hemodynamic changes. Hemodynamic responses that occur with different stimuli in the prefrontal cortex region of the brain can be monitored with these optical systems. In this study, it is planned to measure individuals' prefrontal cortex activations while performing 3 different exercises and a post-exercise cognitive performance test. |
| Body Temperature | immediately before the exercise, immediately after the exercise | Individuals' body temperatures will be measured with the help of an electronic digital thermometer before and after the exercises. |
| Electrodermal Activity | During preintervention cognitive tasks, for 30 minutes during the entire exercise, during postintervention cognitive tasks | Electrodermal activity data will be recorded with the Shimmer device to be used to determine the stress levels of the patients. |
| Cognitive Function | Immediately before the exercise, immediately after the exercise | Stroop test will be used to compare the cognitive performances of the patients before and after exercise and to comment on cognitive fatigue after exercise. |
| Physical Fatigue | Immediately after the exercise | Modified Borg Scale will be used after the exercise to evaluate subjective physical fatigue. The values of this scale range from 0 to 10. While 0 means I have no fatigue, 10 indicates the most severe fatigue. |
| Satisfaction Level satisfaction level Satisfaction Level | Immediately after the exercise | It will be evaluated with the Satisfaction Evaluation Survey of Virtual Rehabilitation Systems. The total score range in this survey varies between 6-30, with higher scores being associated with higher satisfaction. |
| Late-term fatigue | 24 hours later after the exercise | One day after the exercises, patients will be questioned by phone about whether they have arm pain, and in case of pain, they will be asked to score the severity of pain according to Modified Borg Scale. The values of this scale range from 0 to 10. While 0 means I have no fatigue, 10 indicates the most severe fatigue. |
Countries
Turkey (Türkiye)
Outcome results
None listed