Multipl Skleroz Hastalarında Motor ve Kognitif İkili Görevin Yürüyüş Ve Postüral Kontrol Üzerine Etkisi

Abstract

Katmerlikaya, A., The Effect of Motor and Cognitive Dual Task on Gait and Postural Control in Multiple Sclerosis Patients, Hacettepe University, Graduate School of Health Sciences, Neurology Physiotherapy Program, Master of Science Thesis, Ankara, 2021. The aim of this study was to investigate motor and cognitive dual task on gait and postural control in patients with multiple sclerosis (MS). 30 individuals who applied to Hacettepe Hospitals Neurology Clinic with a definite MS diagnosis, mean age of 30.47 ± 6.38 years, with the expanded disability status scale (EDSS) score of less than 5, walking independently, and with Standardized Mini Mental Test score (SMMT) of over 24 were included recruited for the study. As the control group, 30 healthy individuals with a mean age of 29.47 ± 5.66 and without any orthopedic, neurological or systemic disease were included. Descriptive features of individuals were recorded. In order to examine the effects of dual tasks on postural control, stance in tandem (eyes open and closed) timed up and go test and four-frame step tests respectively; without any additional task, by giving a motor dual-task and cognitive dual-task were repeated. Gait variability was evaluated with Gait-trainer Biodex device. For the motor dual-task, the participants were asked to pass the object from one hand to the other. For the cognitive dual-task, they were asked to count backwards 3 by 3 from 100. It was observed that motor and cognitive dual task worsened the performance results of the four-frame test and timed up and go test in MS and healthy individuals, and the cognitive load created a higher task load(p<0.05). It was observed that right or left stance in tandem (eyes open and closed) positions was not affected by motor and cognitive dual task(p>0.05). Individuals with MS were found to walk at a lower speed, fewer steps, use a shorter left step distance, and walk with more variable stride lengths compared to healthy individuals. In addition, it was observed that the right and left stride lengths of individuals with MS did not change with the motor dual-task, but they lengthened when the cognitive dual task was given. This study showed that the gait and balance performances of individuals with MS were affected by motor and cognitive tasks, the cognitive load created more load, and they revealed similar performance as healthy individuals in balance-related results. In our study, it was thought that giving repeated cognitive tasks aimed at the goal from the earliest period in individuals with MS would directly contribute to the individual’s postural control ability.