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    Age-Related Differences in e-Health Literacy in People with Multiple Sclerosis
    (Sage Publications Ltd, 2025) Yavas, Ipek; Karakas, Hilal; Celik, Rabia Gokcen Gozubatik; Cansiz, Melek; Ertekin, Ozge; Kahraman, Turhan
    [Abstract Not Available]
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    Cognitive Difficulties, Coping Strategies and Barriers to Participation in Cognitive Rehabilitation in People with Multiple Sclerosis: A Qualitative Study Across Different Disability Levels
    (Sage Publications Ltd, 2025) Karakas, Hilal; Yavas, Ipek; Gokcen, Rabia; Celik, Gozubatik; Cansiz, Melek; Ertekin, Ozge; Kahraman, Turhan
    [Abstract Not Available]
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    Effect of Telerehabilitation-Based Motor Imagery Training on Pain and Related Factors in People With Multiple Sclerosis: Randomized Controlled Pilot Trial
    (W B Saunders Co-Elsevier Inc, 2025) Karakas, Hilal; Kahraman, Turhan; Ozdogar, Asiye Tuba; Baba, Cavid; Ozakbas, Serkan
    Objectives: To investigate the effect of telerehabilitation-based graded motor imagery (MI, GMI) training on pain and pain-related factors in people with multiple sclerosis (MS). Design: Randomized controlled, assessor-blind pilot trial with repeated-measure design. Setting: Neurology outpatient clinic. Participants: Thirty-two people with MS were randomly allocated to intervention (n=16) and control (n=16) groups. Interventions: During the 8-week GMI training period, the first 2 weeks involved implicit MI training while 6 weeks of explicit MI training were conducted. Main Outcome Measures: The primary outcome was the general pain intensity over the past 2 days, assessed with a visual analog scale, with a minimum clinically important difference (MCID) of 23 mm. Secondary outcomes included general pain and specific body parts' pain intensity over the past 7 days, neuropathic pain intensity, MI ability, fatigue, depression, anxiety, quality of life, sleep quality, daytime sleepiness, and cognitive functions scores. Assessments were conducted at baseline, at weeks 8 (post-treatment) and 12 (follow-up). Results: The intervention group demonstrated a significant reduction in pain intensity over the past 2 days compared with control group (P<.05). Furthermore, at the 8-week assessment, the intervention group surpassed the MCID in pain intensity over the past 2 and 7 days (P<.05), whereas no significant change was observed in the control group (P>.05). Significant effects were observed post-treatment on general pain over the past 7 days, neuropathic pain, MI ability, fatigue, depression, quality of life, processing speed, and visuospatial memory within intervention group compared with control group (P<.05). However, the effect on anxiety, sleep quality, daytime sleepiness, and verbal memory between groups was not significant (P>.05). Conclusions: Telerehabilitation-based GMI training stands out as viable for the management of chronic pain and pain-related psychosocial symptoms for people with MS.
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    Effect of Telerehabilitation-Based Music Therapy and Motor Imagery on Pain, Autonomic Function, and Psychosocial Outcomes in People With Multiple Sclerosis: A Randomized Controlled Trial Protocol
    (Wiley, 2026) Karakas, Hilal; Ertekin, Ozge; Yavas, Ipek; Gozubatik-Celik, Rabia Gokcen; Kazdagli, Hasan; Seebacher, Barbara; Kahraman, Turhan
    Background and Purpose Chronic pain affects approximately 63% of people with multiple sclerosis (pwMS), contributing to fatigue, depression, anxiety, poor sleep, reduced quality of life, and cognitive decline. Within the biopsychosocial model, music therapy has emerged as a promising intervention to address these complex symptoms. This study aims to examine the effects of heart rate-synchronized music therapy combined with motor imagery practice on pain, autonomic and cognitive functions, and psychosocial outcomes in patients with pwMS. We hypothesize that the combined intervention will lead to greater improvements than music therapy alone or routine care. Methods A double-blind, randomized, and three-arm parallel trial will be conducted with 45 patients with pwMS experiencing chronic pain. Participants will be randomly assigned to one of three groups: (1) heart rate-synchronized music therapy combined with motor imagery, (2) heart rate-synchronized music therapy alone, or (3) a control group receiving routine care. Interventions will be delivered twice weekly for 8 weeks, with each session lasting 20-30 min. The experimental groups will receive music therapy via videoconferencing. Assessments will be conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome is pain intensity. Secondary outcomes include neuropathic pain, central sensitization, heart rate variability, anxiety, depression, fatigue, sleep quality, quality of life, and cognitive function. Sample size was calculated using G*Power; HRV data will be analyzed with Kubios software. Statistical analyses will be performed using SPSS and GraphPad Prism 10. Results Following randomization, baseline data will be collected. Blinded assessors will evaluate all outcomes at follow-up points. An independent researcher will perform statistical analyses to assess changes across time and between groups. Discussion This study may provide evidence supporting a novel, non-pharmacological, and telehealth-compatible intervention for chronic pain in pwMS.