Multipl Sklerozlu Hastalarda Klasik Fizyoterapiye Ek Olarak Verilen Görev Odaklı Eğitimin Fonksiyonel Mobilite, Yorgunluk, Denge ve Yaşam Kalitesi Üzerine Etkileri

Abstract

The aim of this study was to investigate the effects of task-oriented training given in addition to classical physiotherapy, based on motor learning principles, on functional mobility skills, fatigue, balance and quality of life in patients with Multiple Sclerosis (MS). Thirty-one patients who were able to walk independently, had no cognitive problems, no other systemic, orthopedic, and neurological problems were included to the study. Control group received physiotherapy consisting of combined exercise training and the study group received task-oriented training in addition to the physiotherapy program. Both trainings were applied for 3 times per week for 6 weeks. The assessments were performed twice before and after treatment. The functional performance of patients were assessed with 6-Minute Walking Test (6MWT), functional mobility and balance were assessed with Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), and Multiple Sclerosis Walking Scale- 12 (MSWS-12). The quality of life were assessed with the Multiple Sclerosis Quality of Life Instrument-54 (MSQoL-54) while the fatigue characteristics were examined with the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). At the end of the study, the values were obtained before and after the treatment were compared and the significance levels of the changes in the groups were examined. 6MWT walking distance increased in both groups and pain during walking decreased in the study group (p<0,05). In the study and control groups, significant improvement was observed in terms of BBS, FRT, TUG, DYI and MSWS-12 after treatment (p<0.05). When the amounts of change in functional skills were compared within the groups, only BBS score change was found higher in the study group (p<0.05). There was a significant decrease in the fatigue severity only in the study group (p<0.05), but FIS decreased significantly only in the control group (p<0.05). There was improvement significantly in quality of life in the mental and physical composites in the study and control groups(p<0.05), but there was no difference between the groups in terms of the amount of change in the mental and physical composites (p>0.05). The increase in quality of life in the study group was due to the improvement in general health, general quality of life and social functions. As a result of our study, classical physiotherapy training and additional task oriented training has positive effects on functional mobility skills, fatigue and quality of life in patients with MS. Task-oriented training has the best improvement on balance and social functioning. To conclude that the task-oriented training included in the rehabilitation program increases the social role participation of people.