Functional Disorders of the Musculoskeletal System in People With Multiple Sclerosis

Charles University, Czech Republic

Status: Completed

Conditions: Rehabilitation; Musculoskeletal Complication; Multiple Sclerosis

Treatments: Behavioral: Dynamic Neuromuscular Stabilization (DNS) Method; Behavioral: Manual physiotherapeutic correction (MFK) Method

Study type: Interventional

Funder types: Other

Identifiers

NCT04973501

EK-VP/25/0/2014/2

Details and patient eligibility

About

The randomized controlled trial is aimed to study the efficacy of treatment approaches based on developmental kinesiology models and its impact on balance, gait and mobility in people with mild to severe multiple sclerosis (pwMS). The main goal is to compare two out-patient physiotherapeutic methods, that will be attended 1-hour twice a week for one month and once a week for next two months (16 therapies in total). The efficacy will be assessed by a blinded independent clinical examiner using clinical examination and questionnaire survey one month before the therapy programme, immediately before and after the therapy and two months after termination of the therapy.

Full description

The participants were randomly divided into two groups for three-month outpatient physiotherapeutic programme.

One group obtained treatment by MFK Method (Manual physiotherapeutic correction) and the second by DNS (Dynamic Neuromuscular Stabilization ). Both treatment methods were developed in the Czech Republic. All participants attended 1-hour MFK Method or DNS twice a week for one month and once a week for next two months (16 therapies in total).

The participants were examined three times - before the start of the physiotherapy program, immediately after its completion and six months apart.

Enrollment: 50 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• exact diagnosis of MS stated by neurologist
• Expanded Disability Status Scale (EDSS) ≥ 2 and ≤ 6,5
• no previous physiotherapy in six months
• no clinical relapses and changes in pharmacotherapy in the previous month or during the rehabilitation trial
• ability to undergo ambulatory physiotherapy

Exclusion criteria

• other neurological disease or conditions disabling movement (e.g. stroke, pregnancy, fracture)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

---

50 participants in 2 patient groups

Manual physiotherapeutic correction (MFK) Method

Experimental group

Description:

The MFK was chosen for our clinical experience- it was developed in Czech Republic.The MFK Method consists of five established steps: anamnesis, assessment, diagnoses, treatment and checkup. In the course of all those steps, the computer MFK System software is used. This software allows us to display and visualize the patient´s functional muscle imbalance at the day of the assesment based on the assessment of muscle strength by manual muscle tests. Hereafter the physiotherapist performs muscle test and records results in the software. Then, the software visually describes the patient´s imbalance at the day of the assessment. Based on these diagnostic maps and the software suggestions the therapist chooses the body areas where the therapeutic techniques may be applied.

Treatment:

Behavioral: Manual physiotherapeutic correction (MFK) Method

Dynamic Neuromuscular Stabilization (DNS) Method

Experimental group

Description:

Dynamic Neuromuscular Stabilization (DNS) is a neurophysiological rehabilitative approach encompassing a set of functional tests assessing the quality of postural stabilization patterns and a treatment approach based on developmental kinesiology models. DNS diagnosis is based on comparison of the individual's postural stabilization pattern to the developmental stabilization pattern of healthy infants. The assessor uses DNS evaluation sheet to screen client's posture in 11 developmental positions if the patient can perform them all. If not, only the tests that the patient can perform sufficiently and safely serve for functional assessment. The strategy of DNS manual treatment is to utilize only those functional exercises in developmental positions that are the most suitable for the specific client. The goal is to improve spinal and joint stability by focusing on the global stabilization system consequently improving quality of movement and mobility.

Treatment:

Behavioral: Dynamic Neuromuscular Stabilization (DNS) Method