Investigation of the Effects of Technology Supported Different Physiotherapy Approaches on Patients With Multiple Sclerosis

Berg Balance Scale will be used to determine the balance exposure level of the volunteers. It is a scale that includes the performance of 14 different tasks between 0 (not applicable) and 4 (normal performance). In this scale, which is evaluated over 56 points; Scores between 0 and 20 indicate imbalance, scores between 21 and 40 indicate that the balance is acceptable, and scores between 41 and 56 indicate that the balance is good.

Individuals' quality of life will be evaluated with MSQOL-54. In this scale consisting of 12 chapters and 54 questions in total, physical function, social function, physical role limitations, emotional role limitations, cognitive function, pain, emotional state, energy, sexual function, health perception, general quality of life, health stress and emotional well-being.

Trunk Impairment Scale will be used to evaluate the volunteers' trunk control. The scale consists of 17 items, 3 of which are related to static balance, 10 to dynamic balance, and 4 to the coordination ability of the stabilizer muscles. The scale is in the range of 0-23 points. High scores indicate good trunk control.

The Timed Get Up and Go Test will be used to evaluate the volunteers' functional mobility skills. Volunteers are asked to sit on a chair. A cone is placed 3 meters away from the chair in a linear fashion. The volunteer is asked to get up, walk around the cone and sit back on the chair. The time to complete this task will be recorded by measuring with a stopwatch. The test will be repeated 3 times and the average time will be noted.

This scale, which is widely used in patient-centered treatment approaches, includes the creation of the goal that the patient wants to reach as a result of the treatment, by the physiotherapist and the patient. The expected result is initially set as "0", -2 means the worst expected result, while +2 represents the most positive possible result.

Fatigue Intensity Scale: Fatigue intensity scale will be used to evaluate fatigue. The scale consists of 9 items. Each item is rated from 1 to 7. The score of the scale is obtained by the arithmetic mean of all items. People with a score of 4 and above are considered to be tired.

ABILHAND Stroke Hand Function Questionnaire will be used to question the hand functions of volunteers. In the questionnaire, the level of difficulty perceived by the volunteers while performing activities such as feeding, dressing and housework is questioned. The questionnaire consists of 56 items and each item is scored as 0 (impossible), 1 (difficult) and 2 (easy). High score means good hand skills.

Minnesota Manual Dexterity test will be used to evaluate volunteers' hand agility. Test 60 blocks; There are two stages of placement and translation. The placement test is performed by the volunteer placing the blocks towards the distance from the target close to him, and the total time is recorded. The placement test will be repeated for both hands. In the flip test, the volunteer is asked to take the blocks from the corner of the dominant side with the non-dominant hand, turn them bimanually and place them with the dominant side. The test goes from the far dominant corner to the non-dominant corner. The second row starts on the non-dominant side and runs towards the dominant side. At this stage, the person takes the block with the dominant hand, turns it bimanually and places it with the non-dominant side. This is repeated in the third and fourth rows as in the first and second rows and the total time is recorded. In the literature, it is recommended for use in patients with MS.

This 12-item scale evaluates the limitations of the MS patient in walking in the last two weeks. Scoring is made between 1-5. In this questionnaire, in which the patient evaluates his own walking performance, a high score indicates that walking ability is affected or the patient has difficulty in walking.

XSENS MVN-Awinda sensors will be used to measure volunteers' joint angles in different functions. This sensor system is frequently used in the literature for motion analysis. Joint angles will be measured using sensors during the following activities:

• Walking
• Functional reaching,
• Sit to Stand
• Touch the middle of the head,
• Hanging jackets,
• Eating,
• Touch the back pocket of your trousers,
• Get the phone to ear. Tests other than walking and standing up without sitting will be performed bilaterally. The materials used during the tests will be in the same physical properties and conditions for all patients.

The scale consists of 4 sub-parameter: posture and gait disturbances, kinetic functions, speech and oculomotor disorders. Posture and gait disturbances sub-parameter consists of 7 questions 34 points, kinetic functions 7 questions 52 points, speech disorders 2 questions 8 points, oculomotor disorders 3 questions 6 points. The score range is 0-100, and higher scores indicate increased disease severity.