The effectiveness of upper extremity focused neuromuscular exercise training in early stage people with MS will be investigated. People with MS enrolled in the study will be randomly assigned to three groups: Neuromuscular Exercise Group (NEG), Conventional Exercise Group (CEG), and Control Group (CG). All three groups will be assessed with primary and secondary outcome measures at baseline, week 8, and week 12. NEG, CEG, and CG will be initially assessed for upper extremity function, cognitive function, lower extremity function, grip strength, proximal muscle strength, sensation, coordination, fatigue, postural sway, and core muscle strength and endurance. Then, NEG will receive clinically supervised upper extremity focused neuromuscular exercise training with a minimum of 60 minutes of session time, 2 days a week for 8 weeks. This exercise training includes steps for postural control, weight transfer, proximal and distal muscle strengthening, proprioception, coordination and reaction speed. Similarly, CEG will receive clinically supervised traditional upper extremity exercise training, twice a week for 8 weeks, with a minimum of 60 minutes of session time. This exercise training includes strengthening with the band and manuel dexterity exercises. In both groups, stretching and mobility exercises will be added to the warm-up and cool-down exercises before and after the program. During this process, CG will be on the waiting list. At the end of 8 weeks, all three groups will be re-evaluated. After the exercise training, follow-up will be done and evaluations will be repeated in the 12th week. This study will provide evidence on the effects of upper extremity-focused neuromuscular exercise training on physical and cognitive functions in early-stage people with MS compared to traditional treatment approaches.
Definite MS according to McDonald criteria,
18-64 years
RRMS,
EDSS < 4,
Having an attack in the last three months,
Mini Mental Test <24 or visual deficit,
Other medical conditions accompanying MS (cardiac, orthopedic or rheumatic, etc.),
Being pregnant or breastfeeding,
Parallel
Neuromuscular Exercise Training
Other interventionThis group will receive neuromuscular exercise training with 60-75 minute sessions per day, 2 days a week, for 8 weeks. Warm-up Program - 5 minutes Postural Control-Weight Transfer - 10-15 minutes Strength Training - 30-35 minutes Proprioception - Coordination - Reaction Speed 10-15 minutes Cool-down Program - 5 minutes
Conventional Exercise Training
Other interventionThis group will be given traditional strength exercise training consisting of 60-75 minute sessions per day, 2 days per week for 8 weeks. Warm-up Program - 5 minutes Strength Training - 30-35 minutes Manuel Dexterity - 15-20 minutes Cool-down Program - 5 minutes
Nine Hole Peg Test
To assess unilateral function of the upper extremity
Minnesota Manual Dexterity Test
To assess bilateral upper extremity function
Manual Ability Measure-36
To assess upper extremity function. A higher score indicates better hand function.
Timed 25-Foot Walk
To assess lower extremity function
Hand Held Dynamometer
To assess elbow muscle strength
Biodex Balance System
To assess postural sway
Laser-pointer Assisted Angle Reproduction Test
To assess of shoulder proprioception
Finger Tapping Test
To assess upper extremity coordination
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