THE EFFECTS OF TAI CHI IN INDIVIDUALS WITH MULTIPLE SCLEROSIS

Multiple Sclerosis (MS) is a chronic, immune-mediated neurological disease characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. Cognitive impairment, fatigue, and depression are among the most common and disabling symptoms in individuals with MS, significantly affecting their quality of life. In addition to pharmacological treatments, exercise-based rehabilitation approaches have gained increasing attention in recent years.

This randomized controlled study investigated the effects of a structured Tai Chi exercise program on cognitive functions, fatigue, and depressive symptoms in individuals with MS. Participants diagnosed with MS were randomly allocated to either a Tai Chi intervention group or an active control group receiving a home-based Frenkel exercise program. Both groups continued their standard medical care throughout the study.

The Tai Chi intervention was conducted over 8 weeks, with two supervised sessions per week. Each session lasted approximately 50 minutes and included warm-up exercises, Tai Chi practice, and cool-down activities.

Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which comprises three tests: the Symbol Digit Modalities Test (SDMT), assessing information processing speed; the California Verbal Learning Test-II (CVLT-II), assessing verbal learning and memory; and the Brief Visuospatial Memory Test-Revised (BVMT-R), assessing visuospatial learning and memory. Fatigue was evaluated using the Fatigue Impact Scale (FIS), while depressive symptoms were assessed using the Beck Depression Inventory (BDI).

The primary outcome was cognitive performance following the intervention, while secondary outcomes included changes in fatigue and depressive symptoms. All outcome measures were assessed at baseline and after the 8-week intervention period.

This study aimed to contribute to the evidence regarding the potential role of Tai Chi as a non-pharmacological rehabilitation approach for managing cognitive and psychological symptoms in individuals with MS.

Participants received an 8-week Tai Chi intervention program designed for individuals with Multiple Sclerosis. The program included coordinated body movements, breathing control, and mindful movement practice, aiming to improve cognitive function, reduce fatigue, and improve depression levels in individuals with MS. The program consisted of progressively taught 8 movements selected from the basic 10 Yang-style forms, focusing on controlled weight shifting, postural alignment, and whole-body coordination. Each session consisted of a warm-up phase with general stretching exercises, a main Tai Chi practice component with form repetition and rest breaks as needed, and a cool-down phase including stretching and controlled breathing exercises.

Other: Tai Chi Exercises Program

Participants in this group received an 8-week home exercise program consisting of Frenkel coordination exercises. They were instructed to perform the prescribed exercises independently at home throughout the study period. Participants did not participate in the Tai Chi intervention. The program served as an active comparator for evaluating the effects of Tai Chi on cognitive function, fatigue, and depression in individuals with MS.

Other: Frenkel Home Exercises

Tai Chi was administered for 8 weeks, 2 days per week, for a total of 16 sessions. Each session lasted approximately 50 minutes and included warm-up stretching exercises (10 minutes), Tai Chi practice (30 minutes), and cool-down exercises (10 minutes). Sessions were conducted in groups of 2-3 participants under physiotherapist supervision.

Participants performed a home-based Frenkel exercise program for 8 weeks, twice weekly. Each session lasted approximately 15-30 minutes, excluding rest periods. Participants received an instructional booklet and an exercise logbook to record their exercise sessions. Adherence was monitored through telephone follow-up calls every two weeks.

Plazo: Baseline and 8 weeks after the intervention

Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which includes the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R).

Plazo: Baseline and 8 weeks after the intervention.

Information processing speed was assessed using the Symbol Digit Modalities Test (SDMT). Higher scores indicate better cognitive performance

Plazo: Baseline and 8 weeks after the intervention.

Verbal learning and memory were assessed using the California Verbal Learning Test-II (CVLT-II). Higher scores indicate better verbal learning and memory performance.

Plazo: Baseline and 8 weeks after the intervention.

Visuospatial learning and memory were assessed using the Brief Visuospatial Memory Test-Revised (BVMT-R). Higher scores indicate better visuospatial learning and memory performance.

Plazo: Baseline and 8 weeks after the intervention

The impact of fatigue on physical, cognitive, and social functioning was assessed using the Fatigue Impact Scale (FIS). Lower scores indicate less fatigue-related impact.

Plazo: Baseline and 8 weeks after the intervention

Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Lower scores indicate fewer depressive symptoms.

THE EFFECTS OF TAI CHI ON EXECUTIVE FUNCTIONS IN INDIVIDUALS WITH MULTIPLE SCLEROSIS: A RANDOMIZED CONTROLLED TRIAL