Effect of whole body vibration training (Vibration Therapy) and Qavoot intake on physical performance and muscles electromyography characteristics involved at the Gait initiation in multiple sclerosis patients

To examine the effects of combined WBV and quinoa supplement on physical performance and electromyographic features of lower limb muscles during walking in MS.

The study was conducted at the University of Birjand, Faculty of Physical Education and Sport Sciences (Behavioral Sciences Campus). Participants were recruited from clinics in Birjand. The whole-body vibration therapy intervention was performed in faculty laboratories (such as the Exercise Physiology Laboratory), and electromyographic and functional assessments were also performed at the same location.

The study was conducted at the University of Birjand, Faculty of Physical Education and Sport Sciences (Behavioral Sciences Campus). Participants were recruited from clinics in Birjand. The whole-body vibration therapy intervention was performed in faculty laboratories (such as the Exercise Physiology Laboratory), and electromyographic and functional assessments were also performed at the same location.

Participants: ۳۴ patients with relapsing-remitting multiple sclerosis (RRMS) with Expanded Disability Status Scale (EDSS) scores from ۱ to ۶ (mean age ۴۱.۹ ± ۸.۹ years, ۷۹.۴% female) recruited from clinics in Birjand.

Whole body vibration plus quinoa supplement (n=۱۰) Whole body vibration (n=۸) Quinoa supplement (n=۹) Placebo (n=۷)

The main outcome variables included the Timed Up and Go (TUG) test to assess dynamic balance and coordination of movement, the 7.5-meter walk test to measure walking speed, and muscle synergy characteristics based on the NMF index in electromyography (EMG) of the lower limb muscles (tibialis anterior, soleus, rectus/biceps femoris, gluteus medius) at the beginning of walking. Sleep quality and wakefulness were also assessed through a questionnaire!

Main method: simple randomization (using random.org). Allocation was done individually Randomization was unstratified. Website www.random.org (online random number generator based on atmospheric noise) Sealed envelopes to store allocation sequence How to create a random sequence First draw the groups (possibly determine the order of the groups or choose the type of the first group) Then randomly select individuals to be allocated to the groups This process was done using www.random.org. The generated sequence was stored in sealed envelopes. Allocation concealment The random sequence was stored in sealed envelopes. Decryption was only possible in emergency situations (serious complications) and under the supervision of the responsible physician. The evaluators and training instructors (implementation team and evaluation team) were unaware of the grouping code.

Those who were blinded to the allocation: Participants (MS patients) were blinded (participants did not know which group they were in). Reason: The intervention and placebo were designed and prepared in exactly the same way in terms of appearance (shape, color, taste) and method of administration. The study is single-blinded from the participants’ perspective. The exercise trainers (the intervention team/those who performed the vibration exercise) were blinded. “The intervention team (the exercise trainers) … were unaware of the allocation codes.” The assessors/those who collected the data or evaluated the results were blinded. “The assessors (those who collected the data or evaluated the results) were unaware of the allocation codes.” This includes assessors of functional tests (e.g. TUG, 7-meter walk), electromyography, and questionnaires. The principal investigator (and other members of the main research team) were blinded. The principal investigator was aware (open-label to the PI). The health-care personnel (neurologist, physician responsible for monitoring complications) Were aware (not blinded). The referring physician was the specialist. The responsible physician was authorized to decode the envelopes in emergency situations. At least one senior physician was aware or could have been aware of the allocation.

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