The Effect of Internal- or External-Focused Exercise Training, Administered in Conjunction With a Cognitive Task, on Walking, Balance, and Cognitive Functions in Individuals With Multiple Sclerosis

Official Summary

This interventional clinical trial aims to investigate the effects of internal and external focus-based exercise training combined with cognitive dual-task training in individuals diagnosed with multiple sclerosis. The primary objective is to determine whether these exercise approaches improve gait, balance, and cognitive functions. The main research questions are: Does dual-task training combined with internal focus-based exercises improve gait, balance, and cognitive performance? Does dual-task training combined with external focus-based exercises lead to greater improvements compared to internal focus strategies? Participants will be divided into two groups, and the researchers will compare the effects of internal focus-based and external focus-based dual-task exercise training on functional outcomes. Participants will: Perform structured exercise sessions under the supervision of a physiotherapist Engage in dual-task activities by combining motor exercises with simple cognitive tasks (e.g., backward counting, word generation) Participate in an 8-week training program, with sessions held twice a week lasting approximately 45-60 minutes Undergo assessments of gait, balance, and cognitive function before and after the intervention This study does not involve invasive procedures or biological sample collection. The findings are expected to contribute to the development of more effective dual-task rehabilitation strategies for individuals with multiple sclerosis.

Study Design

• Study Type: INTERVENTIONAL
• Allocation: RANDOMIZED
• Model: PARALLEL
• Masking: DOUBLE
• Enrollment: 40 participants

Interventions

• BEHAVIORAL: Internal Focus Dual-Task Training — Participants perform dual-task exercise training with instructions focusing on their own body movements during task execution. The program includes gait, balance, and cognitive tasks.
• BEHAVIORAL: External Focus Dual-Task Training — Participants receive dual-task exercise training with external focus instructions directed to movement effects or external targets. The program includes gait, balance, and cognitive tasks performed simultaneously.

Primary Outcomes

• Gait Performance Under Dual-Task Conditions (Baseline and after 8 weeks)

Secondary Outcomes

• Cognitive Function (BICAMS) (Baseline and after 8 weeks)
• Balance Performance (Baseline and after 8 weeks)

Trial Locations

• Kütahya Sağlık Bilimleri Üniversitesi, Sağlıklı Yaşam Fizyoterapi ve Rehabilitasyon Merkezi, Kütahya, Merkez, Turkey (Türkiye)

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