Multiple Sclerosis (Relapsing Remitting)STRES-MSNCT06919900
Motor Learning of Fall Resistant Skills Through Slip and Trip Exposure in Multiple Sclerosis
A study testing Perturbation Training and Treadmill Walking in people with Multiple Sclerosis (Relapsing Remitting), run by Georgia State University at 1 site in United States.
Trial summary
The primary purpose of this interventional study is to examine the overall motor learning capacity from exposure to repeated perturbations among ambulatory people with multiple sclerosis (MS). This project will advance our understanding of learning new motor skills from exposure to external perturbations. Read more about this study
- Who is it for?
- Ages 45 to 89 years
- Conditions the study is for
- Multiple Sclerosis (Relapsing Remitting)
- What is being tested?
- Perturbation Training and Treadmill Walking
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 1 siteUnited States
- Study dates
- 6 Apr 2026to Dec 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 45 to 89 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Clinically confirmed multiple sclerosis
- At least 45 years old
- Able to walk independently at least 25 feet
- Able to stand independently for at least 30 seconds
- Patient Determined Disability Steps score between 0 and 4
- Free from pregnancy
- Montreal Cognitive Assessment score of 23 or higher
Who cannot join
- Previous experience with perturbation training
- T-score from the dual x-ray absorptiometry (DXA) scan of less than -2.5
- Coexisting psychiatric disorders or other neurological conditions, severe medical illness, or cardiovascular diseases
- Participants have had a relapse in the past 8 weeks
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Georgia State University Biomechanics Lab
Atlanta, Georgia, 30303
Feng Yang, PhD, 404-413-8357, fyang@gsu.edu
About this study
The primary purpose of this interventional study is to examine the overall motor learning capacity from exposure to repeated perturbations among ambulatory people with multiple sclerosis (MS). This project will advance our understanding of learning new motor skills from exposure to external perturbations. If it is proven that people with MS can learn motor skills from perturbation training, the findings from this study will pave a theoretical foundation for applying perturbation training as a promising fall prevention intervention for people with MS.
Read the detailed description
Falls present a significant health risk for people with multiple sclerosis (PwMS). Perturbation training has emerged as a promising strategy to prevent falls. This type of training, which is based on sensorimotor adaptation and motor learning, capitalizes on the central nervous system's (CNS) ability to develop new motor skills. With repeated exposure to large-scale slip or trip perturbations, participants can quickly learn how to better respond to falls. The primary benefits of this training include improved dynamic stability control, both proactively and reactively, by adjusting the body's center of mass (COM) relative to its base of support (BOS).
Sixty-four individuals with relapsing-remitting multiple sclerosis (MS) will be randomly assigned to one of two groups: Group A (training) and Group B (control). Both groups will first participate in an acquisition session. Group A will undergo a training procedure blending slips, trips, and unperturbed walking on a treadmill. In contrast, Group B will walk on the treadmill for the same duration without any perturbations. Immediately following the acquisition session, both groups will experience an unexpected slip and trip while walking over ground (with the order of the slip and trip randomized). Three and six months later, both groups will complete two retention sessions. Each retention session will involve experiencing a treadmill slip and trip (treadmill reslip and retrip) and an overground slip and trip (overground reslip and retrip), with the order randomized. Responses to these perturbations will be measured using the outcomes of fall or non-fall, dynamic stability, leg muscle reaction times, and recovery step length. Additionally, real-life prospective falls and near falls will be monitored for both groups over the six months following the acquisition session.
This project will advance our understanding of learning new motor skills from exposure to external perturbations. If it is proven that people with MS can learn motor skills from perturbation training, the findings from this study will pave a theoretical foundation for applying perturbation training as a promising fall prevention intervention for people with MS.
- Conditions
- Multiple Sclerosis (Relapsing Remitting)
- Being tested
- Perturbation Training, Treadmill Walking
- Keywords
- Falls, Fall prevention, Slips, Trips
- Medical subject headings
- Multiple Sclerosis, Relapsing-Remitting
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Perturbation TrainingBehavioural
Unexpected slips blended with trips and unperturbed walking trials on a treadmill. A safety harness will be worn at all times.
Treadmill WalkingBehavioural
Treadmill walking for the same amount of time as the training group without perturbation. A safety harness will be worn at all times.
| Study group | Role | What they receive |
|---|---|---|
| Training Group | Experimental | During the acquisition session, this group will undergo perturbation training on the treadmill while wearing a safety harness. Then, they will experience an unexpected slip and trip while wearing a safety harness and walking overground. During the 3-month and 6-month retention sessions, they will experience a slip and trip during treadmill walking and a slip and trip during overground walking. Receives: Behavioral: Perturbation Training |
| Control Group | Active comparator | During the acquisition session, this group will walk on the treadmill without perturbations for the same amount of time as the training group. Then, they will experience an unexpected slip and trip while wearing a safety harness and walking overground. During the 3-month and 6-month retention sessions, they will experience a slip and trip during treadmill walking and a slip and trip during overground walking. Receives: Behavioral: Treadmill Walking |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perturbation Outcome (Fall or Non-Fall) on the Treadmill or Overground
A loadcell will be connected to the safety harness (above the participant's head) and will measure the force exerted on the safety harness during each perturbation trial. Perturbation outcomes will be classified as falls if the peak loadcell force exceeds 30% of the body weight. Otherwise, perturbation outcomes will be classified as non-falls.
Measured: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Secondary outcomes (4)
Dynamic Gait Stability as defined by the Feasible Stability Region (FSR) Theory
FSR-based dynamic gait stability considers both the center of mass position and velocity during the slip or trip recovery process. Dynamic stability will be calculated at the foot touchdown before and after the perturbation onset. For slip-falls (or trip-falls), the larger (or smaller) the stability value, the more stable one is in resisting slip-related backward (or trip-induced forward) falling.
Measured: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Leg Muscle Reaction Time
The reaction times will be determined as the duration from the perturbation onset to the instant when the respective muscle is activated.
Measured: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Recovery Step Length
Recovery step length will be calculated as the distance between the heels at recovery foot touchdown and normalized to body height.
Measured: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Prospective Real-Life Falls and Near Falls
Both groups will report their fall or near-fall incidents through an online survey weekly.
Measured: 6 month period after the acquisition session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Apr 2025
- Study start6 Apr 2026
- Primary completionMar 2028 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Multiple Sclerosis (Relapsing Remitting)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 64 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Georgia State University
- Sponsor type
- University, hospital or other
- Collaborators
- National Multiple Sclerosis Society
- Responsible party
- Principal investigator, Feng Yang, PhD, Georgia State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06919900
- Sponsor's protocol ID
- H25443
- Acronym
- STRES-MS
- Status last verified
- Jun 2026
- First submitted
- 2 Apr 2025
- Last updated
- 17 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Yang F, Pai YC. Automatic recognition of falls in gait-slip training: Harness load cell based criteria. J Biomech. 2011 Aug 11;44(12):2243-9. doi: 10.1016/j.jbiomech.2011.05.039. Epub 2011 Jun 21.
PubMed 21696744Yang F, Bhatt T, Pai YC. Generalization of treadmill-slip training to prevent a fall following a sudden (novel) slip in over-ground walking. J Biomech. 2013 Jan 4;46(1):63-9. doi: 10.1016/j.jbiomech.2012.10.002. Epub 2012 Nov 8.
PubMed 23141636Yang F, Su X, Wen PS, Lazarus J. Adaptation to repeated gait-slip perturbations among individuals with multiple sclerosis. Mult Scler Relat Disord. 2019 Oct;35:135-141. doi: 10.1016/j.msard.2019.07.019. Epub 2019 Jul 23.
PubMed 31376685
Study at a glance
From the registry record, last updated by the sponsor on 17 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Motor Learning of Fall Resistant Skills Through Slip and Trip Exposure in Multiple Sclerosis
- ClinicalTrials.gov ID
- NCT06919900
- Acronym / sponsor ID
- STRES-MS / H25443
- Conditions
- Multiple Sclerosis (Relapsing Remitting)
- Keywords
- Falls, Fall prevention, Slips, Trips
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 64 participants (estimated)
- Lead sponsor
- Georgia State UniversityUniversity, hospital or other
- Collaborators
- National Multiple Sclerosis Society
- Study start
- 6 Apr 2026 (actual)
- Primary completion
- Mar 2028 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 9 Apr 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this interventional study is to examine the overall motor learning capacity from exposure to repeated perturbations among ambulatory people with multiple sclerosis (MS). This project will advance our understanding of learning new motor skills from exposure to external perturbations. If it is proven that people with MS can learn motor skills from perturbation training, the findings from this study will pave a theoretical foundation for applying perturbation training as a promising fall prevention intervention for people with MS.
Detailed description
Falls present a significant health risk for people with multiple sclerosis (PwMS). Perturbation training has emerged as a promising strategy to prevent falls. This type of training, which is based on sensorimotor adaptation and motor learning, capitalizes on the central nervous system's (CNS) ability to develop new motor skills. With repeated exposure to large-scale slip or trip perturbations, participants can quickly learn how to better respond to falls. The primary benefits of this training include improved dynamic stability control, both proactively and reactively, by adjusting the body's center of mass (COM) relative to its base of support (BOS).
Sixty-four individuals with relapsing-remitting multiple sclerosis (MS) will be randomly assigned to one of two groups: Group A (training) and Group B (control). Both groups will first participate in an acquisition session. Group A will undergo a training procedure blending slips, trips, and unperturbed walking on a treadmill. In contrast, Group B will walk on the treadmill for the same duration without any perturbations. Immediately following the acquisition session, both groups will experience an unexpected slip and trip while walking over ground (with the order of the slip and trip randomized). Three and six months later, both groups will complete two retention sessions. Each retention session will involve experiencing a treadmill slip and trip (treadmill reslip and retrip) and an overground slip and trip (overground reslip and retrip), with the order randomized. Responses to these perturbations will be measured using the outcomes of fall or non-fall, dynamic stability, leg muscle reaction times, and recovery step length. Additionally, real-life prospective falls and near falls will be monitored for both groups over the six months following the acquisition session.
This project will advance our understanding of learning new motor skills from exposure to external perturbations. If it is proven that people with MS can learn motor skills from perturbation training, the findings from this study will pave a theoretical foundation for applying perturbation training as a promising fall prevention intervention for people with MS.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Training Group | Experimental | Behavioral: Perturbation TrainingDuring the acquisition session, this group will undergo perturbation training on the treadmill while wearing a safety harness. Then, they will experience an unexpected slip and trip while wearing a safety harness and walking overground. During the 3-month and 6-month retention sessions, they will experience a slip and trip during treadmill walking and a slip and trip during overground walking. |
| Control Group | Active comparator | Behavioral: Treadmill WalkingDuring the acquisition session, this group will walk on the treadmill without perturbations for the same amount of time as the training group. Then, they will experience an unexpected slip and trip while wearing a safety harness and walking overground. During the 3-month and 6-month retention sessions, they will experience a slip and trip during treadmill walking and a slip and trip during overground walking. |
Who may qualify
- Ages
- 45 to 89 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Clinically confirmed multiple sclerosis
- At least 45 years old
- Able to walk independently at least 25 feet
- Able to stand independently for at least 30 seconds
- Patient Determined Disability Steps score between 0 and 4
Key exclusion criteria (4 listed)
- Previous experience with perturbation training
- T-score from the dual x-ray absorptiometry (DXA) scan of less than -2.5
- Coexisting psychiatric disorders or other neurological conditions, severe medical illness, or cardiovascular diseases
- Participants have had a relapse in the past 8 weeks
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Perturbation TrainingUnexpected slips blended with trips and unperturbed walking trials on a treadmill. A safety harness will be worn at all times. | Behavioural | Training Group |
| Treadmill WalkingTreadmill walking for the same amount of time as the training group without perturbation. A safety harness will be worn at all times. | Behavioural | Control Group |
Primary outcome
Perturbation Outcome (Fall or Non-Fall) on the Treadmill or Overground
Time frame: Baseline (acquisition session), 3-month retention session, 6-month retention session.
A loadcell will be connected to the safety harness (above the participant's head) and will measure the force exerted on the safety harness during each perturbation trial. Perturbation outcomes will be classified as falls if the peak loadcell force exceeds 30% of the body weight. Otherwise, perturbation outcomes will be classified as non-falls.
4 secondary outcomes
Dynamic Gait Stability as defined by the Feasible Stability Region (FSR) Theory
Time frame: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Leg Muscle Reaction Time
Time frame: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Recovery Step Length
Time frame: Baseline (acquisition session), 3-month retention session, 6-month retention session.
Prospective Real-Life Falls and Near Falls
Time frame: 6 month period after the acquisition session
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Jun 2026.
- Background: PubMed 21696744Yang F, Pai YC. Automatic recognition of falls in gait-slip training: Harness load cell based criteria. J Biomech. 2011 Aug 11;44(12):2243-9. doi: 10.1016/j.jbiomech.2011.05.039. Epub 2011 Jun 21.
- Background: PubMed 23141636Yang F, Bhatt T, Pai YC. Generalization of treadmill-slip training to prevent a fall following a sudden (novel) slip in over-ground walking. J Biomech. 2013 Jan 4;46(1):63-9. doi: 10.1016/j.jbiomech.2012.10.002. Epub 2012 Nov 8.
- Background: PubMed 31376685Yang F, Su X, Wen PS, Lazarus J. Adaptation to repeated gait-slip perturbations among individuals with multiple sclerosis. Mult Scler Relat Disord. 2019 Oct;35:135-141. doi: 10.1016/j.msard.2019.07.019. Epub 2019 Jul 23.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Perturbation Training and Treadmill Walking in people with Multiple Sclerosis (Relapsing Remitting), run by Georgia State University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 17 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Feng Yang, Ph.D. (404-413-8357, fyang@gsu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perturbation Outcome (Fall or Non-Fall) on the Treadmill or Overground (time frame: Baseline (acquisition session), 3-month retention session, 6-month retention session.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06919900, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jun 2026.