Aerobic Fitness in Multiple Sclerosis: The Relationship Between Balance and Sensory Dual-Tasking

The aim of this study is to comparatively examine the effect of aerobic fitness levels on walking and balance performance, sensory dual-task (proprioceptive and vestibular) performance, balance confidence, and fatigue levels in individuals diagnosed with MS. Research hypotheses H1: MS patients with high aerobic fitness exhibit superior walking speed and balance performance compared to MS patients with low aerobic fitness. H2: In sensory dual-task tests involving proprioceptive and vestibular manipulations (BOSU ball, soft surface, and head movements synchronized with a metronome), MS patients with high aerobic fitness demonstrate better performance than the group with low aerobic fitness. H3: MS patients with high aerobic fitness report higher levels of balance confidence compared to the group with low aerobic fitness. H4: Perceived fatigue is greater in MS patients with low aerobic fitness compared to the group with high aerobic fitness. H5: There is a significant relationship between aerobic capacity levels and sensory dual-task performance, balance confidence, and fatigue severity in MS patients.

Inclusion Criteria: * Having been diagnosed with Relapsing-Remitting or Progressive MS. * Being between 18-65 years of age. * Having an Expanded Disability Status Scale score between 1.5-5. * Being able to walk independently or with a unilateral assistive device. * Having full cooperation and orientation, and a cognitive level to understand given commands: Mini Mental Test score of 24 or higher. Exclusion Criteria: * Having experienced an MS relapse or received acute corticosteroid treatment within the last 3 months. * Having an additional neurological, orthopedic, or rheumatological condition unrelated to MS that may affect balance and walking. * Having severe cardiovascular or respiratory disease that may make aerobic fitness assessment risky. * Having significant vision or hearing loss that would impede understanding test instructions. * Experiencing significant pain during measurements. * Having cognitive impairment that would prevent understanding or answering questions - scoring below 24 on the Minimental Test.