This cross-sectional observational study aims to investigate the relationship between obstacle crossing performance under single-task and dual-task conditions and the levels of fatigue and disability in individuals with Relapsing-Remitting Multiple Sclerosis (RRMS). Walking performance will be assessed under standard walking and obstacle crossing conditions with and without a concurrent cognitive task. The study will examine how increased task complexity affects walking performance and its association with fatigue, disability, cognition, and functional mobility.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that frequently causes gait impairment, fatigue, cognitive dysfunction, and reduced functional mobility. Since daily activities often require simultaneous motor and cognitive performance, assessment under dual-task conditions provides clinically meaningful information beyond conventional gait evaluation. Obstacle crossing represents a more demanding walking task than level walking and may better reflect mobility challenges encountered in everyday life. Although dual-task walking has been investigated in individuals with MS, studies examining obstacle crossing performance under both single-task and dual-task conditions and its relationship with fatigue and disability remain limited. This cross-sectional observational study will include men and women aged 18 to 65 years with Relapsing-Remitting Multiple Sclerosis who are followed at the Neurology Outpatient Clinic of Kocaeli City Hospital. Participants will complete walking assessments under four conditions: single-task walking, dual-task walking, single-task obstacle crossing, and dual-task obstacle crossing. The dual-task condition will require participants to perform serial-3 subtraction while walking. Clinical assessments including fatigue, walking limitation, cognition, health-related quality of life, and fear of movement will also be collected. The study aims to determine the association between obstacle crossing performance and fatigue and disability levels in individuals with RRMS.
Study Type
OBSERVATIONAL
Enrollment
30
Afyonkarahisar Health Sciences University
Afyonkarahisar, Merkez, Turkey (Türkiye)
RECRUITINGDual-Task Cost During Obstacle Crossing
Walking performance will be assessed using the 10-Meter Walk Test under four conditions: single-task walking, dual-task walking with serial-3 subtraction, single-task obstacle crossing, and dual-task obstacle crossing with serial-3 subtraction. Walking time and cognitive task performance will be recorded. Dual-Task Cost (DTC, %) will be calculated to quantify the effect of performing a concurrent cognitive task during walking.
Time frame: Baseline
The Modified Fatigue Impact Scale (MFIS)
The Modified Fatigue Impact Scale (MFIS) evaluates the impact of fatigue on physical, cognitive, and psychosocial functioning during the previous month. Total scores range from 0 to 84, with higher scores indicating greater fatigue impact
Time frame: Baseline
Multiple Sclerosis Walking Scale-12 (MSWS-12)
The Multiple Sclerosis Walking Scale-12 is a patient-reported outcome measure that evaluates the impact of multiple sclerosis on walking ability. Raw total scores range from 12 to 60, with higher scores indicating greater walking limitation.
Time frame: Baseline
Monitoring My Multiple Sclerosis Scale (MMMS)
The Monitoring My Multiple Sclerosis Scale (MMMS) evaluates physical status, relationships, energy, and cognitive or mental status. Total scores range from 26 to 104, with higher scores indicating better health status and functioning.
Time frame: Baseline
Tampa Scale for Kinesiophobia (TSK)
The Tampa Scale for Kinesiophobia (TSK) is a 17-item questionnaire used to assess fear of movement. Total scores range from 17 to 68, with higher scores indicating greater kinesiophobia.
Time frame: Baseline
Fatigue Severity Scale (FSS)
The Fatigue Severity Scale (FSS) assesses the severity of fatigue and its impact on daily functioning. It consists of 9 items scored from 1 to 7. The total score is calculated as the mean of the 9 items, ranging from 1 to 7, with higher scores indicating greater fatigue severity.
Time frame: Baseline
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