Unravelling The Optimisation And Consolidation Of Motor Skills In People With Multiple Sclerosis With Mild to Moderate Gait Impairment: A Feasibility Study

University Hospital of Ferrara18 enrolled

Overview

The goal of this feasibility study is to test the safety and effectiveness of an high-intensity task oriented circuit training program, followed by three months of telerehabilitation in people with mild to moderate Multiple Sclerosis (MS). The main questions it aims to answer are: * Can high-intensity task oriented circuit training improve gait and balance functional capacity? * Can telerehabilitation mantain the benefits in gait and balance gained via circuit training for a six month period? Participants will: * Complete 10 session ( one hour each, three times a week) of high-intensity task oriented circuit training administered in a hospital setting. The training will target key motor skills such as walking, stepping, supine to stand transitions and general mobility. * Engage in 3 months of asynchronous telerehabilitation (without physiotherapist supervision)

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Multiple Sclerosis

Interventions

Participants will receive 10 sessions of high-intensity, task-oriented circuit training, three times a week. Each session will last 60 minutes, with minutes of active training. Each session will include three rounds, each lasting 55 minutes. During each round, participants will rotate between stations working for four minutes at each station, followed by three minutes of rest. The stations will focus on key motor skills, including supine to stand transitions, walking speed and functional capacity, walking adaptability and stepping. After in-hospital treatment participants will receive 36 sessions of asynchronous telerehabilitation, three times a week for 12 weeks. This intervention will be supported by low-cost, off-the-shelf technology for treatment delivery and monitoring.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of primary or secondary progressive multiple sclerosis according to the McDonald criteria. * Mini-Mental State Examination (MMSE) score \> 24. * Expanded Disability Status Scale (EDSS) score ≤ 6. Exclusion Criteria: * Presence of other psychiatric or neurological disorders. * Cardiopulmonary, renal, or liver diseases. * Pregnancy. * Modifications in drug treatment within the last 3 months.

Outcomes

Primary Outcomes

Change in Balance

The change in balance will be assessed using the Fullerton Advanced Balance Scale

Time frame: Baseline testing (T0), score changes after the 4 weeks in-hospital treatment (T1), score changes after the 3-months asynchronous telerehabilitation intervention (T1) and score changes at follow up, 3 months after telerehabilitation intervetion (T3)

Secondary Outcomes

Change in mobility, balance, walking ability, and fall risk

Mobility, balance, walking ability, and fall risk will be assessed through Timed Up and Go Test

Change in Dual task Cost

Dual Task Cost will be assessed by the difference between Timed Up and Go and Dual Task Timed Up and Go

Change in quantitative mobility and leg function performance

Leg function performance and quantitative mobility assessed through Timed 25 Foot Walk

Change in auditory information processing speed and flexibility

Paced Auditory Serial Addition Test will be used to assess auditory information processing speed and flexibility

Change in Walking Speed

10 Meters Walking Test will be used to assess the change in walking speed

Change in ability to modify balance while walking in the presence of external demands

The extended version of the Dynamic Gait Index will be used to assess ability to modify balance while walking in the presence of external demands

Change in dynamic balance during an activity requiring weight-shift and movement while in single-leg stance

Step Test will be used to assess the change in dynamic balance during an activity requiring weight-shift and movement while in single-leg stance

Change in ability to transition from a supine positon to a standing position.

The Supine To Stand Test will be used to assess the ability to transition from a supine positon to a standing position.

Change in functional lower extremity strength

Five Times Sit to Stand will be used to assess functional lower extremity strength

Change in Walking capacity

Walking capacity will be assessed through the 6 Minute Walking Test

Change in Subjective Trait Fatigue

Change in subjective trait fatigue will be assessed through Modified Fatigue Impact Scale

Change in impacts of multiple sclerosis in people' lifes

The impact of multiple sclerosis in people' lifes will be assessed through Multiple Sclerosis Impact Scale 29.

Change in balance confidence

Change in balance confidence will be assessed through Activity-Specific Balance Confidence Scale.

Change in perceieved impact of MS on the individual's walking ability.

The 12-item Multiple Sclerosis Walking Scale (MSWS-12) will be used to measure of the impact of MS on the individual's walking ability.

Change in Walking Fatigability

The Distance Walking Index will be used to assess the Change in Walking Fatigability