Evaluation of the Effect of Mental Imagery Training Combined With Modified Constraint-Induced Movement Therapy in Individuals With Multiple Sclerosis

Treatment tested

• odified Constraint-Induced Movement Therapy + Mental Imagery Training

Compared with

• Modified Constraint-Induced Movement Therapy

Other measures (7)

Inclusion Criteria: 1. A definitive diagnosis of multiple sclerosis (MS) by a neurologist according to the McDonald criteria. 2. Presence of an asymmetric upper extremity motor deficit attributable to MS, determined by calculating the difference in performance time between the extremities using the Nine-Hole Peg Test (9HPT). 3. Marked non-use of the more affected upper extremity during activities of daily living (Motor Activity Log average item score ≤2.5). 4. Ability to perform at least 20° of wrist extension starting from full wrist flexion, at least 10° of thumb extension or abduction, and at least 10° of extension at the metacarpophalangeal and interphalangeal joints of the other fingers. 5. No relapse within the previous 3 months. 6. Right-hand dominance. 7. Basic computer skills, including turning the computer on and off, opening and closing the relevant program, and adjusting the volume. Exclusion Criteria: 1. A score greater than 1 on the Modified Ashworth Scale (MAS >1) in at least one upper extremity muscle. 2. Upper extremity pain, defined as a score greater than 4 on the Visual Analog Scale (VAS). 3. A score below 24 on the Mini-Mental State Examination (MMSE). 4. Severe hearing and/or speech impairment. 5. Presence of an additional neurological, musculoskeletal, or other condition that may affect upper extremity motor function. 6. Previous receipt of Constraint-Induced Movement Therapy (CIMT).

This study aims to investigate the effects of mental imagery training combined with modified constraint-induced movement therapy in individuals with multiple sclerosis. Participants will be randomly assigned to an intervention group receiving mental imagery training combined with modified constraint-induced movement therapy or a control group receiving modified constraint-induced movement therapy alone.