Multiple SclerosisNCT07461987
Tai Chi and Square-Stepping Exercises in Women With Multiple Sclerosis
A study testing Tai Chi, Square Stepping Exercise (SSE) and Home-based Frenkel Coordination Exercises in people with Multiple Sclerosis, run by Pamukkale University at 1 site in Turkey (Türkiye).
Trial summary
Tai Chi is an exercise approach consisting of slow and controlled movements, whereas square stepping exercises are an exercise method in which specific step patterns are followed. Read more about this study
- Who is it for?
- Ages 20 to 45 years, women only
- Conditions the study is for
- Multiple Sclerosis
- What is being tested?
- Tai Chi, Square Stepping Exercise (SSE) and Home-based Frenkel Coordination Exercises
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 39 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Feb 2026to 22 Jun 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
- Women only
- No healthy volunteers
- Adult
Who may be able to join
- Willing to participate and provide informed consent.
- Diagnosed with multiple sclerosis (MS) according to the McDonald diagnostic criteria.
- Relapsing-remitting MS (RRMS) phenotype.
- EDSS score < 3.5.
- Female, 20-45 years of age.
- No MS relapse within the past 1 month.
- No lower-extremity spasticity according to the Modified Ashworth Scale (MAS).
Who cannot join
- Any neurological disease other than MS.
- Experiencing an MS relapse during the study period.
- History of orthopedic surgery that may affect balance.
- Cognitive or psychiatric impairment that may interfere with study participation.
- Cardiovascular or pulmonary history that may prevent participation.
- Use of medications that may affect clinical assessment (e.g., antipsychotic use; continuous corticosteroid or immunosuppressive use within the past 1 month).
- Participation in any other exercise program
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Department of Neurology, Pamukkale University Hospital
Denizli, 20070
About this study
Official title: The Effects of Tai Chi and Square Stepping Exercises on Joint Position Sense and Clinical Outcomes in Women With Multiple Sclerosis
Tai Chi is an exercise approach consisting of slow and controlled movements, whereas square stepping exercises are an exercise method in which specific step patterns are followed. The aim of this study is to comparatively examine the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels in women with multiple sclerosis.
Read the detailed description
Multiple Sclerosis (MS) is a chronic and demyelinating disease of the central nervous system observed in young adults. As the disease progresses, impairments occur in motor and sensory functions. Somatosensory inputs, such as knee joint position sense, which is particularly critical for balance and postural control, are frequently affected. In addition to these impairments, a decrease in lower extremity muscle strength and fatigue affecting the vast majority of patients restrict participation in activities of daily living.
Within the scope of this study, women diagnosed with MS will be randomized into one of three different intervention arms: a Tai Chi group incorporating postural stability exercises based on the Yang style; a Square Stepping Exercise (SSE) group consisting of coordinated step patterns aimed at improving sensorimotor integration; or a control group in which Frenkel exercises, representing traditional coordination approaches, are applied. Exercise interventions in all groups were planned for 8 weeks, twice a week.
The study aims to comparatively demonstrate the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels, and to develop evidence-based strategies for these parameters in MS rehabilitation
- Conditions
- Multiple Sclerosis
- Being tested
- Tai Chi, Square Stepping Exercise (SSE), Home-based Frenkel Coordination Exercises
- Keywords
- Multiple sclerosis, Tai Chi, Square stepping exercise, Position sense, Fatigue, Lower extremity muscle strength
- Medical subject headings
- Multiple Sclerosis, Fatigue
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Tai ChiBehavioural
Tai Chi will be delivered for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will last approximately 45-60 minutes and will include warm-up stretching, main Tai Chi practice, and cool-down stretching plus controlled breathing techniques.
Square Stepping Exercise (SSE)Behavioural
SSE will be delivered for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will be completed in approximately 45-60 minutes, including warm-up and cool-down periods.
Home-based Frenkel Coordination ExercisesBehavioural
Frenkel Coordination Exercises will be delivered as a home program for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will last 15-30 minutes, excluding rest periods.
| Study group | Role | What they receive |
|---|---|---|
| Tai Chi | Experimental | Participants in this arm will perform a supervised, group-based Tai Chi program. The program consists of selected movements from the Yang-style 24-form taught progressively, with emphasis on controlled weight shifting, postural alignment, and coordinated whole-body movement. Each session includes a warm-up period with general stretching, a main Tai Chi practice component with repeated form practice (with rest breaks as needed), and a cool-down period that includes stretching and controlled breathing techniques. Receives: Behavioral: Tai Chi |
| Square Stepping Exercise (SSE) | Experimental | Participants in this arm will receive supervised, group-based Square Stepping Exercise (SSE) performed on a 250 cm × 100 cm mat divided into 40 squares (25 cm each). Participants will practice predefined stepping patterns that include forward, backward, horizontal (lateral), and diagonal steps. Selected patterns will be repeated 3-5 times, followed by the mirrored version for the same number of repetitions. If a participant has difficulty with a pattern, it will be repeated until learned; progression will occur after the participant completes the pattern correctly three consecutive times. Receives: Behavioral: Square Stepping Exercise (SSE) |
| Home Exercise Program (Frenkel) | Active comparator | Participants in this arm will follow a home-based program consisting of Frenkel Coordination Exercises (FKE), a coordination-focused exercise approach developed to address gait, balance, and coordination. The exercises emphasize slow, accurate, and well-controlled movements, typically supported by visual guidance and repeated practice to improve movement sequencing and coordination. Receives: Behavioral: Home-based Frenkel Coordination Exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Knee joint position sense
Knee joint position sense will be assessed using an electrogoniometer. For standardization, participants will be evaluated in a seated position with back support, with the hip and knee at 90° flexion. A target angle of 30° knee extension (relative to the start position) will be used. When the participant reaches the target angle, she will be asked to hold the position for 5 seconds to learn the angle. The knee will then be returned to the neutral position and the participant will be asked to reproduce the target angle. Measurements will be repeated three times, the mean value will be calculated, and the absolute error (in degrees) will be recorded. Assessments will be conducted in a quiet room with eyes closed, with the joint exposed and barefoot.
Measured: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Secondary outcomes (2)
Five-Repetition Sit-to-Stand Test (5STS)
Lower-extremity functional strength will be assessed using the Five-Repetition Sit-to-Stand Test (5STS). Participants will sit on a standard chair and fold their arms across the chest. They will be instructed (with verbal explanation and practice before testing) to stand up and sit down five times as quickly as possible. Timing starts from the seated position and ends when the participant returns to the seated position after the 5th repetition. The result will be recorded in seconds; lower times indicate better performance.
Measured: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Fatigue Impact Scale (FIS)
Fatigue will be assessed using the Fatigue Impact Scale (FIS), which evaluates how fatigued the participant has felt over the past month including the day of assessment. The scale includes three domains: cognitive (10 items), physical (10 items), and social (20 items). Each item is rated from 0 to 4 (0 = no problem; 4 = very big problem). Domain scores are calculated by summing item scores within each domain, and the total score is calculated by summing all domain scores.
Measured: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Mar 2026
- Study start15 Feb 2026
- Primary completion22 Jun 2026
- Study completion22 Jun 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 Pamukkale 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
- Model description
- Randomized, three-arm, parallel-group trial. Participants will be randomly assigned to Tai Chi, Square Stepping Exercise and home-based Frenkel exercise (control). Interventions will be delivered for 8 weeks (2 sessions/week). Outcomes will be assessed at baseline and post-intervention
- Masking
- None (open label)
- Enrolment
- 39 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pamukkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, müge içelli, Pamukkale University
- Investigators
- Müge İçelli Güneş, PhD, Principal investigator, Pamukkale University Denizli Health Services Vocational School of Higher Education
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07461987
- Sponsor's protocol ID
- PU-FTR-MI-03
- Status last verified
- Jun 2026
- First submitted
- 5 Mar 2026
- Last updated
- 23 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Tai Chi and Square Stepping Exercises on Joint Position Sense and Clinical Outcomes in Women With Multiple Sclerosis
- ClinicalTrials.gov ID
- NCT07461987
- Acronym / sponsor ID
- PU-FTR-MI-03
- Conditions
- Multiple Sclerosis
- Keywords
- Multiple sclerosis, Tai Chi, Square stepping exercise, Position sense, Fatigue, Lower extremity muscle strength
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 39 participants (actual)
- Lead sponsor
- Pamukkale UniversityUniversity, hospital or other
- Study start
- 15 Feb 2026 (actual)
- Primary completion
- 22 Jun 2026 (actual)
- Study completion
- 22 Jun 2026 (actual)
- First posted
- 10 Mar 2026 (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.
Tai Chi is an exercise approach consisting of slow and controlled movements, whereas square stepping exercises are an exercise method in which specific step patterns are followed. The aim of this study is to comparatively examine the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels in women with multiple sclerosis.
Detailed description
Multiple Sclerosis (MS) is a chronic and demyelinating disease of the central nervous system observed in young adults. As the disease progresses, impairments occur in motor and sensory functions. Somatosensory inputs, such as knee joint position sense, which is particularly critical for balance and postural control, are frequently affected. In addition to these impairments, a decrease in lower extremity muscle strength and fatigue affecting the vast majority of patients restrict participation in activities of daily living.
Within the scope of this study, women diagnosed with MS will be randomized into one of three different intervention arms: a Tai Chi group incorporating postural stability exercises based on the Yang style; a Square Stepping Exercise (SSE) group consisting of coordinated step patterns aimed at improving sensorimotor integration; or a control group in which Frenkel exercises, representing traditional coordination approaches, are applied. Exercise interventions in all groups were planned for 8 weeks, twice a week.
The study aims to comparatively demonstrate the effects of Tai Chi and Square Stepping Exercises on knee joint position sense, lower extremity muscle strength, and fatigue levels, and to develop evidence-based strategies for these parameters in MS rehabilitation
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Randomized, three-arm, parallel-group trial. Participants will be randomly assigned to Tai Chi, Square Stepping Exercise and home-based Frenkel exercise (control). Interventions will be delivered for 8 weeks (2 sessions/week). Outcomes will be assessed at baseline and post-intervention
| Arm | Type | Receives |
|---|---|---|
| Tai Chi | Experimental | Behavioral: Tai ChiParticipants in this arm will perform a supervised, group-based Tai Chi program. The program consists of selected movements from the Yang-style 24-form taught progressively, with emphasis on controlled weight shifting, postural alignment, and coordinated whole-body movement. Each session includes a warm-up period with general stretching, a main Tai Chi practice component with repeated form practice (with rest breaks as needed), and a cool-down period that includes stretching and controlled breathing techniques. |
| Square Stepping Exercise (SSE) | Experimental | Behavioral: Square Stepping Exercise (SSE)Participants in this arm will receive supervised, group-based Square Stepping Exercise (SSE) performed on a 250 cm × 100 cm mat divided into 40 squares (25 cm each). Participants will practice predefined stepping patterns that include forward, backward, horizontal (lateral), and diagonal steps. Selected patterns will be repeated 3-5 times, followed by the mirrored version for the same number of repetitions. If a participant has difficulty with a pattern, it will be repeated until learned; progression will occur after the participant completes the pattern correctly three consecutive times. |
| Home Exercise Program (Frenkel) | Active comparator | Behavioral: Home-based Frenkel Coordination ExercisesParticipants in this arm will follow a home-based program consisting of Frenkel Coordination Exercises (FKE), a coordination-focused exercise approach developed to address gait, balance, and coordination. The exercises emphasize slow, accurate, and well-controlled movements, typically supported by visual guidance and repeated practice to improve movement sequencing and coordination. |
Who may qualify
- Ages
- 20 to 45 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Willing to participate and provide informed consent.
- Diagnosed with multiple sclerosis (MS) according to the McDonald diagnostic criteria.
- Relapsing-remitting MS (RRMS) phenotype.
- EDSS score < 3.5.
- Female, 20-45 years of age.
Key exclusion criteria (7 listed)
- Any neurological disease other than MS.
- Experiencing an MS relapse during the study period.
- History of orthopedic surgery that may affect balance.
- Cognitive or psychiatric impairment that may interfere with study participation.
- Cardiovascular or pulmonary history that may prevent participation.
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 |
|---|---|---|
| Tai ChiTai Chi will be delivered for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will last approximately 45-60 minutes and will include warm-up stretching, main Tai Chi practice, and cool-down stretching plus controlled breathing techniques. | Behavioural | Tai Chi |
| Square Stepping Exercise (SSE)SSE will be delivered for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will be completed in approximately 45-60 minutes, including warm-up and cool-down periods. | Behavioural | Square Stepping Exercise (SSE) |
| Home-based Frenkel Coordination ExercisesFrenkel Coordination Exercises will be delivered as a home program for 8 weeks, 2 days per week, 1 session per day (total 16 sessions). Each session will last 15-30 minutes, excluding rest periods. | Behavioural | Home Exercise Program (Frenkel) |
Primary outcome
Knee joint position sense
Time frame: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Knee joint position sense will be assessed using an electrogoniometer. For standardization, participants will be evaluated in a seated position with back support, with the hip and knee at 90° flexion. A target angle of 30° knee extension (relative to the start position) will be used. When the participant reaches the target angle, she will be asked to hold the position for 5 seconds to learn the angle. The knee will then be returned to the neutral position and the participant will be asked to reproduce the target angle. Measurements will be repeated three times, the mean value will be calculated, and the absolute error (in degrees) will be recorded. Assessments will be conducted in a quiet room with eyes closed, with the joint exposed and barefoot.
2 secondary outcomes
Five-Repetition Sit-to-Stand Test (5STS)
Time frame: Baseline (pre-intervention) and immediately post-intervention (Week 8).
Fatigue Impact Scale (FIS)
Time frame: Baseline (pre-intervention) and immediately post-intervention (Week 8).
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 23 Jun 2026.
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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.
Müge İçelli Güneş, PhD principal investigator
Pamukkale University Denizli Health Services Vocational School of Higher Education
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Tai Chi, Square Stepping Exercise (SSE) and Home-based Frenkel Coordination Exercises in people with Multiple Sclerosis, run by Pamukkale 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 7 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 23 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 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?
Knee joint position sense (time frame: Baseline (pre-intervention) and immediately post-intervention (Week 8).). 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 23 Jun 2026.