Multipl Sklerozlu Bireylerde Servikal Mobilizasyonun Spastisite ve Denge Üzerine Etkisi

Abstract

The aim of this study is to investigate the effect of cervical mobilization on balance and spasticity in individuals with multiple sclerosis. A total of 30 MS patients between 2-5 EDSS points were included in the randomized controlled, single blinded study for spasticity assessments. The stories of patients, demographic information and physical characteristics of the individuals included in the study were recorded. Modified Ashworth Scale (MAS) and active range of motion (AROM) measurements were performed for spasticity evaluations. In balance evaluations; sensory organization test (SOT), stability limit test (SLT), adaptation test (ADT) of computerized dynamic posturography, berg balance scale (BBS) and time of one leg steady stance test were recorded. Patients were divided into 2 groups by closed envelope method. There was no intervention in the control group while single session cervical mobilization was applied to the study group. At the end of the study, only gastrocnemius and quadriceps femoris MAS values were improved in the study group (p <0.05), whereas only AROM were recorded improvement in the foot dorsi flexion (p <0.05). According to sensory organization test results, visual and vestibular scores (p <0.05) were increased in the study group. In the study group, the composite balance score also increased (p <0.05). A significant increase (p <0.05) was observed in all parameters of SLT in all directions. In the ADT, the oscillation energies decreased in both groups after treatment (p <0.05). In the control group, which no intervention was conducted, the learning effect of evaluation methods was investigated. And as a result, learning effect is not observed. These results have shown that cervical mobilization in MS subjects regulates spasticity and increases balance control. Our study suggests that cervical mobilization may be added to physiotherapy and rehabilitation programs for individuals with MS who have dysbalance and spasticity and may be a good treatment option.