The effectiveness of balance-sensory exercises on motor function in patients with MS

INTERVENTION: Intervention 1: Intervention group: Number: 15 people with multiple sclerosis‐ Intervention program: Performing balance exercises according to Canadian guidelines Physical activity of adults with multiple sclerosis on a textured surface (material: rubber ‐ 6 mm thick, area 1 in 1.5 m with dentin tissue 3 mm thick And the distance between the dentin 2.5 mm) Duration: 6 weeks (2 one‐hour sessions per week). Intervention 2: Control group: Number: 15 people with multiple sclerosis‐ Intervention program: Performing balance exercises according to Canadian guidelines Physical activity of adults with multiple sclerosis on a tissue‐free surface (material: rubber ‐ 6 mm thick, area 1 in 1.5 meters with a tissue‐free surface) ‐ Duration: 6 weeks (2 one‐hour sessions per week). CONDITION: Multiple sclerosis. ; Multiple sclerosis PRIMARY OUTCOME: Dynamic balance. Timepoint: Before the intervention, a week after the intervention. Method of measurement: Timed up and go test: Participants sit on a chair to start the test They are asked to walk with maximum speed during test. They rise with a "go" signal and walk until reach a line at 3 meters distance from the chair then turn and walk back to the chair and sit on it. The time is recorded using a stopwatch. Somatosensory(sense of joint position). Timepoint: Before the intervention, a week after the intervention. Method of measurement: Ankle proprioception was measured using perception of the inclination whilst participants stood over an adjustable slope box with closed eyes. Spatial‐temporal parameters of gait. Timepoint: Before the intervention, a week after the intervention. Method of measurement: Walking of participant will be recorded using a motion capture system then parameters of the "gait symmetry" calculated and reported using a Visual 3D software. Static balance. Timepoint: Before the intervention, a week after the intervention. Method of measurement: Participants are asked to stand quiet on the force‐plate while put the feet together and keep the arms relaxed beside the body. The center of pressure is recorded during 60 second of standing. SECONDARY OUTCOME: Fatigue. Timepoint: Before the intervention, a week after the intervention. Method of measurement: The level of fatigue will be measured using "Fatigue severity scale". Pain. Timepoint: Before the intervention, a week after the intervention. Method of measurement: The participants' pain will be quantified using "Visual analog scale". Spasticity. Timepoint: Before the intervention, a week after the intervention. Method of measurement: Muscle spasticity will be measured using "Modified Ashworth scale". INCLUSION CRITERIA: Diagnosis of a neurologist Weakness in somatosensory function based on sensory evaluation EDSS score 2 to 5.5 (for the ability to perform or complete gait tests according to previous studies) The ability to walk a distance of 25 feet with or without assistive device Ability to stand independently for 2 minutes