Combined Motor Imagery and Vestibular Rehab for MS

NCT ID: NCT07230015

Last Updated: 2025-11-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-31

Study Completion Date

2026-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This trial investigates the first combined use of motor imagery and vestibular rehabilitation in multiple sclerosis, aiming to evaluate their joint effect on balance, cognition, and quality of life.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Multiple sclerosis often causes balance disturbance, cognitive decline, and reduced quality of life. Motor imagery and vestibular rehabilitation are established methods in MS care, but their effects have only been studied separately. This randomized controlled trial introduces a combined program of motor imagery and vestibular training to explore whether their integration provides broader benefits. The study will recruit patients with relapsing-remitting MS, apply an 8-week intervention, and compare outcomes in cognition, balance, physical performance, and quality of life against conventional therapy.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Multiple Sclerosis (MS) - Relapsing-remitting

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a parallel group randomized controlled trial with two arms: an intervention group receiving motor imagery plus vestibular rehabilitation and a control group receiving conventional therapy only.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participants will not be informed of their group allocation. Due to the nature of the intervention, the investigator and care provider will be aware of the assignments, and the outcome assessments will also be conducted by the investigator."

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

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.

Group Type EXPERIMENTAL

Motor Imagery + Vestibular Rehabilitation group

Intervention Type BEHAVIORAL

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.

Group Type OTHER

Conventional therapy group

Intervention Type BEHAVIORAL

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

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

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.

Intervention Type BEHAVIORAL

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.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Diagnosis of Multiple Sclerosis (MS) Confirmed using McDonald 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

Other neurological disorder, progressive multiple sclerosis Non-MS related vestibular disorders (e.g., BPPV, Meniere's disease) that would interfere with vestibular rehab.

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
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Medipol University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Gehad Salem Mohamed Mohamed Menshawi

PT, MSc (Cand.)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Merve Yılmaz Menek, Assoc. Prof

Role: STUDY_DIRECTOR

Assoc. Prof. Merve Yılmaz Menek

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Gehad Salem Mohamed Mohamed Menshawi

Istanbul, Beykoz/İstanbul, Turkey (Türkiye)

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Turkey (Türkiye)

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Gehad Salem menshawi, PT, MSc (Cand.)

Role: CONTACT

+201040131964 ext. +905524590178

aliaa Salem menshawi, PT, MSc (Cand.)

Role: CONTACT

+9055244212805 ext. +96599743406

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

gehad Salem Menshawi, PT, MSc (Cand.)

Role: primary

01040131964 ext. +905524590178

Role: backup

References

Explore related publications, articles, or registry entries linked to this study.

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.

Reference Type BACKGROUND
PMID: 27050082 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 29725348 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 37932990 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19260980 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28262642 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 17579805 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 16870739 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25887060 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 27216225 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28360754 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33620411 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 38097800 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33174475 (View on PubMed)

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.

Reference Type RESULT
PMID: 32098162 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

https://pubmed.ncbi.nlm.nih.gov/27919495/

Clinical characteristics of patients with multiple sclerosis enrolled in a new registry in Egypt

https://pubmed.ncbi.nlm.nih.gov/28367411/

Multiple Sclerosis: Pathogenesis, Symptoms, Diagnoses and Cell-Based Therapy

https://pubmed.ncbi.nlm.nih.gov/38394496/

Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment

https://www.taylorfrancis.com/books/edit/10.1201/b12666/multiple-sclerosis-rehabilitation-marcia-finlayson

Book Multiple Sclerosis Rehabilitation From Impairment to Participation Edited ByMarcia Finlayson

https://pubmed.ncbi.nlm.nih.gov/33435410/

Effectiveness of Motor Imagery on Motor Recovery in Patients with Multiple Sclerosis: Systematic Review

https://www.iomcworld.org/open-access/the-effectiveness-of-vestibular-rehabilitation-on-balance-related-impairments-among-multiple-sclerosis-patients-a-systematic-revie-53345.html

The Effectiveness of Vestibular Rehabilitation on Balance Related Impairments among Multiple Sclerosis Patients: A Systematic Review

https://pubmed.ncbi.nlm.nih.gov/30207860/

Motor imagery in multiple sclerosis: exploring applications in therapeutic treatment

https://pubmed.ncbi.nlm.nih.gov/32098162/

Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

https://ejnpn.springeropen.com/articles/10.1186/s41983-021-00303-6

Reliability and validity of Arabic version of the brief international cognitive assessment for multiple sclerosis: Egyptian dialect

https://www.researchgate.net/publication/275642108_Validation_of_the_Arabic_version_of_the_Berg_Balance_Scale_A-BBS_among_elderly_residents_in_a_rural_community

Validation of the Arabic version of the Berg Balance Scale (A-BBS) among elderly residents in a rural community

https://pubmed.ncbi.nlm.nih.gov/31656104/

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

https://pubmed.ncbi.nlm.nih.gov/39727197/

Validation of the Arabic Version of the Multiple Sclerosis Impact Scale (MSIS-29): a Rasch Analysis Study

https://pubmed.ncbi.nlm.nih.gov/31422507/

Combined upper limb and breathing exercise programme for pain management in ambulatory and non-ambulatory multiple sclerosis individuals: part II analyses from feasibility study

https://pubmed.ncbi.nlm.nih.gov/15575796/

Exercise and multiple sclerosis

https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-75#citeas

Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines

https://pubmed.ncbi.nlm.nih.gov/33466699/

Effects of Motor Imagery Training on Balance and Gait in Older Adults: A Randomized Controlled Pilot Study

https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-019-1353-z#citeas

Rehabilitation to improve gaze and postural stability in people with multiple sclerosis: study protocol for a prospective randomized clinical trial

https://pubmed.ncbi.nlm.nih.gov/33243182/

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

https://levittown-nls.na.iiivega.com/search/card?id=db4b0e0a-e0b6-5a85-8776-5fd2b5ecd6b1&entityType=FormatGroup

Exercises for multiple sclerosis : a safe and effective program to fight fatigue, build strength, and improve balance

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

E-10840098-202.3.02-1593

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.