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Multiple SclerosisNCT04838886

The Effect of Telerehabilitation Based Pilates Training in Multiple Sclerosis Patients

A study testing Telerehabilitation-based Pilates Exercise in people with Multiple Sclerosis, run by Gazi University 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 (MS) is a chronic inflammatory disease of the central nervous system characterized by myelin, oligodendrocyte, and axon damage. MS usually begins with attacks due to demyelination of axons in the brain, optic nerve, and spinal cord; over time it develops into a neurodegenerative disease associated… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Multiple Sclerosis
What is being tested?
Telerehabilitation-based Pilates Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteTurkey (Türkiye)
Study dates
15 Apr 2021to 25 May 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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18-65 years of age
  • Voluntarily participate in research to accept
  • Having a diagnosis of "Multiple Sclerosis" by a specialist physician
  • Relapse free in the last 3 mounts
  • An Expanded Disability Status Scale (EDSS) score less than or equal to 4

Who cannot join

  • Any cardiovascular, orthopedic, visual, hearing, and perception problems that may affect the results of the research.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation

    Ankara

Other trials in Turkey (Türkiye)

About this study

Official title: The Effect of Telerehabilitation Based Pilates Training on Physical Performance and Quality of Life in Multiple Sclerosis Patients

Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by myelin, oligodendrocyte, and axon damage. MS usually begins with attacks due to demyelination of axons in the brain, optic nerve, and spinal cord; over time it develops into a neurodegenerative disease associated with neurotrophic support deficiency and neuronal loss. In MS, various loss of strength, balance, fatigue, cognitive and gait disturbances arise in the central nervous system due to sensory and/or motor neuron degeneration. These disorders affect the quality of life by limiting the individual's activities and participation in their daily lives. Therefore, it is important to treat these disorders in the treatment of MS.

There are various pharmacological treatments and invasive procedures for the management of MS symptoms and one of the most commonly used treatment options is rehabilitation. Clinically-based exercise and rehabilitation are some of the most beneficial rehabilitation strategies in people with MS (PwMS). Clinically-based exercise and rehabilitation have been shown to stabilize or improve many physical symptoms of MS including loss of strength, balance dysfunction, impaired mobility, and fatigue. These benefits have led many practitioners to consider physical exercise as a nonpharmaceutical disease-modifying treatment. However, due to various factors such as mobility disorders, fatigue, and related problems, geographic location, time constraints, transportation difficulties, health insurance coverage, and financial burden, clinical-based exercise may be problematic in some pwMS. To overcome these challenges, approaches to rehabilitation have been developed such as telerehabilitation. The telerehabilitation system provides benefits such as continuity in patient education and rehabilitation, showing progress in rehabilitation, making changes in the treatment program, and saving individuals time and financial expenses. It is also an innovative and potential alternative to face-to-face interventions for treating disease-related disorders in pwMS. In literature, there are many studies examining the effectiveness of telerehabilitation in pwMS. According to these studies, ıt has been shown that telerehabilitation, with its technical facilities, had the potential to make clinical interventions widely accessible and effective for MS, however, telerehabilitation-based interventions could not replace traditional interventions but could perfectly complement. It has been found that telerehabilitation improved balance and postural control in MS patients and had no side effects. However, it was emphasized that the evidence levels of the studies were insufficient for methodological reasons. It has been determined additional studies are needed to investigate examining the effect on walking.

Read more

Another clinical-based exercise method is Pilates. Pilates is a "core" stability-based exercise method that includes endurance, flexibility, movement, posture, and respiratory control. Studies have shown that Pilates training can improve balance, mobility, and muscle strength, fatigue in pwMS due to its structure consisting of balance and strengthening exercises. When the literature is reviewed in terms of Telerehabilitation based on Pilates in pwMS, it is seen that there are only two studies. In both studies, pwMS were given 20 minutes of yoga, 20 minutes of Pilates, and 20 minutes of dual-task exercise. However, these studies were in the project phase and the results are still not reported. On the other hand, in both studies, Pilates is given as combined training.

As a result, telerehabilitation is an alternative method to MS treatment. In addition, while there are many clinical-based Pilates studies in the literature, telerehabilitation-based Pilates studies are insufficient. Telerehabilitation-based Pilates training studies are needed. Therefore, the investigators planned this study to investigate the effect of telerehabilitation-based pilates training on physical performance and quality of life in pwMS.

Read the detailed description

This study is planned as a randomized control trial. Patients will be randomly divided into two groups as intervention and control. The intervention group will be received telerehabilitation-based pilates training three times a week for six weeks. Telerehabilitation-based pilates will be provided via videoconferencing.

The first session will be the introduction session, patients will be informed about basic principles of Pilates and it will be included teaching inward movement of the lower abdominal wall and supine exercises of segmental movements involving trunk muscle recruitment to maintain a neutral posture. Afterward the session, a typical session will be included supine, side-lying, quadruped exercise, sitting on the exercise ball, and standing exercises. Exercises will be included thoracic extension, general abdominal strengthening, core stabilization exercises for the deep abdominal muscles. The difficulty of these exercises will be gradually increased and focused on keeping neutral positions of the spine in different gravity orientations. The control group will be a wait-list group without any additional specific treatment. All assessments will be done before and after the 6-week intervention program or waiting period. The demographic characteristics of the participants initially will be taken and the Expanded Disability Status Scale score of those of MS will be recorded. Primary outcomes are balance, gait, core endurance and power, and muscle strength; secondary outcomes are physical activity, fatigue, and quality of life

Being tested
Telerehabilitation-based Pilates Exercise
Keywords
Multiple Sclerosis, Pilates, Exercise, Telerehabilitation, Physical performance, Balance, Gait, Fatigue
Medical subject headings
Multiple Sclerosis, Motor Activity, Fatigue

What participants receive

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

  • Telerehabilitation-based Pilates ExerciseOther

    The group that will receive telerehabilitation-based pilates training via telerehabilitation

Study groups in NCT04838886
Study groupRoleWhat they receive
Exercise groupExperimentalThe intervention group will be received telerehabilitation-based pilates training three times a week for 6 weeks.
Receives: Other: Telerehabilitation-based Pilates Exercise
WaitlistNo interventionThe control group will be a wait-list group without any additional specific treatment.

What is being measured

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

  1. Dynamic Balance- Baseline

    Berg Balance Scale. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function. (0 = worst,56 = best)

    Measured: Assessment will be conducted before the intervention

  2. Dynamic Balance-Post intervention

    Berg Balance Scale. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function. (0 = worst,56 = best)

    Measured: Assessment will be conducted immediately after the intervention.

  3. Static Balance- Baseline

    Biodex Balance System

    Measured: Assessment will be conducted before the intervention.

  4. Static Balance- Post intervention

    Biodex Balance System

    Measured: Assessment will be conducted immediately after the intervention.

  5. An individual's confidence in performing activities- Baseline

    Activities-specific Balance Confidence Scale. Items are rated on a 0% to 100% whole number rating scale. (0 = worst,100 = best)

    Measured: Assessment will be conducted before the intervention.

  6. An individual's confidence in performing activities- Post intervention

    Activities-specific Balance Confidence Scale. Items are rated on a 0% to 100% whole number rating scale. (0 = worst,100 = best)

    Measured: Assessment will be conducted immediately after the intervention.

  7. Exercise capacity- Baseline

    Six minute walk test

    Measured: Assessment will be conducted before the intervention.

  8. Exercise capacity- Post intervention

    Six minute walk test

    Measured: Assessment will be conducted immediately after the intervention.

  9. Gait parameters- Baseline

    Wearable system (G-Walk)

    Measured: Assessment will be conducted before the intervention.

  10. Gait parameters- Post intervention

    Wearable system (G-Walk)

    Measured: Assessment will be conducted immediately after the intervention.

  11. Functional mobility- Baseline

    Timed up go test

    Measured: Assessment will be conducted before the intervention.

  12. Functional mobility- Post intervention

    Timed up go test

    Measured: Assessment will be conducted immediately after the intervention.

  13. Core endurance- Baseline

    Mcgill core endurance tests

    Measured: Assessment will be conducted before the intervention.

  14. Core endurance- Post intervention

    Mcgill core endurance tests

    Measured: Assessment will be conducted immediately after the intervention.

  15. Core strength- Baseline

    Mcgill core strength tests

    Measured: Assessment will be conducted before the intervention.

  16. Core strength-Post intervention

    Mcgill core strength tests

    Measured: Assessment will be conducted immediately after the intervention.

  17. Muscle Strength outcomes- Baseline

    Hand dynamometer (Baseline®, White Plains, New York, US)

    Measured: Assessment will be conducted before the intervention.

  18. Muscle Strength outcomes- Post intervention

    Hand dynamometer (Baseline®, White Plains, New York, US)

    Measured: Assessment will be conducted immediately after the intervention.

Secondary outcomes (8)
  1. Physical activity level- Baseline

    international physical activity questionnaire (IPAQ). IPAQ assesses physical activity undertaken across a comprehensive set of domains including leisure time, domestic and gardening (yard) activities, work-related and transport-related activity. The items were structured to provide separate scores on walking; moderate-intensity; and vigorous-intensity activity as well as a combined total score to describe overall level of activity. Computation of the total score requires summation of the duration (in minutes) and frequency (days) of walking, moderate-intensity and vigorous-intensity activity. (0 Metabolic equivalents (MET) minutes/week= worst, >3000 MET minutes/week= best)

    Measured: Assessment will be conducted before the intervention.

  2. Physical activity level- Post intervention

    international physical activity questionnaire (IPAQ). IPAQ assesses physical activity undertaken across a comprehensive set of domains including leisure time, domestic and gardening (yard) activities, work-related and transport-related activity. The items were structured to provide separate scores on walking; moderate-intensity; and vigorous-intensity activity as well as a combined total score to describe overall level of activity. Computation of the total score requires summation of the duration (in minutes) and frequency (days) of walking, moderate-intensity and vigorous-intensity activity. (0 Metabolic equivalents (MET) minutes/week= worst, >3000 MET minutes/week= best)

    Measured: Assessment will be conducted immediately after the intervention.

  3. Fatigue severity- Baseline

    Fatigue severity scale, A self-report scale is a 9-item scale which measures the severity of fatigue. Answers are scored on a seven point scale where 1 = strongly disagree and 7 = strongly agree. This means the minimum score possible is nine and the highest is 63 (9 = best, 63 = worst)

    Measured: Assessment will be conducted before the intervention.

  4. Fatigue severity- Post intervention

    Fatigue severity scale, A self-report scale is a 9-item scale which measures the severity of fatigue. Answers are scored on a seven point scale where 1 = strongly disagree and 7 = strongly agree. This means the minimum score possible is nine and the highest is 63 (9 = best, 63 = worst)

    Measured: Assessment will be conducted immediately after the intervention.

  5. Impact of fatigue on activities- Baseline

    Fatigue impact scale. The FIS was developed to assess the symptom of fatigue as part of an underlying chronic disease or condition. Consisting of 40 items, the instrument evaluates the effect of fatigue on three domains of daily life: cognitive functioning, physical functioning, and psychosocial functioning. Answers are scored on a four point scale where 0 = no problem and 4 = extreme problem. (0 = best, 160 = worst)

    Measured: Assessment will be conducted before the intervention.

  6. Impact of fatigue on activities- Post intervention

    Fatigue impact scale. The FIS was developed to assess the symptom of fatigue as part of an underlying chronic disease or condition. Consisting of 40 items, the instrument evaluates the effect of fatigue on three domains of daily life: cognitive functioning, physical functioning, and psychosocial functioning. Answers are scored on a four point scale where 0 = no problem and 4 = extreme problem. (0 = best, 160 = worst)

    Measured: Assessment will be conducted immediately after the intervention.

  7. Health related quality of life- Baseline

    Multiple Sclerosis Quality of Life (MSQOL)-54 scale.. There is no single overall score for the MSQOL-54. Two summary scores -physical health and mental health- can be derived from a weighted combination of scale scores. (0=worst, 100=best)

    Measured: Assessment will be conducted before the intervention.

  8. Health related quality of life- Post intervention- Post intervention

    Multiple Sclerosis Quality of Life (MSQOL)-54 scale.. There is no single overall score for the MSQOL-54. Two summary scores -physical health and mental health- can be derived from a weighted combination of scale scores. (0=worst, 100=best)

    Measured: Assessment will be conducted immediately after the intervention.

Timeline

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

  1. First posted9 Apr 2021
  2. Study start15 Apr 2021
  3. Primary completion15 May 2022
  4. Study completion25 May 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
Model description
Intervention and control groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04838886
Sponsor's protocol ID
Gazi 2
Status last verified
May 2022
First submitted
30 Mar 2021
Last updated
27 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is not a plan to make individual participant data but when the statistical analysis of all data are made, all results will be shared

Publications

  • Eldemir K, Guclu-Gunduz A, Eldemir S, Saygili F, Ozkul C, Irkec C. Effects of Pilates-based telerehabilitation on physical performance and quality of life in patients with multiple sclerosis. Disabil Rehabil. 2024 May;46(9):1807-1814. doi: 10.1080/09638288.2023.2205174. Epub 2023 May 6.

    PubMed 37147864

Questions about this trial

What is this clinical trial studying?

A study testing Telerehabilitation-based Pilates Exercise in people with Multiple Sclerosis, run by Gazi University 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 5 inclusion and 1 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 27 May 2022. 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?

Dynamic Balance- Baseline (time frame: Assessment will be conducted before the intervention). The study lists 18 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 NCT04838886, which also lists 1 linked publication.

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 27 May 2022.

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