RecruitingNot ApplicableNCT07230015

Combined Motor Imagery and Vestibular Rehab for MS

The Effectiveness of Combination of Motor Imagery and Vestibular Rehabilitation on Balance, Cognition, and Quality of Life in Patients With Multiple Sclerosis

Sponsor

Medipol University

Enrollment

30 participants

Start Date

Dec 1, 2025

Study Type

INTERVENTIONAL

Conditions

Multiple Sclerosis (MS) - Relapsing-remitting

Summary

This trial investigates the first combined use of motor imagery and vestibular rehabilitation in multiple sclerosis, aiming to evaluate their joint effect on balance, cognition, and quality of life.

Eligibility

Min Age: 18 YearsMax Age: 45 Years

Inclusion Criteria8

Diagnosis of Multiple Sclerosis (MS) Confirmed using McDonald Criteria
Patient diagnosed relapsing-remitting multiple sclerosis (RRMS).
Mild MS between 0-3 according to PDDS.
Age from (18-45)
Mild cognitive impairment
Balance impairment (mild to moderate impairment)
Vestibular dysfunction Related to MS (dizziness, vertigo , gaze instability ) 8. Native language is Arabic to ensure clear communication during cognitive tasks and exercise instructions
\. Be able to joined the treatment (motor imagery, vestibular rehabilitaiton )

Exclusion Criteria2

Other neurological disorder, progressive multiple sclerosis Non-MS related vestibular disorders (e.g., BPPV, Meniere's disease) that would interfere with vestibular rehab.
Severe Psychiatric Conditions (schizophrenia, bipolar, etc) Sever balance disorder Sever fatigue Medical instability eg (cardiovascular disease, respiratory, infections, severe uncontrolled diabetes, or severe visual impairments.) Sever cognitive impairment Pregnant Advance disability ( wheelchair , unable to stand ) Use of Vestibular-Suppressing Medications Non - speaker Arabic

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Interventions

BEHAVIORALMotor Imagery + Vestibular Rehabilitation group

This 8-week program, 3 sessions/week, 55- 60 min each, includes 4 steps: Warm-up (5 min): Breathing exercises progressing from basic diaphragmatic and pursed-lip breathing (weeks 1-2), light movement with breathing (weeks 3-4), to Inspiratory Muscle Training device (weeks 5-8). Motor Imagery (15 min): Foundational phase (weeks 1-2) imagining basic movements, skills building (weeks 3-4) with functional daily tasks, advanced phase (weeks 5-8) imagining complex tasks, environmental and cognitive challenges (e.g., sports, obstacle navigation, walking on uneven surfaces). Vestibular Rehabilitation (15 min): Foundational (weeks 1-2) gaze stabilization and static balance (VOR, VSR, VCR), dynamic balance and dual-task exercises (weeks 3-6), advanced functional balance and vestibular-cognition integration (weeks 7-8). Cool-down (10 min): Relaxation and symptom monitoring to prevent overexertion, dizziness, or fatigue.

BEHAVIORALConventional therapy group

This 8-week program, 3 sessions/week, 55- 60 min each, includes: Warm-up: Seated/standing marching, neck and shoulder stretching. Strength \& Functional Movements: Sit-to-stand, side leg raises, step-ups. Core \& Upper Body: Bridge exercise, seated core activation, seated leg lifts, wall push-ups, seated shoulder press. Flexibility \& Balance: Calf and hamstring stretches, spinal flexibility, single-leg stance, lunges, tandem walking. Cool-down: Deep breathing and gentle stretching.