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Pediatric Multiple SclerosisNCT04660227

Exercise Training in Pediatric-Onset Multiple Sclerosis Patients

A study testing Exercise Trainning in people with Pediatric Multiple Sclerosis, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Multiple sclerosis is one of the leading causes of disability in young adults. It is known that patients with pediatric onset multiple sclerosis (POMS) experience their first demyelinating attack before the age of 18. Read more about this study

Who is it for?
Ages 15 to 25 years
Conditions the study is for
Pediatric Multiple Sclerosis
What is being tested?
Exercise Trainning
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteTurkey (Türkiye)
Study dates
23 Nov 2020to 1 Jan 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 25 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Being diagnosed with pediatric onset multiple sclerosis
  • EDSS <6
  • Having internet access

Who cannot join

  • Having an orthopedic problem affecting its mobility
  • Blurred vision problem
  • Having another diagnosis in addition to the diagnosis of pediatric onset multiple sclerosis
  • Having had an attack or received corticosteroid treatment 3 months before participating in the study

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site

  • Istanbul University-Cerrahpasa

    Bakırköy, Istanbul, 34100

Other trials in Turkey (Türkiye)

About this study

Official title: Effectiveness of Exercise Training in Pediatric-Onset Multiple Sclerosis Patients

Multiple sclerosis is one of the leading causes of disability in young adults. It is known that patients with pediatric onset multiple sclerosis (POMS) experience their first demyelinating attack before the age of 18. However, studies conducted with individuals with pediatric onset of multiple sclerosis have been reported to be few and have affected parameters such as physical activity, fatigue balance and quality of life. Therefore, this study is planned to consist of two stages. These are the following stages;

  1. Assessment of people with pediatric onset multiple sclerosis with the evaluation methods detailed below. After these evaluations, the relationship between the 6-minute walk test performance of the patients and other evaluations will be examined. Within the scope of the project, a publication will be prepared and uploaded with the data obtained from this stage.
  2. The patients are divided into two groups, one group is included in the online exercise program, and the other group is included in the exercise program after being put on the waiting list.
Read the detailed description

People with pediatric onset multiple sclerosis (POMS) experience various sensory, motor, cerebellar and cognitive dysfunctions due to the destruction of the central nervous system. These disorders may cause limitation of physical activity in people with POMS. In a study comparing people with POMS with monophasic acquired demyelinating syndrome (mono-ADS) and healthy controls in terms of physical activity levels, it was reported that people with POMS performed less physical activity compared to other groups. In addition, it has been reported that people with POMS have increased complaints such as depression and fatigue and their quality of life decreases. The aim of this study is to (1) investigate functional exercise capacity and its relationship between physical activity level, muscle strength, balance, fatigue and quality of life in POMS patients and (2) examine the effect of online exercise training on physical activity, balance, fatigue and quality of life in POMS patients. Participants will be randomly divided into two groups, the online exercise program group and the control group, after the evaluations. Participants in the online exercise program group will be given a treatment protocol consisting of aerobic exercise and strengthening exercises in the presence of a physiotherapist for a total of 8 weeks, 1 hour on 2 days a week. The exercise program will be created according to the condition of the people and progression will be provided every 2 weeks. After the exercises are completed, cooling will be done with stretching exercises. Participants in the control group will be put on the waiting list after all assessment methods are applied and will be re-evaluated at the end of 8 weeks. Application of the exercise training online will prevent the difficulties of continuing the exercise program due to transportation problems, disability level or pandemic and will facilitate the participation of people with POMS in the study.

Being tested
Exercise Trainning, Control Group
Keywords
Physical Activity, Physiotherapy, Degenerative diseases, Exercise
Medical subject headings
Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exercise TrainningProcedure or surgery

    Participants in the online exercise program group will be given a treatment protocol consisting of aerobic exercise and strengthening exercises in the presence of a physiotherapist for a total of 8 weeks, 2 days a week for 1 hour. Before starting the exercise, the risk of possible injury will be minimized by doing warm-up exercises and preparations will be made to start the exercise. Then, the exercise program will be started with aerobic exercise. Strengthening exercises will be planned for large muscle groups, targeting body parts such as hips, knees, shoulders, abdomen and trunk. In exercises, it is planned to do 2 sets of 10-15 repetitions using elastic band, free weights or body weight. The exercise program will be created according to the condition of the people and progression will be provided every 2 weeks. After the exercises are completed, cool down will be done with relaxation and stretching exercises.

  • Control GroupOther

    Participants in the control group will be put on the waiting list after all assessment methods have been applied and will be re-evaluated at the end of 8 weeks. After the final evaluations, they will be directed to the exercise group.

Study groups in NCT04660227
Study groupRoleWhat they receive
Exercise GroupExperimentalParticipants in the online exercise program group will be given a treatment protocol consisting of aerobic exercise and strengthening exercises in the presence of a physiotherapist for a total of 8 weeks, 2 days a week for 1 hour.
Receives: Procedure: Exercise Trainning
Control GroupOtherParticipants in the control group will be put on the waiting list after all assessment methods have been applied and will be re-evaluated at the end of 8 weeks.
Receives: Other: Control Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Leisure-Time Exercise Questionnaire (The change between the initial value and the value after 2 months will be evaluated).

    It is a self-reported questionnaire with two questions that measures the physical activity behavior of the participants. In the first question, the frequencies of mild, moderate and intense physical activity performed for more than 15 minutes in a normal week are questioned. Weekly frequencies of light, moderate, and vigorous physical activities are multiplied by 3, 5 and 9 metabolic equivalents, respectively, and the sum of the results is recorded as total leisure activity. Second question seeks the frequency of activity that causes sweating in a normal week is questioned. Less than 14 scores means insufficiently active/sedentary, 14-23 scores means moderately active and 24 scores or more means active. So higher scores better outcomes.

    Measured: Baseline and end of weeks 8.

  2. One-Week Step Count Measurement with Pedometer for Physical Activity Assessment (The change between the initial value and the value after 2 months will be evaluated).

    It is one of the objective methods used to evaluate physical activity. It is used to record the number of steps taken. The estimated step length is entered into the device and recorded as a step when the vertical oscillation of the body exceeds a certain threshold value. In our study, the number of steps taken by the participants during a week before and after treatment will be calculated and recorded. Higher scores better outcomes.

    Measured: Baseline and end of weeks 8.

Secondary outcomes (8)

  1. Evaluation of Isokinetic Muscle Strength of Quadriceps and Hamstring Muscles with Biodex Multi-Joint System (The change between the initial value and the value after 2 months will be evaluated).

    Evaluation of muscle strength will be made with "Biodex Multi-Joint System" isokinetic device. Isokinetic tests are evaluations that allow the measurement of muscle strength, strength and endurance with an isokinetic device at constant angular velocity and constant resistance objectively. Angular velocities to be used during the test are between low 30-60°/s , medium 90-120°/s and high 180-300°/s. Force tests are performed at low speeds, and strength and endurance tests are performed at high speeds. In our study, the concentric isokinetic muscle strength of the knee flexor and extensor muscles for the lower extremity at angular speeds of 30, 60 and 90°/s will be evaluated.

    Measured: Baseline and end of weeks 8.

  2. Knee Joint Proprioception Assessment with Biodex Multi-Joint System (The change between the initial value and the value after 2 months will be evaluated).

    Participants' knee joint proprioception will be evaluated using the Biodex Multi-Joint System. To show the participant the target angles, the participant's leg will be passively moved to the target angles and the knee will be held in the target position for 10 seconds and then brought back to the starting position (90°). The participant will then be asked to bring the index to the chosen target angle and press the stop button when bringing the index to the target angle. Each test attempt will be performed three times after a 30-second rest in a quiet environment. An eye patch will be used to prevent the use of visual inputs during the test. By measuring the target position three times, the average joint position absolute error degrees will be calculated. A lower mean absolute error value indicates better knee proprioception.

    Measured: Baseline and end of weeks 8.

  3. Static and Dynamic Postural Stability Assessment with Biodex Balance System (The change between the initial value and the value after 2 months will be evaluated).

    The Biodex Balance System is a platform that allows an objective assessment of the participant's ability to regulate his balance while standing on a stable or unstable surface. In our study, the postural stability abilities of the participants will be evaluated. The assessment will measure the General Stability Index, anterior/posterior stability index and medial/lateral stability index. Each participant will be asked to take a postural stance on the balance platform with bare feet, with eyes open and as still as possible for 20 seconds. Postural stability assessment in Biodex Balance System is applied on two different grounds as static and dynamic ground. While the static evaluation surface is fixed, the dynamic evaluation will be tested at the stability level 7 of the surface. Evaluation results will be recorded with the automatic reporting of the Biodex Balance System at the end of the evaluation.

    Measured: Baseline and end of weeks 8.

  4. 6 Minute Walk Test (The change between the initial value and the value after 2 months will be evaluated).

    It is a simple, practical test applied according to the standard protocol of the American Thoracic Society to measure walking capacity. It has been reported that the test is valid and reliable in MS patients with mild and moderate disability. In our study, 6 MWTs will be performed in accordance with the standards set in the guidelines for MS patients. The participant will be asked to walk as fast as possible at his own walking pace on the 30-meter track for 6 minutes. Before starting the test, participants will be explained that they can rest if they develop excessive fatigue or respiratory distress during the test and that this time is included in the test period. As a result of the test, the distance traveled by the participant will be recorded in meters.

    Measured: Baseline and end of weeks 8.

  5. Timed 25-Foot Walk (The change between the initial value and the value after 2 months will be evaluated).

    It is a performance test that provides information about the participant's mobility and leg function. The standardized protocol is very simple. The participant will be requested to walk as quickly and safely as possible (ie maximum walking speed) along a clearly marked, linear 25 feet or 7.62 m track. The participant can use an assistive device while walking. The person will walk two different times on the marked track and the average of two consecutive attempts in seconds will be recorded as a result of the test.

    Measured: Baseline and end of weeks 8.

  6. Timed Up and Go (The change between the initial value and the value after 2 months will be evaluated).

    It is a test used to evaluate dynamic balance. The test measures the time it takes a participant to get up from the chair and walk 3 meters at a comfortable pace and return to the chair and sit down. The test begins when the participant gets up from the chair and ends when the participant sits down on the chair again. The time measured is recorded in seconds. A shorter period represents better mobility.

    Measured: Baseline and end of weeks 8.

  7. The Pediatric Quality of Life Inventory 4.0 (The change between the initial value and the value after 2 months will be evaluated).

    The Pediatric Quality of Life Inventory is a 23-item multidimensional inventory that includes: 1- Physical Functions (8 Items), 2- Emotional Functions (5 Items), 3- Social Functions (5 Items), and 4- School Functions (5 Items). The inventory includes two parallel forms, the Child and Family form. In the inventory prepared according to the five-point Likert system, questions are scored between 0-4 points. In calculating the total score of the scale, a linear transformation is applied and an evaluation is made over 0-100 points. Therefore, the higher the Pediatric Quality of Life Inventory score indicates that the health-related quality of life is better.

    Measured: Baseline and end of weeks 8.

  8. Fatigue Severity Scale (The change between the initial value and the value after 2 months will be evaluated).

    It is a scale that evaluates the fatigue of MS patients in daily functions. In the evaluation made with 9 questions, each question is scored between 1 (totally disagree) - 7 (totally agree). The result score is the average value of nine questions. High score indicates increased severity of fatigue.

    Measured: Baseline and end of weeks 8.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Dec 2020
  2. Study start23 Nov 2020
  3. Primary completion25 Nov 2021
  4. Study completion1 Jan 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04660227
Sponsor's protocol ID
IU-C2020-26
Status last verified
May 2023
First submitted
25 Nov 2020
Last updated
19 May 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Grover SA, Aubert-Broche B, Fetco D, Collins DL, Arnold DL, Finlayson M, Banwell BL, Motl RW, Yeh EA. Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis. Neurology. 2015 Nov 10;85(19):1663-9. doi: 10.1212/WNL.0000000000001939. Epub 2015 Aug 12.

    PubMed 26268901

  • Grover SA, Sawicki CP, Kinnett-Hopkins D, Finlayson M, Schneiderman JE, Banwell B, Till C, Motl RW, Yeh EA. Physical Activity and Its Correlates in Youth with Multiple Sclerosis. J Pediatr. 2016 Dec;179:197-203.e2. doi: 10.1016/j.jpeds.2016.08.104. Epub 2016 Oct 4.

    PubMed 27717498

  • Sikes EM, Richardson EV, Motl RW. A Qualitative Study of Exercise and Physical Activity in Adolescents with Pediatric-Onset Multiple Sclerosis. Int J MS Care. 2019 Mar-Apr;21(2):81-91. doi: 10.7224/1537-2073.2018-033.

    PubMed 31049039

  • Storm Van's Gravesande K, Blaschek A, Calabrese P, Rostasy K, Huppke P, Kessler J J, Kalbe E, Mall V; MUSICADO Study group. Fatigue and depression predict health-related quality of life in patients with pediatric-onset multiple sclerosis. Mult Scler Relat Disord. 2019 Nov;36:101368. doi: 10.1016/j.msard.2019.08.010. Epub 2019 Aug 9.

    PubMed 31557681

  • Hebert D, Geisthardt C, Hoffman H. Insights and Recommendations From Parents Receiving a Diagnosis of Pediatric Multiple Sclerosis for Their Child. J Child Neurol. 2019 Jul;34(8):464-471. doi: 10.1177/0883073819842420. Epub 2019 Apr 23.

    PubMed 31012369

  • Weikert M, Motl RW, Suh Y, McAuley E, Wynn D. Accelerometry in persons with multiple sclerosis: measurement of physical activity or walking mobility? J Neurol Sci. 2010 Mar 15;290(1-2):6-11. doi: 10.1016/j.jns.2009.12.021. Epub 2010 Jan 8.

    PubMed 20060544

  • Warren JM, Ekelund U, Besson H, Mezzani A, Geladas N, Vanhees L; Experts Panel. Assessment of physical activity - a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil. 2010 Apr;17(2):127-39. doi: 10.1097/HJR.0b013e32832ed875.

    PubMed 20215971

  • Moghadasi A, Ghasemi G, Sadeghi-Demneh E, Etemadifar M. The Effect of Total Body Resistance Exercise on Mobility, Proprioception, and Muscle Strength of the Knee in People With Multiple Sclerosis. J Sport Rehabil. 2020 Feb 1;29(2):192-199. doi: 10.1123/jsr.2018-0303.

    PubMed 30676232

  • Abdin MMN, Abdelazeim F, Elshennawy S. Immediate effect of induced fatigue of the unaffected limb on standing balance, proprioception and vestibular symptoms in children with hemiplegia. J Pediatr Rehabil Med. 2020;13(2):119-125. doi: 10.3233/PRM-180587.

    PubMed 32444572

  • Greve JM, Cug M, Dulgeroglu D, Brech GC, Alonso AC. Relationship between anthropometric factors, gender, and balance under unstable conditions in young adults. Biomed Res Int. 2013;2013:850424. doi: 10.1155/2013/850424. Epub 2013 Jan 16.

    PubMed 23509788

  • Soysal Tomruk M, Uz MZ, Kara B, Idiman E. Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis. Mult Scler Relat Disord. 2016 May;7:70-3. doi: 10.1016/j.msard.2016.03.008. Epub 2016 Mar 22.

    PubMed 27237762

  • Paltamaa J, West H, Sarasoja T, Wikstrom J, Malkia E. Reliability of physical functioning measures in ambulatory subjects with MS. Physiother Res Int. 2005;10(2):93-109. doi: 10.1002/pri.30.

    PubMed 16146327

  • Marrie RA, Goldman M. Validity of performance scales for disability assessment in multiple sclerosis. Mult Scler. 2007 Nov;13(9):1176-82. doi: 10.1177/1352458507078388. Epub 2007 Jul 10.

    PubMed 17623733

  • Rampello A, Franceschini M, Piepoli M, Antenucci R, Lenti G, Olivieri D, Chetta A. Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: a randomized crossover controlled study. Phys Ther. 2007 May;87(5):545-55. doi: 10.2522/ptj.20060085. Epub 2007 Apr 3.

    PubMed 17405806

  • Savci S, Inal-Ince D, Arikan H, Guclu-Gunduz A, Cetisli-Korkmaz N, Armutlu K, Karabudak R. Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis. Disabil Rehabil. 2005 Nov 30;27(22):1365-71. doi: 10.1080/09638280500164479.

    PubMed 16372431

Questions about this trial

What is this clinical trial studying?

A study testing Exercise Trainning in people with Pediatric Multiple Sclerosis, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 May 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Leisure-Time Exercise Questionnaire (The change between the initial value and the value after 2 months will be evaluated). (time frame: Baseline and end of weeks 8.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04660227, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 May 2023.

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