Dysphagia therapy in Multiple Sclerosis

INTERVENTION: Control Group : The second group is provided usual cares. This protocol included changes in speed, volume and viscosity of food. This treatment is provided for 30 min in 3 days of week and for 6 weeks. Intervention 1: Intervention Group: The first group is provided traditional dysphagia therapy. It is included computational treatments , postural changes, oral‐motor exercise, swallowing manures and usual cares. This treatment is provided for 30 min in 3 days of week and for 6 weeks. Intervention 2: Control Group : The second group is provided usual cares. This protocol included changes in speed, volume and viscosity of food. This treatment is provided for 30 min in 3 days of week and for 6 weeks. Intervention Group: The first group is provided traditional dysphagia therapy. It is included computational treatments , postural changes, oral‐motor exercise, swallowing manures and usual cares. This treatment is provided for 30 min in 3 days of week and for 6 weeks. Rehabilitation CONDITION: Difficulty in swallowing Dysphagia. ; Difficulty in swallowing PRIMARY OUTCOME: MASA Score. Timepoint: Beginning the first week, End of the third week, End of the sixth week, End of the twelfth week. Method of measurement: standard questionaire. SECONDARY OUTCOME: Aspiration‐Penetration Scale Score. Timepoint: Beginning the first week, End of the third week, End of the sixth week, End of the twelfth week. Method of measurement: Fiberoptic Endoscopic Evaluation of Swallowing. INCLUSION CRITERIA: Inclusion Criteria 1‐ Multiple Sclerosis patient; 2‐ age ranges 20‐60; 3‐ Not having history of relapses and not receiving steroid drugs in the last month; 4‐ Not having history of stroke, Parkinson's disease, cervical spinal cord injury, traumatic brain injury, amyotrophic lateral sclerosis and myasthenia gravis; 5‐ Not having history of cognitive disorders such as Dementia; 4‐ dysphagia and aspiration diagnosed by MASA test; 6‐Not having history of receiving any dysphagia therapy; Exclusion criteria: 1‐ Having Severe reflux; 2‐ Having Dysphagia due to drug toxicity; 3‐ Pregnancy; 4‐ The patient's unwillingness to continue treatment