Effects of Activity Based Interventions on Performance in People with Multiple Sclerosis

INTERVENTION: Intervention 1: The intervention group receives visual perception interventions with a three‐dimensional printing pen for 2 sessions per week, 30 minutes per sessions for four weeks. In the first session in addition to the explanation, therapist produces a three dimensional design in order to teach the method. In each session, the therapist presents a plan for producing a three‐dimensional image for patient. In each session, four steps should be performed by the patient. In the first stage, Drawing lines on the plane. In this step, patients drew objects such as triangles or pentagons using stencils from the website (http://the3doodler.com/projects/). in the second stage, Drawing lines in the 3D space. In this step, patients recognized a 3D structure on paper and then drew lines in 3D space to recreate the same 3D structures dimensional space, in the third stage, Making structures by attaching 2D outputs. In this step, patients drew lines in separate planes using stencils and attached the planes to produce a complete 3D structure in the forth stage, Making structures by connecting 2D outputs with additional 3D drawing. In this step, patients drew lines using stencils and connected the plane lines to each other to produce a complete 3D structure with appropriate spatial configuration. Intervention 2: Control group: Receives conventional occupational therapy interventions for 8 sessions 2 times a week and 30 minutes per session. Interventions include:stretching and spasm control exercises using with theraband and wedge, gross motor skills and balance using with steps, balance beam , parallel bars and tilt board and fine motor skills using with putty, peg board , eye hand coordination and eye foot coordination exercises with ball and peg board,exercises in PNF technic and activities daily of living. CONDITION: multiple sclerosis. ; Multiple sclerosis PRIMARY OUTCOME: Occupational performance score in performing daily activities. Timepoint: Pre and post treatment. Method of measurement: Canadian occupational performance measure (COPM). Satisfaction score in performing daily activities. Timepoint: Pre and post treatment. Method of measurement: Canadian occupational performance measure. SECONDARY OUTCOME: Depth perception. Timepoint: pre and post treatment. Method of measurement: depth perception peg board. Visual pathway. Timepoint: pre and post treatment. Method of measurement: visual evoked potential. INCLUSION CRITERIA: Age Between 18 and 50 years Multiple Sclerosis Diagnosed by Neurologist DTVP‐A Score Below 90 MMSE Score Above 21 Normal Sightedness or Corrected with Assistive Devices The Hand has the Ability to Grip and Use Three‐dimensional Printing pen At least 3 months have passed from relapse of the disease