The effect of combination of Alphalipoic acid and neuromuscular exercises on electrical activity of affected muscles in patients with multiple sclerosis.

Evaluation of the effect of ultrasound therapy and nerve gliding techniques in patients with mild to moderate carpal tunnel syndrome

Clinical trial with a control group, with parallel groups, Single blind, randomized, phase 3 on 36 patients. The block method will be used for randomization.

This study is conducted in Razi Birjand Hospital, South Khorasan Province. 36 patients are randomly divided into three intervention groups one, two and three (A-C).

Our study population is patients with multiple sclerosis (MS) in Birjand city under treatment with rituximab. Subjects' inclusion criteria include: age between 20 and 45 years, relapsing and relapsing MS patients with severe disease activity who are treated with rituximab, - patients with disability grade 5.4 to 6; - Patients who are able to walk without help, patients who are able to walk at least 100 meters, and the criteria for leaving the subjects include: unwillingness of patients to cooperate with the research team, absence of more than 3 sessions in training sessions, lack of regular consumption Alpha lipoic acid drug and failure to answer phone calls to continue treatment.

The patients examined in the study in one of three groups including: the first group receiving alpha lipoic acid supplement for 2 months in the form of 300 mg tablets twice a day (morning and night) (A), the second group receiving exercise Neuromuscular In a period of 8 weeks (3 days a week), 18 training stations are divided in a circle including static and dynamic exercises (B) and the third group receiving supplement + neuromuscular training (C).

Average kinematic parameters of lower limb joints (three-dimensional angles of ankle, knee and thigh joints), average performance variables (timed 7.5 meters walking, rising and walking tests)

Due to the inconsistency of the title of the trial with other parts of the study, it needed to be updated.

Placement of people in each group randomly in one of three groups including: the first group receiving alpha lipoic acid supplement for 2 months in the form of 300 mg tablets twice a day (morning and night) (A), the second group receiving The recipient of neuromuscular training in a period of 8 weeks (3 days per week) will be divided into 18 training stations in a circle including static and dynamic exercises (B) and the third group receiving supplement + neuromuscular training (C). Then, first, various triple blocks (ABC, ACB, BAC, BCA, CAB, CBA) are created on different cards. One of these blocks will be randomly selected using the lottery method and the patients will be divided into one of three groups A, B or C. Then randomization is done for other patients as well. This will be done by the secretary.

Outcome evaluator: The study administrator will perform the necessary evaluation without knowing the type of intervention received by the patients and will be recorded in the checklist that was designed for this purpose.