Multiple SclerosisNCT07137624
Motor Imagery and Action Observation for Gait Function in MS
A study testing Action Observation + Motor Imagery and Nature Video in people with Multiple Sclerosis, run by Hacettepe University at 1 site in Turkey (Türkiye).
Trial summary
This study will investigate whether mentally simulating walking movements while watching others walk can improve walking performance in individuals with Multiple Sclerosis (MS). Participants will be divided into two groups: one group will watch walking videos and imagine themselves walking, while the other group will… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Multiple Sclerosis
- What is being tested?
- Action Observation + Motor Imagery and Nature Video
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 3 Jan 2026to Nov 2026
- Phase
- Interventional
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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- A confirmed diagnosis of multiple sclerosis (MS) by a neurologist
- No history of relapse within the past 3 months and not currently experiencing a relapse
- A score of 24 or higher on the standardized Mini Mental State Examination
Who cannot join
- Presence of serious health conditions affecting the muscles, heart, lungs, or metabolism that could interfere with participation
- History of other neurological disorders, head injury, or chronic psychiatric conditions
- Chronic pain lasting longer than six months
- Significant muscle stiffness in the legs that may affect EMG recordings
- Hearing difficulties
- Vision problems as determined by the Snellen visual acuity test
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Hacettepe University, Faculty of Physical Therapy and Rehabilitation
Ankara
Yeliz Salcı, Assoc. Prof., 03123243847, fztyelizsalci@gmail.com
About this study
Official title: Effects of Motor Imagery and Action Observation on Gait Initiation and Spatiotemporal Gait Parameters in Multiple Sclerosis
This study will investigate whether mentally simulating walking movements while watching others walk can improve walking performance in individuals with Multiple Sclerosis (MS). Participants will be divided into two groups: one group will watch walking videos and imagine themselves walking, while the other group will watch nature scenes. The study will measure muscle activity and walking patterns to assess the effects. The results may help support the use of mental practice techniques to improve mobility in people with MS.
Read the detailed description
This study aims to explore the impact of mental simulation of walking movements on walking performance in individuals with Multiple Sclerosis (MS). The participants will be randomly assigned to two groups: the experimental group will watch walking-related videos and engage in mental imagery exercises, imagining themselves walking, while the control group will watch nature scenes without any walking-related content.
Objectives:
To determine whether mental imagery can enhance walking ability and gait parameters in individuals with MS.
To measure the effect of mental simulation on muscle activity and walking patterns, including stride length, walking speed, and balance.
Study Procedure:
The study will consist of multiple sessions, where participants will first undergo baseline assessments of walking ability. Following this, they will engage in either the walking video and imagery task (experimental group) or the nature video viewing task (control group) for a predetermined period of time. Measurements of muscle activity using electromyography (EMG) and walking patterns will be recorded before and after the intervention.
Potential Impact:
The results from this study may provide insights into the use of mental practice techniques as a non-invasive intervention to improve mobility in individuals with MS, a population often affected by walking difficulties. Mental imagery could serve as an adjunct therapy to traditional physical rehabilitation methods.
- Conditions
- Multiple Sclerosis
- Being tested
- Action Observation + Motor Imagery, Nature Video
- Keywords
- Motor imagery, Action Observation
- Medical subject headings
- Multiple Sclerosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Action Observation + Motor ImageryBehavioural
Participants will watch videos showing walking actions and will be instructed to mentally simulate the movement.
Nature VideoBehavioural
Participants will watch a video of nature scenes.
| Study group | Role | What they receive |
|---|---|---|
| Arm 1 | Experimental | Arm 1: Experimental Group: Action Observation + Motor Imagery Receives: Behavioral: Action Observation + Motor Imagery |
| Arm 2 | Other | Arm 2: Control Group: Nature video Receives: Behavioral: Nature Video |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Tibialis Anterior and Gastrocnemius Medialis Muscle Activity Amplitude
Change in muscle activity amplitude (microvolts, µV) of tibialis anterior and gastrocnemius medialis during gait initiation measured by surface EMG.
Measured: Before and immediately after the intervention
Change in Tibialis Anterior and Gastrocnemius Medialis Muscle Activity Onset Latency
Change in onset latency (milliseconds, ms) of tibialis anterior and gastrocnemius medialis muscle activation during gait initiation measured by surface EMG.
Measured: Before and immediately after the intervention.
Change in Step Length
Change in step length (centimeters, cm) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Change in Step Time
Change in step time (seconds, s) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Change in Step Width
Change in step width (centimeters, cm) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Change in Double Support Period
Change in double support period (percentage of gait cycle, %) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Change in Gait Velocity
Change in gait velocity (centimeters per second, cm/s) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Change in Cadence
Change in cadence (steps per minute, steps/min) during gait initiation measured by the GAITRite system.
Measured: Before and immediately after the intervention
Secondary outcomes (8)
Motor Imagery Vividness
Kinesthetic and visual imagery vividness will be assessed using the Kinesthetic and Visual Imagery Questionnaire-20 (KVIQ-20), which includes 10 visual and 10 kinesthetic items (20 total). Each item is rated on a 5-point Likert scale (1 = no image/sensation, 5 = vivid image/sensation). Higher scores indicate better imagery ability.
Measured: Baseline only
Mental Chronometry Ratio
The ratio between imagined and actual Timed Up and Go (TUG) performance time (both measured in seconds, s) will be calculated. During imagined trials, participants will press a button to mark the start and end of the imagined movement sequence. A ratio closer to 1 indicates better temporal congruence between imagined (iTUG) and executed TUG performance.
Measured: Baseline only
Limb Laterality Recognition Performance
Right-left discrimination ability will be evaluated using the Recognise Foot App™ developed by the NOI Group™. Both accuracy (percentage of correct responses, %) and response time (milliseconds, ms) will be recorded.
Measured: Baseline only
Cognitive Status
General cognitive functioning will be screened using the Standardized Mini-Mental State Examination (SMMSE). The test is scored on a 30-point scale (0-30). Scores ≥24 indicate normal cognitive functioning.
Measured: Baseline only
Fatigue Level
Fatigue severity specific to MS will be measured with the Fatigue Severity Scale (FSS). The FSS consists of 9 items rated on a 7-point Likert scale (1 = strongly disagree; 7 = strongly agree). The final score is calculated as the mean of all items (range: 1-7), with higher scores indicating greater fatigue severity.
Measured: Baseline only
Anxiety and Depression
Emotional state will be assessed using the Hospital Anxiety and Depression Scale (HADS). The scale consists of 14 items divided into two subscales: anxiety (7 items) and depression (7 items). Each item is scored from 0 to 3, yielding subscale scores ranging from 0 to 21. Higher scores indicate greater levels of anxiety or depression.
Measured: Baseline only
Disability Level
Expanded Disability Status Scale (EDSS) scoring will be performed using the standardized Neurostatus-EDSS format. This scale evaluates functional systems such as motor ability, balance, vision, and sensory function to quantify disability level in individuals with multiple sclerosis. Scores range from 0 to 10 in 0.5-point increments, where 0 indicates normal neurological status and 10 represents death due to MS. Higher scores reflect greater disability.
Measured: Baseline only
Visual Acuity
Participants' visual acuity will be assessed using the Snellen chart under standard conditions. The test will be conducted with or without corrective lenses depending on the participant's usual visual aid usage. Visual acuity will be recorded as a Snellen fraction (e.g., 20/20, 20/40), where larger denominators indicate poorer visual performance.
Measured: Baseline only
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Aug 2025
- Study start3 Jan 2026
- Primary completionNov 2026 (estimated)
- Study completionNov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Multiple SclerosisStudies 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
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned to either the experimental group (motor imagery + action observation) or the control group (nature video).
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 20 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hacettepe University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Merve Ünal, Hacettepe University
- Investigators
- Yeliz Salcı, Assoc. Prof., Study chair, Hacettepe University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07137624
- Sponsor's protocol ID
- FTREK25/48
- Status last verified
- Sep 2026
- First submitted
- 6 Aug 2025
- Last updated
- 21 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Wright DJ, Williams J, Holmes PS. Combined action observation and imagery facilitates corticospinal excitability. Front Hum Neurosci. 2014 Nov 27;8:951. doi: 10.3389/fnhum.2014.00951. eCollection 2014.
PubMed 25505880Rocca MA, Meani A, Fumagalli S, Pagani E, Gatti R, Martinelli-Boneschi F, Esposito F, Preziosa P, Cordani C, Comi G, Filippi M. Functional and structural plasticity following action observation training in multiple sclerosis. Mult Scler. 2019 Oct;25(11):1472-1487. doi: 10.1177/1352458518792771. Epub 2018 Aug 7.
PubMed 30084706Gil-Bermejo-Bernardez-Zerpa A, Moral-Munoz JA, Lucena-Anton D, Luque-Moreno C. Effectiveness of Motor Imagery on Motor Recovery in Patients with Multiple Sclerosis: Systematic Review. Int J Environ Res Public Health. 2021 Jan 9;18(2):498. doi: 10.3390/ijerph18020498.
PubMed 33435410Chye S, Valappil AC, Wright DJ, Frank C, Shearer DA, Tyler CJ, Diss CE, Mian OS, Tillin NA, Bruton AM. The effects of combined action observation and motor imagery on corticospinal excitability and movement outcomes: Two meta-analyses. Neurosci Biobehav Rev. 2022 Dec;143:104911. doi: 10.1016/j.neubiorev.2022.104911. Epub 2022 Nov 5.
PubMed 36349570Salamci M, Salci Y, Topuz S, Yalcin AI, Acar Ozen P, Tuncer A. Gait initiation in multiple sclerosis patients with and without functional loss. Mult Scler Relat Disord. 2023 Nov;79:104990. doi: 10.1016/j.msard.2023.104990. Epub 2023 Sep 4.
PubMed 37708821