Comparison of the effect of dual task exercise versus combined exercise in water and land on balance and gait of patients with multiple sclerosis.

Comparison of the effect of dual-task exercise v.s combined exercise in water and land on balance and gait of patients with multiple sclerosis.

RCT with the control group, the double-blinded factorial group on 78 patients. Participants will be randomized using block randomization at http://randomizer.org/.

This study focuses on exercise therapy on people with multiple sclerosis as pre-test and post-test. gait biomechanics analysis tests in the laboratory, cognitive and movement tests are evaluated pre and post twelve-week treatment. The movement biomechanics laboratory, swimming pool, and gym will be at the Khwarazmi University of Karaj. outcome assessor who does not know the hypothesis and study methods will be blinded to group allocation, also the data analysts will analyze the information of individuals in a code format.so he will be blinded too.

inclusion criteria: patients with relapsing-remitting type, The (EDSS) should be between 1.0 and 5.5. exclusion criteria: Inability to stand and walk without aids.

1. Intervention group: dual-task exercise in water: dual-task exercise will be done in the swimming pool. 2. Intervention group: dual-task exercise on land: dual-task exercise will be done in the gym. 3. Intervention group: combined exercise in water: combined exercise will be done in the swimming pool. 4. Intervention group: combined exercise on land: combined exercise will be done in a gym 5. Control group: patients with multiple sclerosis walking in water. 6. Control group: patients with multiple sclerosis walking in land.

static and dynamic Balance rate; gait biomechanics.

This study underwent changes after the time of registration due to the following reasons: 1. Because the type of study was changed from parallel to factorial, the researchers should have added another control group to the study so that the factorial type was 3-2-2 In this case, even the environmental factor was properly investigated in the study. so the participant number increased from 65 to 78. 2. Participants genders changed from only women to both 3. the primary and the secondary outcome exchanged, Because the statistical error will be reduced.

Randomization method: block randomization Randomization unit: it is individual. Randomization type: Randomization will be online randomization using the website http://randomizer.org/. Patients who meet the inclusion criteria will be randomly assigned to the experimental group (exercise in water and exercise on land) and the control groups. In this site, first, the number of sets of random numbers that is needed is determined (six sets of numbers are needed; 1. experimental group A, 2. experimental group B, 3. experimental group C, 4. experimental group D, 5. group Control E, and 6. control group F). The numbers that Research Randomizer needs to generate in each set are determined (six sets of 13 numbers are needed for each group). We specify the minimum and maximum amount of numbers that need to be produced (from 1 to 78). Concealment: Concealment of random assignment using a block randomization table (blocks of 10) generated by computer (number 1 for experimental group 1, number 2 for experimental group 2, number 3 for experimental group 3 and number 4 for experimental group, number 5 for control group and number 6 for control group) will be done before the start of data collection by a researcher who will not participate in calling or treating patients. Randomization tool: Random numerical sequence is placed in non-transparent and sealed envelopes. Another investigator, blinded to the initial assessment, will open an envelope and proceed with treatment as assigned by the group.

This study,is doubled blinded, and the outcome assessor and the data analyst will be blind (uninformed) regarding the allocation of groups. Patients will be aware of the type of study. Outcome assessor : In this study, an independent evaluator who does not know the hypothesis and methods of the study will evaluate the results before the interventions and 12 weeks after the interventions. Data analyst: The data analyst is blinded. the collected data will be matched with the codes given to each patient. so, the data analyst will see each patient in the form of a code, and the grouping of patients will not be recognizable to him.

Data files such as files related to the biomechanics of walking and motion analysis and gait tests, files related to EMG of worked muscles, dual-task questionnaires Balance scores and battery testsare the data that are examined in this study. will be. Data can potentially be shared after de-identifying individuals.

The access period starts 6 months after the results are published in validate journals.

Only researchers working in academic and scientific institutions

1. if the originality of the work is preserved and the names and information of the authors of this study are mentioned. 2. After the original data are published by the main researchers in a valid journal, permission is given to use the documents.

saharnazary1992@gmail.com saharnazary1992@khu.ac.ir Sahar Nazary Soltan Ahmad

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