Study Results
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Basic Information
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NOT_YET_RECRUITING
NA
30 participants
INTERVENTIONAL
2025-12-31
2026-05-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Motor Imagery + Vestibular Rehabilitation Group
Participants receive a combined intervention of motor imagery and vestibular rehabilitation. Sessions last 55 minutes, including 5 min breathing warm-up, 20 min motor imagery training, 20 min vestibular exercises for balance and dizziness reduction, and 10 min cool-down/relaxation. The program aims to improve balance, cognitive function, and quality of life in patients with Multiple Sclerosis. Symptoms are monitored to avoid overexertion or symptom exacerbation.
Motor Imagery + Vestibular Rehabilitation group
This 8-week program, 3 sessions/week, 55- 60 min each, includes 4 steps:
Warm-up (5 min): Breathing exercises progressing from basic diaphragmatic and pursed-lip breathing (weeks 1-2), light movement with breathing (weeks 3-4), to Inspiratory Muscle Training device (weeks 5-8).
Motor Imagery (15 min): Foundational phase (weeks 1-2) imagining basic movements, skills building (weeks 3-4) with functional daily tasks, advanced phase (weeks 5-8) imagining complex tasks, environmental and cognitive challenges (e.g., sports, obstacle navigation, walking on uneven surfaces).
Vestibular Rehabilitation (15 min): Foundational (weeks 1-2) gaze stabilization and static balance (VOR, VSR, VCR), dynamic balance and dual-task exercises (weeks 3-6), advanced functional balance and vestibular-cognition integration (weeks 7-8).
Cool-down (10 min): Relaxation and symptom monitoring to prevent overexertion, dizziness, or fatigue.
Conventional Group
Participants receive conventional care for Multiple Sclerosis, including routine medical follow-up and standard physiotherapy if applicable. No specific motor imagery or vestibular rehabilitation exercises are administered. This group serves as a comparison to evaluate the effects of the experimental intervention.
Conventional therapy group
This 8-week program, 3 sessions/week, 55- 60 min each, includes:
Warm-up: Seated/standing marching, neck and shoulder stretching.
Strength \& Functional Movements: Sit-to-stand, side leg raises, step-ups.
Core \& Upper Body: Bridge exercise, seated core activation, seated leg lifts, wall push-ups, seated shoulder press.
Flexibility \& Balance: Calf and hamstring stretches, spinal flexibility, single-leg stance, lunges, tandem walking.
Cool-down: Deep breathing and gentle stretching.
Interventions
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Motor Imagery + Vestibular Rehabilitation group
This 8-week program, 3 sessions/week, 55- 60 min each, includes 4 steps:
Warm-up (5 min): Breathing exercises progressing from basic diaphragmatic and pursed-lip breathing (weeks 1-2), light movement with breathing (weeks 3-4), to Inspiratory Muscle Training device (weeks 5-8).
Motor Imagery (15 min): Foundational phase (weeks 1-2) imagining basic movements, skills building (weeks 3-4) with functional daily tasks, advanced phase (weeks 5-8) imagining complex tasks, environmental and cognitive challenges (e.g., sports, obstacle navigation, walking on uneven surfaces).
Vestibular Rehabilitation (15 min): Foundational (weeks 1-2) gaze stabilization and static balance (VOR, VSR, VCR), dynamic balance and dual-task exercises (weeks 3-6), advanced functional balance and vestibular-cognition integration (weeks 7-8).
Cool-down (10 min): Relaxation and symptom monitoring to prevent overexertion, dizziness, or fatigue.
Conventional therapy group
This 8-week program, 3 sessions/week, 55- 60 min each, includes:
Warm-up: Seated/standing marching, neck and shoulder stretching.
Strength \& Functional Movements: Sit-to-stand, side leg raises, step-ups.
Core \& Upper Body: Bridge exercise, seated core activation, seated leg lifts, wall push-ups, seated shoulder press.
Flexibility \& Balance: Calf and hamstring stretches, spinal flexibility, single-leg stance, lunges, tandem walking.
Cool-down: Deep breathing and gentle stretching.
Eligibility Criteria
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Inclusion Criteria
2. Patient diagnosed relapsing-remitting multiple sclerosis (RRMS).
3. Mild MS between 0-3 according to PDDS.
4. Age from (18-45)
5. Mild cognitive impairment
6. Balance impairment (mild to moderate impairment)
7. Vestibular dysfunction Related to MS (dizziness, vertigo , gaze instability ) 8. Native language is Arabic to ensure clear communication during cognitive tasks and exercise instructions
9\. Be able to joined the treatment (motor imagery, vestibular rehabilitaiton )
Exclusion Criteria
Severe Psychiatric Conditions (schizophrenia, bipolar, etc) Sever balance disorder Sever fatigue Medical instability eg (cardiovascular disease, respiratory, infections, severe uncontrolled diabetes, or severe visual impairments.) Sever cognitive impairment Pregnant Advance disability ( wheelchair , unable to stand ) Use of Vestibular-Suppressing Medications Non - speaker Arabic
18 Years
45 Years
ALL
No
Sponsors
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Medipol University
OTHER
Responsible Party
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Gehad Salem Mohamed Mohamed Menshawi
PT, MSc (Cand.)
Principal Investigators
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Merve Yılmaz Menek, Assoc. Prof
Role: STUDY_DIRECTOR
Assoc. Prof. Merve Yılmaz Menek
Locations
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Gehad Salem Mohamed Mohamed Menshawi
Istanbul, Beykoz/İstanbul, Turkey (Türkiye)
Countries
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Central Contacts
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Gehad Salem menshawi, PT, MSc (Cand.)
Role: CONTACT
aliaa Salem menshawi, PT, MSc (Cand.)
Role: CONTACT
Facility Contacts
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gehad Salem Menshawi, PT, MSc (Cand.)
Role: primary
Role: backup
References
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Ozgen G, Karapolat H, Akkoc Y, Yuceyar N. Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial. Eur J Phys Rehabil Med. 2016 Aug;52(4):466-78. Epub 2016 Apr 6.
Abraham A, Hart A, Andrade I, Hackney ME. Dynamic Neuro-Cognitive Imagery Improves Mental Imagery Ability, Disease Severity, and Motor and Cognitive Functions in People with Parkinson's Disease. Neural Plast. 2018 Mar 14;2018:6168507. doi: 10.1155/2018/6168507. eCollection 2018.
Aljarallah S, Alkhathlan H, Almushawah A, Badahdah A, Alfaifi N, Abdulmaged-Ahmed DA, Alkhawajah NM. Performance of an Arabic translation of the patient determined disease steps (PDDS) scale in Saudi patients with multiple sclerosis. Medicine (Baltimore). 2023 Nov 3;102(44):e35889. doi: 10.1097/MD.0000000000035889.
Rahman TT, El Gaafary MM. Montreal Cognitive Assessment Arabic version: reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo. Geriatr Gerontol Int. 2009 Mar;9(1):54-61. doi: 10.1111/j.1447-0594.2008.00509.x.
Manago MM, Schenkman M, Berliner J, Hebert JR. Gaze stabilization and dynamic visual acuity in people with multiple sclerosis. J Vestib Res. 2016;26(5-6):469-477. doi: 10.3233/VES-160593.
Mulder T. Motor imagery and action observation: cognitive tools for rehabilitation. J Neural Transm (Vienna). 2007;114(10):1265-78. doi: 10.1007/s00702-007-0763-z. Epub 2007 Jun 20.
Urgesi C, Moro V, Candidi M, Aglioti SM. Mapping implied body actions in the human motor system. J Neurosci. 2006 Jul 26;26(30):7942-9. doi: 10.1523/JNEUROSCI.1289-06.2006.
Volz MS, Suarez-Contreras V, Portilla AL, Fregni F. Mental imagery-induced attention modulates pain perception and cortical excitability. BMC Neurosci. 2015 Mar 15;16:15. doi: 10.1186/s12868-015-0146-6.
Khan F, Amatya B. Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews. Arch Phys Med Rehabil. 2017 Feb;98(2):353-367. doi: 10.1016/j.apmr.2016.04.016. Epub 2016 May 20.
Efendi H. Clinically Isolated Syndromes: Clinical Characteristics, Differential Diagnosis, and Management. Noro Psikiyatr Ars. 2015 Dec;52(Suppl 1):S1-S11. doi: 10.5152/npa.2015.12608. Epub 2015 Dec 1.
McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA. 2021 Feb 23;325(8):765-779. doi: 10.1001/jama.2020.26858.
Habbestad A, Willumsen JS, Aarseth JH, Grytten N, Midgard R, Wergeland S, Myhr KM, Torkildsen O. Increasing age of multiple sclerosis onset from 1920 to 2022: a population-based study. J Neurol. 2024 Apr;271(4):1610-1617. doi: 10.1007/s00415-023-12047-9. Epub 2023 Dec 14.
Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, Robertson N, La Rocca N, Uitdehaag B, van der Mei I, Wallin M, Helme A, Angood Napier C, Rijke N, Baneke P. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 2020 Dec;26(14):1816-1821. doi: 10.1177/1352458520970841. Epub 2020 Nov 11.
Garcia-Munoz C, Cortes-Vega MD, Heredia-Rizo AM, Martin-Valero R, Garcia-Bernal MI, Casuso-Holgado MJ. Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. J Clin Med. 2020 Feb 21;9(2):590. doi: 10.3390/jcm9020590.
Related Links
Access external resources that provide additional context or updates about the study.
Clinical characteristics of patients with multiple sclerosis enrolled in a new registry in Egypt
Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy
Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment
Book Multiple Sclerosis Rehabilitation From Impairment to Participation Edited ByMarcia Finlayson
Effectiveness of Motor Imagery on Motor Recovery in Patients with Multiple Sclerosis: Systematic Review
The Effectiveness of Vestibular Rehabilitation on Balance Related Impairments among Multiple Sclerosis Patients: A Systematic Review
Motor imagery in multiple sclerosis: exploring applications in therapeutic treatment
Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis
Vestibular Rehabilitation
Reliability and validity of Arabic version of the brief international cognitive assessment for multiple sclerosis: Egyptian dialect
Advances in dynamic visual acuity test research
Validation of the Arabic version of the Berg Balance Scale (A-BBS) among elderly residents in a rural community
The reliability and validity of the Timed Up and Go as a clinical tool in individuals with and without disabilities across a lifespan: a systematic review
Validation of the Arabic Version of the Multiple Sclerosis Impact Scale (MSIS-29): a Rasch Analysis Study
Combined upper limb and breathing exercise programme for pain management in ambulatory and non-ambulatory multiple sclerosis individuals: part II analyses from feasibility study
Exercise and multiple sclerosis
Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines
Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study
Rehabilitation to improve gaze and postural stability in people with multiple sclerosis: study protocol for a prospective randomized clinical trial
Vestibular rehabilitation in multiple sclerosis: study protocol for a randomised controlled trial and cost-effectiveness analysis comparing customised with booklet based vestibular rehabilitation for vestibulopathy and a 12 month observational cohort stu
Exercises for multiple sclerosis : a safe and effective program to fight fatigue, build strength, and improve balance
Other Identifiers
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E-10840098-202.3.02-1593
Identifier Type: -
Identifier Source: org_study_id
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