Effect of Cervical Mobilization on Balance and Plantar Pressure Distribution in Multiple Sclerosis

Hasan Kalyoncu University

Status: Completed

Conditions: Cervical Region Disorder Nos; Multiple Sclerosis; Pressure Area; Muscle Spasticity

Treatments: Other: Traditional Rehabilitation for multiple sclerosis; Other: Cervical mobilization for multiple sclerosis

Study type: Interventional

Funder types: Other

Identifiers

NCT04543448

2019/0107

Details and patient eligibility

About

MS patients were randomly divided into traditional therapy and traditional therapy + cervical mobilization groups. While muscle strengthening, stretching, balance and coordination exercises were given to the traditional group, cervical mobilization was applied in addition to these in cervical group. Patients received treatments twice a week for 4 weeks. The effect of the applied treatment on the tonus and plantar pressure distribution was analyzed. Treatments were interrupted for 4 weeks and the groups continued with the treatment they did not receive (crossover design). The group that received traditional treatment in the first period completed traditional + cervical mobilization, and the other group with traditional + cervical mobilization traditionally completed the treatment.

Full description

Cervical region is rich in terms of muscle spindle and reseptors. When this region is touched by physiotherapists, muscle spindles is activited. The cervical region is parasympathetic area have common relaxed effect. Thus this part can be benefit to improvement of balance. As improve balance, the plantar pressure distribution of patients may change.

Enrollment: 12 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Expanded Disability Status Scale (EDSS) score was between 2-5,
• According to the modified Ashworth Scale, spasticity is between 1 and 3,
• EDSS Cerebellar System Sub-Scale, Functional System Score ˃1,
• medical condition is stable and no medication changes were made in the last month,
• Vertebro-basillar test negative,
• Not have any other neurological disorder and orthopedic problem to prevent participation in this study
• A score of at least 24 from the Mini Mental Test,

Exclusion criteria

• presence of psychiatric or severe cognitive dysfunction,

• pregnancy,

• Having a neurological disease other than MS,

  • having had an attack in the last 3 months,

• Botulinum toxin application within the last 6 months,

• participating in physiotherapy program in the last 6 months

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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12 participants in 2 patient groups

Traditional Rehabilitation

Other group

Description:

Traditional Rehabilitation program was included strengthening exercises for the muscles needed, balance and coordination exercises according to the individual's level, stretching for the lower limbs in all individuals. Indıvıduals participated in 2 training sessions per week for 4 weeks. Each training session consisted of a 5-minute non-balance coordination exercise, a 30-minute balance and coordination exercise, a 10-minute stretching and strengthing.

Treatment:

Other: Traditional Rehabilitation for multiple sclerosis

Cervical Mobilization

Experimental group

Description:

Cervical Mobilization program, cervical mobilization techniques were applied to the patients for 30 minutes in addition to the traditional program. Cervical mobilization includes suboccipital relaxing techniques, myofascial muscle relaxing techniques for Levator scapula, trapezius, scalenes muscles. These techniques were applied bilaterally.

Treatment:

Other: Cervical mobilization for multiple sclerosis