Multiple SclerosisNCT07233044
Effect of Visually-Guided Gait Training on Balance, Mobility and Risk of Falling in Patients With Multiple Sclerosis
A study testing Visually-guided gait training and Conventional gait training in people with Multiple Sclerosis, run by Cairo University at 1 site in Egypt.
Trial summary
The aim of this study is to assess both immediate and long-term effects of visually-guided gait training on balance, mobility, and risk of falling in patients with multiple sclerosis. Read more about this study
- Who is it for?
- Ages 20 to 45 years
- Conditions the study is for
- Multiple Sclerosis
- What is being tested?
- Visually-guided gait training and Conventional gait training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteEgypt
- Study dates
- 30 Nov 2025to 30 Apr 2026
- 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 20 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Clinically definite MS (relapsing and remitting) patients who are stable for at least three months.
- Expanded Disability Status Scale (EDSS) score of ≤ 4 (fully ambulatory, self-sufficient, and able to stand and walk without any aid or orthosis at least 500 meters) to minimize the impact of motor weakness interfering with their ability to perform the task.
- Normal or corrected to normal vision, wearing eyeglasses.
- The age will range from 20 - 45 years.
- All patients with MS were required to report subjective perceived imbalance or history of falls (in the last year)
Who cannot join
- Patients with any other neurological deficits or orthopedics abnormalities.
- Patients with secondary musculoskeletal complications such as fractures, contractures, or deformities.
- Patients with vision problems that impaired walking ability.
- Patients with severe cognitive impairment or psychological disorders impaired the ability to follow the procedures of the study.
- Patients with cardiovascular and respiratory diseases.
- Patients with serious unstable medical condition or Patients had an acute exacerbation of MS within last month.
- Pregnant women.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Visually-Guided Gait Training on Balance, Mobility and Risk of Falling in Patients With Multiple Sclerosis: A Randomized Controlled Study
The aim of this study is to assess both immediate and long-term effects of visually-guided gait training on balance, mobility, and risk of falling in patients with multiple sclerosis.
Read the detailed description
Balance and mobility impairments are the most common deficits in people with multiple sclerosis (MS), arising early in the disease course and gradually progressing over time, leading to loss of independence and quality of life. Moreover, static, and dynamic balance deficits in MS patients have been demonstrated to play a major role in patients' perception of walking ability during daily life and in predicting future falls. Given the strong impact of balance impairments on MS patients' disability.
Also, it was reported that the ability to coordinate visual information with movement is normally important to interact with the environment. Indeed, visually guided walking requires the brain to maintain an accurate relationship (or visuomotor mapping) between the perceived stepping location and the motor command necessary to direct the foot to that position on the ground with minimal error. Besides, previous research reported that people with MS, with neuronal transmission impairment or lesions on somatosensory ways, are more dependent on visual compensation for maintain balance. As lesions on somatosensory ways alter postural stability as this fundamental feedback is impaired, making a postural compensation and the visual feedback often more necessary to maintain balance.
To overcome these highly disabling issues, different rehabilitative approaches have been proposed so far in the literature. However, rehabilitation interventions in individuals with MS are limited to aerobic, resistance, and combined aerobic and resistance exercises and instrumental adapted exercise modalities including body-weight-supported treadmill walking or robotic technology. Few studies have addressed the effects of external sensory stimulations (visual, auditory) during gait training on motor performance in patients with multiple sclerosis.
So, visually-guided gait training could be beneficial for improvement of balance and mobility measures and decrease risk of falling for people with MS.
- Conditions
- Multiple Sclerosis
- Being tested
- Visually-guided gait training, Conventional gait training
- Medical subject headings
- Multiple Sclerosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Visually-guided gait trainingOther
The program runs for eight weeks, with two 60-minute sessions per week, integrating gaze strategy, task-specific mobility, and dual-task cognitive training. Participants first learn systematic visual scanning using saccades and gridline searches. In task-specific training, they perform precision walking-stepping accurately on targets-and obstacle avoidance, navigating a 6 m path with variable pole positions to enhance visual-motor coordination. Finally, dual-task training adds cognitive challenges, such as word generation or backward counting, to improve attention, adaptability, and functional mobility.
Conventional gait trainingOther
It will be received for eight weeks, twice per week, each session lasting 30 minutes, consisting of standing and walking activities maintaining a stable base of support; static postural control exercises, weight shifting and perturbations exercises, weight-bearing exercises through lower limbs; and adequate weight transfer and forward progression with trunk, limb, and pelvic kinematics consistent with safe walking, walking forward and backward, side-stepping, standing and walking on varied surfaces.
| Study group | Role | What they receive |
|---|---|---|
| Visually-guided gait training + Conventional gait training | Experimental | This group will consist of twenty patients, who will receive visually-guided gait training and conventional gait training for 8 weeks. Receives: Other: Visually-guided gait training; Other: Conventional gait training |
| Conventional gait training | Active comparator | This group will consist of twenty patients, who will receive conventional gait training only for 8 weeks. Receives: Other: Conventional gait training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Dynamic Balance Performance (%):
The percentage score representing how accurately the participant maintained the red spot path within the designated frame during the dynamic balance test.
A higher percentage indicates better balance control and greater stability.
Measured: 8 weeks and follow up after 4 weeks.
Front Average Deviation
The mean displacement of the participant's center of pressure (COP) in the forward (anterior) direction.
Measured: 8 weeks and follow up after 4 weeks
Back Average Deviation
The mean displacement of the participant's center of pressure (COP) in the backward (posterior) direction.
Measured: 8 weeks and follow up after 4 weeks
Right Average Deviation
The mean displacement of the participant's center of pressure (COP) in the right (lateral) direction.
Measured: 8 weeks and follow up after 4 weeks
Left Average Deviation
The mean displacement of the participant's center of pressure (COP) in the left (lateral) direction.
Measured: 8 weeks and follow up after 4 weeks
Secondary outcomes (3)
The Four-Square Step Test (FSST)
The Four Square Step Test (FSST) is a valid and reliable tool for assessing mobility in patients with multiple sclerosis (MS). It evaluates self-perceived walking limitations and the ability to quickly change direction and step over obstacles. Using four sticks arranged in a cross, participants step forward, backward, and sideways through each square, then reverse the sequence. The time to complete the task (in seconds) is recorded, with two trials conducted after a practice run; the best time is used. Trials are repeated if balance is lost or an obstacle is touched. Longer completion times (>15 s) indicate greater mobility impairment.
Measured: 8 weeks and follow up after 4 weeks
The Ten-Meter Walk Test (10MWT)
The Ten-Meter Walk Test (10MWT) is a widely recognized, valid, and reliable tool for assessing walking speed in patients with multiple sclerosis (MS). It demonstrates excellent inter- and intra-rater reliability. Participants walk 14 meters, with the middle 10 meters timed to exclude acceleration and deceleration phases. The middle ten meters of a fourteen-meter walkway are timed for 3 trails to calculate average walking speed (m/s). The time taken (in seconds) reflects gait efficiency and mobility performance. As slower walking speed strongly correlates with increased fall risk, the 10MWT also serves as an indirect indicator of fall susceptibility in MS patients.
Measured: 8 weeks and follow up after 4 weeks
Arabic version of Falls Efficacy Scale-International (FES-I)
The arabic version of Falls Efficacy Scale-International (FES-I) is a valid and reliable tool for evaluating fear of falling and fall risk in older adults and individuals with multiple sclerosis (MS). It assesses concern about falling during 16 daily activities performed both indoors and outdoors. Each item is rated on a 4-point Likert scale (1 = not at all concerned to 4 = very concerned), reflecting how worried the individual feels about falling, regardless of actual participation in the activity. The total score ranges from 16 to 64, with higher scores indicating greater fear of falling and reduced confidence in maintaining balance.
Measured: 8 weeks and follow up after 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Nov 2025
- Study start30 Nov 2025
- Primary completion20 Apr 2026
- Study completion30 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Multiple SclerosisStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- None (open label)
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Manar El-Sayed Reda Abd El-Fattah, Cairo University
- Investigators
- Abeer Abo Bakr, PhD, Study chair, Professor, Cairo universityIbrahim Hamoda, PhD, Study director, Assistant professor, Kafr Elsheikh univeristy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07233044
- Sponsor's protocol ID
- P.T.REC/012/005505
- Status last verified
- Nov 2025
- First submitted
- 14 Nov 2025
- Last updated
- 9 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Visually-Guided Gait Training on Balance, Mobility and Risk of Falling in Patients With Multiple Sclerosis: A Randomized Controlled Study
- ClinicalTrials.gov ID
- NCT07233044
- Acronym / sponsor ID
- P.T.REC/012/005505
- Conditions
- Multiple Sclerosis
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 30 Nov 2025 (actual)
- Primary completion
- 20 Apr 2026 (actual)
- Study completion
- 30 Apr 2026 (actual)
- First posted
- 18 Nov 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to assess both immediate and long-term effects of visually-guided gait training on balance, mobility, and risk of falling in patients with multiple sclerosis.
Detailed description
Balance and mobility impairments are the most common deficits in people with multiple sclerosis (MS), arising early in the disease course and gradually progressing over time, leading to loss of independence and quality of life. Moreover, static, and dynamic balance deficits in MS patients have been demonstrated to play a major role in patients' perception of walking ability during daily life and in predicting future falls. Given the strong impact of balance impairments on MS patients' disability.
Also, it was reported that the ability to coordinate visual information with movement is normally important to interact with the environment. Indeed, visually guided walking requires the brain to maintain an accurate relationship (or visuomotor mapping) between the perceived stepping location and the motor command necessary to direct the foot to that position on the ground with minimal error. Besides, previous research reported that people with MS, with neuronal transmission impairment or lesions on somatosensory ways, are more dependent on visual compensation for maintain balance. As lesions on somatosensory ways alter postural stability as this fundamental feedback is impaired, making a postural compensation and the visual feedback often more necessary to maintain balance.
To overcome these highly disabling issues, different rehabilitative approaches have been proposed so far in the literature. However, rehabilitation interventions in individuals with MS are limited to aerobic, resistance, and combined aerobic and resistance exercises and instrumental adapted exercise modalities including body-weight-supported treadmill walking or robotic technology. Few studies have addressed the effects of external sensory stimulations (visual, auditory) during gait training on motor performance in patients with multiple sclerosis.
So, visually-guided gait training could be beneficial for improvement of balance and mobility measures and decrease risk of falling for people with MS.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Visually-guided gait training + Conventional gait training | Experimental | Other: Visually-guided gait training, Other: Conventional gait trainingThis group will consist of twenty patients, who will receive visually-guided gait training and conventional gait training for 8 weeks. |
| Conventional gait training | Active comparator | Other: Conventional gait trainingThis group will consist of twenty patients, who will receive conventional gait training only for 8 weeks. |
Who may qualify
- Ages
- 20 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Clinically definite MS (relapsing and remitting) patients who are stable for at least three months.
- Expanded Disability Status Scale (EDSS) score of ≤ 4 (fully ambulatory, self-sufficient, and able to stand and walk without any aid or orthosis at least 500 meters) to minimize the impact of motor weakness interfering with their ability to perform the task.
- Normal or corrected to normal vision, wearing eyeglasses.
- The age will range from 20 - 45 years.
- All patients with MS were required to report subjective perceived imbalance or history of falls (in the last year)
Key exclusion criteria (7 listed)
- Patients with any other neurological deficits or orthopedics abnormalities.
- Patients with secondary musculoskeletal complications such as fractures, contractures, or deformities.
- Patients with vision problems that impaired walking ability.
- Patients with severe cognitive impairment or psychological disorders impaired the ability to follow the procedures of the study.
- Patients with cardiovascular and respiratory diseases.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Visually-guided gait trainingThe program runs for eight weeks, with two 60-minute sessions per week, integrating gaze strategy, task-specific mobility, and dual-task cognitive training. Participants first learn systematic visual scanning using saccades and gridline searches. In task-specific training, they perform precision walking-stepping accurately on targets-and obstacle avoidance, navigating a 6 m path with variable pole positions to enhance visual-motor coordination. Finally, dual-task training adds cognitive challenges, such as word generation or backward counting, to improve attention, adaptability, and functional mobility. | Other | Visually-guided gait training + Conventional gait training |
| Conventional gait trainingIt will be received for eight weeks, twice per week, each session lasting 30 minutes, consisting of standing and walking activities maintaining a stable base of support; static postural control exercises, weight shifting and perturbations exercises, weight-bearing exercises through lower limbs; and adequate weight transfer and forward progression with trunk, limb, and pelvic kinematics consistent with safe walking, walking forward and backward, side-stepping, standing and walking on varied surfaces. | Other | Conventional gait training, Visually-guided gait training + Conventional gait training |
Primary outcome
Dynamic Balance Performance (%):
Time frame: 8 weeks and follow up after 4 weeks.
The percentage score representing how accurately the participant maintained the red spot path within the designated frame during the dynamic balance test. A higher percentage indicates better balance control and greater stability.
Front Average Deviation
Time frame: 8 weeks and follow up after 4 weeks
The mean displacement of the participant's center of pressure (COP) in the forward (anterior) direction.
Back Average Deviation
Time frame: 8 weeks and follow up after 4 weeks
The mean displacement of the participant's center of pressure (COP) in the backward (posterior) direction.
Right Average Deviation
Time frame: 8 weeks and follow up after 4 weeks
The mean displacement of the participant's center of pressure (COP) in the right (lateral) direction.
Left Average Deviation
Time frame: 8 weeks and follow up after 4 weeks
The mean displacement of the participant's center of pressure (COP) in the left (lateral) direction.
3 secondary outcomes
The Four-Square Step Test (FSST)
Time frame: 8 weeks and follow up after 4 weeks
The Ten-Meter Walk Test (10MWT)
Time frame: 8 weeks and follow up after 4 weeks
Arabic version of Falls Efficacy Scale-International (FES-I)
Time frame: 8 weeks and follow up after 4 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jun 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Abeer Abo Bakr, PhD study chair
Professor, Cairo university
Ibrahim Hamoda, PhD study director
Assistant professor, Kafr Elsheikh univeristy
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Visually-guided gait training and Conventional gait training in people with Multiple Sclerosis, run by Cairo University at 1 site in Egypt.
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 7 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 9 Jun 2026. 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 Egypt. 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 Performance (%): (time frame: 8 weeks and follow up after 4 weeks.). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 9 Jun 2026.