Relapsing Remitting MS (RRMS)
Conditions
Brief summary
This randomized controlled trial investigated the effects of sequential laterality, motor imagery, and mental rotation training in individuals with relapsing-remitting multiple sclerosis. Both groups received conventional physiotherapy, while the intervention group received structured cognitive-motor training and the control group received active visual-attention training.
Detailed description
Fifty-four participants were randomly assigned to the intervention or control group. Both groups received 45-minute sessions three times per week for six weeks. Mental rotation ability was the primary outcome, while upper-extremity function, manual ability, motor imagery, grip strength, dexterity, and information-processing speed were assessed as secondary outcomes. Assessments were performed before and after the intervention by a researcher blinded to group allocation.
Interventions
OTHERLaterality, Motor Imagery, and Mental Rotation Training
Participants received 30 minutes of conventional physiotherapy followed by 15 minutes of structured training, three times per week for six weeks. The training progressed sequentially through laterality recognition, motor imagery, and mental rotation. Laterality training involved identifying right- and left-hand images. Motor imagery training involved imagining the hand positions and movements shown in the images without performing an observable movement. Mental rotation training involved mentally rotating figures and selecting the correct response.
OTHERActive Visual-Attention Control Training
Participants received 30 minutes of conventional physiotherapy followed by 15 minutes of active visual-attention control training, three times per week for six weeks. The training included images of neutral objects, colors, geometric shapes, and symbols that did not depict body parts. Participants classified the images according to color, shape, size, position, or similarity and difference.
Sponsors
Abant Izzet Baysal University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with definite relapsing-remitting multiple sclerosis by a neurologist according to the revised McDonald criteria * Not experiencing an acute MS relapse * Mini Mental State Examination score ≥24 * No clinical MS relapse within the previous 3 months * No corticosteroid treatment for an MS relapse within the previous 3 months * Expanded Disability Status Scale score between 1.5 and 6.0 * Modified Ashworth Scale score ≤2 * Sufficient communication ability to understand visual and verbal instructions and follow the training protocol * Able to attend at least 80% of the planned sessions * Able to complete the Movement Imagery Questionnaire-3
Exclusion criteria
* Any medication change within the previous 3 months * Uncorrected severe visual or hearing impairment * A communication disorder preventing the perception of or response to the visual and verbal stimuli used in the study * Participation in another structured upper-extremity rehabilitation program or interventional study during the study period * Presence of an additional neurological disorder * Advanced sensory loss or proprioceptive impairment that could affect participation in the intervention * Botulinum toxin injection within the previous 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Purdue Spatial Visualization Test | Baseline and immediately after the 6-week intervention. | The Purdue Spatial Visualization Test a widely used mental rotation tests, consists of 30 three-dimensional spatial perception questions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Symbol Digit Modalities Test | Baseline and immediately after the 6-week intervention. | The Symbol Digit Modalities Test is a widely used assessment tool for measuring information-processing speed in patients with MS. |
| Nine-Hole Peg Test | Baseline and immediately after the 6-week intervention. | In the Nine-Hole Peg Test, nine wooden pegs were placed into a wooden board containing nine holes using one hand. |
| Kinesthetic and Visual Imagery Questionnaire | Baseline and immediately after the 6-week intervention. | Motor imagery ability was evaluated and scored using 20 items examining movements of different body parts in a sitting position, with two subscales assessing kinesthetic and visual imagery abilities. The total score ranges from 10 to 50, with each subscale ranging from 5 to 25. |
| Grip Strength | Baseline and immediately after the 6-week intervention | Grip strength was assessed using a Jamar hand dynamometer. |
| Abilhand | Baseline and immediately after the 6-week intervention. | Abilhand is a patient-reported scale used to determine the perceived level of difficulty individuals experience when using their hands during activities of daily living. The Abilhand total raw score ranges from 0 to 46, with higher scores indicating better self-perceived manual ability in performing daily bimanual activities. |
| The Action Research Arm Test (ARAT) | Baseline and immediately after the 6-week intervention. | The Action Research Arm Test was used to evaluate upper extremity functional capacity and consists of four subdomains: grasp, grip, pinch, and gross movement. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATOREnes Tayyip Benli, phd
Abant Izzet Baysal University
Outcome results
None listed