Telerehabilitation Based Motor Imagery and Action Observation Training in Multiple Sclerosis

May 30, 2026 updated by: Burcu Talu, Inonu University

Effect of Telerehabilitation-Based Motor Imagery and Action Observation Training on Balance and Functional Mobility in Multiple Sclerosis: Randomized Controlled Study

This study aims to investigate the effects of the treatment combination consisting of motor imagery and action observation therapy on balance, functional mobility, lower extremity muscle strength, fatigue and quality of life.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The study population was participants with relapsing remitting multiple sclerosis. The traditional rehabilitation program consists of a joint treatment in which lower extremity strengthening and balance exercises are carried out synchronously for the experimental and control groups. Motor imagery and action observation therapy based on telerehabilitation of certain movements will be applied to the experimental group. All treatments will be carried out online via the Whatsapp program. The treatment program will be applied 3 times a week for 6 weeks. Evaluations will be made before and after the treatment program. Assessments include balance, lower extremity muscle strength and functional mobility, fatigue, and quality of life.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
29

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Turkey (Türkiye)
    • Battalgazi
      • Malatya, Battalgazi, Turkey (Türkiye), 44280
        • Inonu University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being diagnosed with mulltiple sclerosis according to the McDonald criteria
  • Expanded Disability Status Scale<5.5,
  • Being between the ages of 18-65,
  • Mini mental test score>24,
  • Have a phone that can adapt to participating in a video call

Exclusion Criteria:

  • Having another additional neurological disease that may cause balance and coordination disorders,
  • having received physical therapy and regularly engaged in sports in the last 6 months
  • Having an attack in the last 3 months
  • Refusal to participate in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental group
Individuals will receive standard rehabilitation and telerehabilitation-based motor imagery and action observation therapy.
Other: Traditional rehabilitation
The program consists of a joint treatment in which lower extremity strengthening and balance exercises are carried out synchronously. The program will include a total of 5 minutes of warm-up, 5 minutes of cool-down and 30 minutes of exercises related to the program. The difficulty of the program will increase by changing the number of exercises and increasing the weight in strengthening exercises. Progress in balance and coordination exercises will vary by changing the ground, increasing the standing time, and keeping the eyes open and closed.
Other: Action observation therapy and motor imagery
In the experimental group, in addition to traditional telerehabilitation, action observation and motor imagery of 4 exercises will be performed in each session. A video will be prepared for 4 exercises. Then, the participant will perform 2 minutes of action observation of each movement, followed by 1 minute of motor imagery. In addition to the traditional telerehabilitation program, a 12-minute combination of action observation and motor imagery will be performed in each session. Exercises will be changed every two weeks, gradually increasing the difficulty.
Experimental: Control group
Individuals will receive standard rehabilitation.
Other: Traditional rehabilitation
The program consists of a joint treatment in which lower extremity strengthening and balance exercises are carried out synchronously. The program will include a total of 5 minutes of warm-up, 5 minutes of cool-down and 30 minutes of exercises related to the program. The difficulty of the program will increase by changing the number of exercises and increasing the weight in strengthening exercises. Progress in balance and coordination exercises will vary by changing the ground, increasing the standing time, and keeping the eyes open and closed.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Berg Balance Scale
Time Frame: Baseline
Berg Balance Scale consists of a total of 14 items. Evaluation for each stage is made between 0-4. Higher score indicates better functional balance performance
Baseline
Berg Balance Scale
Time Frame: 6 weeks after baseline
Berg Balance Scale consists of a total of 14 items. Evaluation for each stage is made between 0-4. Higher score indicates better functional balance performance
6 weeks after baseline
Muscle strength and functional mobility
Time Frame: Baseline
The participant will be asked to sit and stand up from a standard chair between 42-45 cm, with hands crossed on the chest, without support, 5 times. The time will be stopped when the participant completes the last sitting. It will be recorded in seconds.
Baseline
Muscle strength and functional mobility
Time Frame: 6 weeks after baseline
The participant will be asked to sit and stand up from a standard chair between 42-45 cm, with hands crossed on the chest, without support, 5 times. The time will be stopped when the participant completes the last sitting. It will be recorded in seconds.
6 weeks after baseline

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Fatigue Severity Scale
Time Frame: Baseline
This scale consists of a total of 9 items and is scored between 0-7. >4 points indicate fatigue
Baseline
Fatigue Severity Scale
Time Frame: 6 weeks after baseline
This scale consists of a total of 9 items and is scored between 0-7. >4 points indicate fatigue
6 weeks after baseline
Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire
Time Frame: Baseline
The scale consists of 31 questions in 9 dimensions (subscales). The index score is calculated as the average of these subscale scores. All 9 dimensions and the index score are linearly transformed and standardized on a scale from 0 to 100; where 0 indicates the worst possible level of quality of life and 100 indicates the best level.
Baseline
Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire
Time Frame: 6 weeks after baseline
The scale consists of 31 questions in 9 dimensions (subscales). The index score is calculated as the average of these subscale scores. All 9 dimensions and the index score are linearly transformed and standardized on a scale from 0 to 100; where 0 indicates the worst possible level of quality of life and 100 indicates the best level.
6 weeks after baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Inonu University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Burcu talu, Inonu University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 20, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 15, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 25, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 21, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 4, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 6, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 2, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 30, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025/7369

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Study data can be shared with other researchers if desired.

IPD Sharing Time Frame

After the study was published

IPD Sharing Access Criteria

If requested from the authors, it can be shared with researchers at the authors' discretion.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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