Multipl Sklerozlu Bireylerde Motor İmgeleme ve Aksiyon Gözlemi Eğitiminin Kas Oksijenizasyonu, Yorgunluk, Gövde Kontrolü ve Yürüme Üzerine Etkilerinin İncelenmesi

Abstract

This study was planned to investigate the effects of Motor Imagery (MI) and Action Observation (AO) training applied in addition to standard rehabilitation on muscle oxygenation, fatigue, trunk control, and walking in individuals with multiple sclerosis (MS). The 38 patients included in the study were randomly divided into three groups: MI group, AO group, and Control group. While the standard rehabilitation program was applied to the control group for six weeks, three days a week, 40 minutes a day, the MI group received 20 minutes of MI training in addition to the standard rehabilitation, and the AO group received 20 minutes of AO training in addition to the standard rehabilitation. In the study, muscle oxygenation (Moxy Monitor device), fatigue (Fatigue Severity Scale), trunk control (Trunk Impairment Scale and Core Stability Tests), walking distance (6 Minute Walk Test), dynamic balance during walking (Timed Up and Go Test, Dynamic Walking) Index), perceived walking ability (12-Item Multiple Sclerosis Walking Scale) and time-distance characteristics of gait (step time, step length, walking speed, cadence, stance phase, swing phase, single support phase and double support with the RehaGait® Gait Analysis Device phase) was evaluated. The mean age of the groups was 46.25±5.24 years in the MI group, 42.25±6.85 years in the AO group, and 43.58±6.18 years in the control group. Baseline values were similar in all clinical evaluations of the groups (p>0.05). After treatment, significant improvements were seen in muscle oxygenation, fatigue, trunk control, and walking parameters in all three groups (p<0.05). MI training applied in addition to standard rehabilitation was found to be more effective on fatigue severity, dynamic balance during walking, step time, walking speed, and cadence parameters than standard rehabilitation (p<0.05). However, it was determined that AO training applied in addition to standard rehabilitation was more effective than standard rehabilitation in terms of fatigue severity, walking distance, dynamic balance during walking, perceived walking ability, step time, walking speed, cadence, stance phase, swing phase, and single support phase parameters. (p<0.05). When the effectiveness of MI and AO training applied in addition to standard rehabilitation is compared, similar results were obtained for all parameters evaluated in the study (p>0.05). Our study results showed that adding MI and AO training to the standard rehabilitation programs for individuals with MS would be beneficial in terms of increasing muscle oxygenation, reducing the severity of fatigue, improving trunk control, and enhancing walking function.