Evaluate the effect of High-Intensity Focused Electromagnetic Therapy on dynamic balance, fall risk, core muscle function, and quality of life in patients with multiple sclerosis.
Confirmed clinical diagnosis of Multiple Sclerosis according to the revised McDonald criteria.
Expanded Disability Status Scale score range between 3.0 and 5.5.
Clinically stable condition with no neurological relapses or corticosteroid therapy within the past 3 months.
Presence of pacemakers, internal defibrillators, or metallic implants in the torso/abdominal region.
Severe cognitive impairment interfering with the understanding of instructions or questionnaires.
Other concomitant neurological or musculoskeletal orthopedic conditions that independently affect balance or gait.
Severe visual deficits or uncorrected vestibular disorders.
Parallel
High-Intensity Focused Electromagnetic Therapy
DeviceFor 8 weeks, two weekly sessions of High-Intensity Focused Electromagnetic Therapy will be used to induce supramaximal contractions to strengthen the central core stabilizers (rectus abdominis, transversus abdominis, and erector spinae)
Balance Exercises
Other interventionStandardized balance training including static stance variations, dynamic weight-shifting, perturbation training, and functional gait adjustments will be conducted for 30-45 minutes per session through three weekly sessions for a total duration of 8 weeks.
Balance
Berg Balance Scale will be used to assess balance. A 14-item objective clinical rating scale evaluating functional balance performance (e.g., reaching, turning, standing on one leg). Scores range from 0 to 56, where higher scores indicate better balance control.
Health-Related Quality of Life
Multiple Sclerosis Quality of Life-54 Questionnaire will be used to assess quality of life. It is a multidimensional, disease-specific questionnaire combining generic and disease-specific items. It generates 12 subscales along with distinct physical and mental health composite summary scores. Higher scores indicate a better quality of life.
Risk of Fall
The Fall Risk Questionnaire will be used to assess the risk of fall. The Fall Risk Questionnaire consists of 12 yes/no questions. For scoring, a "no" answer is scored as zero for all questions, while a "yes" answer is scored as two for the first two questions and as one for the remaining 10 questions. A total Fall Risk Questionnaire score of 4 or higher indicates increased fall risk.
Core Muscle Function
The Trunk Impairment Scale will be used to assess core muscle function. It scores static sitting balance, dynamic sitting balance, and trunk coordination. Total scores range from 0 to 23, with higher scores indicating superior core control.
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