Impact of Pilates suspension with self-awareness on gait and metacognition in multiple sclerosis: Randomized, single-blinded and parallel-group trial.

Background: Exercise and self-awareness are popular in the management of people with MS (pwMS). The combination of these techniques for diminishing mental and cognitive imparements doesn't apply. Since the capacity to monitor one's mind and maintain balance and efficient mobility is fundamental for carrying out the daily affairs of pwMS, in this study we assess the effect of Pilates Suspension with Self-awareness on Gait and Metacognition of pwMS. We also evaluate whether metacognition is trainable and, if so, which component of self-awareness (mental and physical) would be instrumental in this improvement.

Method: Twenty-four female PwMS who scored 2-6.5 on the EDSS were homogeneously divided into two intervention groups [one received pilates suspension training (PST) with Benson relaxation (PSBR), and the other received PST with Jacobson's progressive muscle relaxation (PSJR)] and one control group for 7 consecutive weeks. Relaxation training was used as a means to self-awareness. Due to the coronavirus pandemic around the world during the research process, baseline and postintervention tests and training sessions were held online. Dynamic Gait Index (DGI) and Metacognition Questionnaire-30 (MCQ-30), outcome measures were collected before and after the intervention.

Results: Analysis of group data revealed significant improvement between baseline and intervention phases for Dynamic Gate Index (p = 0.002 for Benson relaxation and p = 0.001 for Jacobson's progressive muscle) and Metacognition Questionnaire-30 (p = 0.02 for Benson relaxation and p = 0.002 for Jacobson's progressive muscle).

Conclusions: With regard to multidimensional disorders of pwMS, a combined training protocol is recommended for pwMS.