The effect of square stepping exercises on mobility, balance and knee joint position sense in patients with multiple sclerosis

Aim: The aim of this study is to examine the effect of the Square Stepping Exercise (SSE) program, which we think provides sensorimotor interaction through correct foot placement, fast and coordinated step patterns, on mobility, balance and knee joint position sense in persons with multiple sclerosis (pwMS). Materials and Methods: Thirty four iwMS between the ages of 20-50 were divided into two groups by simple random sampling method. Study group (n=17) underwent the SSE, while control group (n=17) received a home exercise consisting of Frenkel Coordination Exercises. The exercise trainings were carried out twice a week for 8 weeks for both groups. To assess mobility, Timed 25-Foot Walk Test (T25-FW), to assess balance Five Times Sit-to-Stand Test (5TSTS), Four Square Step Test (FSST), and Activities-specific Balance Confidence Scale (ABC) were applied. Knee joint position sense was assessed using K-FORCE Sens® electrogoniometer. Target measurement values were determined as 30° and 60°. Results: In the study group, significant improvement was achieved in all measurement parameters assessing mobility, balance, and position sense after treatment (p<0,05). In the control group, only 5TSTS and FSST results and knee joint position sense improved at 30° extension target angle (p<0.05). While the T25-FW, FSST, ABC and knee joint position sense measurement results differed between the study group and the control group (p<0.05), there was no difference in the 5TSTS measurement results (p>0.05). Conclusion: This study shows that SSE may be an effective exercise method in terms of improving mobility, balance, and knee joint position sense in iwMS. Keywords: Balance; Mobility; Multiple Sclerosis; Position Sense; Square Stepping Exercises