Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.
Neurorehabilitation is a fundamental aspect in the treatment approach for multiple sclerosis (MS), in which new technologies have gained popularity, especially the use of virtual reality (VR). The aim of this paper is to analyze an occupational therapy (OT) intervention compared with OT + VR (OT + VR) on the manual dexterity of patients with MS. 26 MS subjects were initially recruited from an MS patient association and randomized into two groups. The OT group received 20 conventional OT sessions distributed in two sessions per week. The OT + VR group received 20 sessions of VR interventions, twice weekly and lasting 30 minutes, consisting of VR games accessed via the online web page motiongamingconsole.com, in addition to the conventional OT sessions. Pre- and postintervention assessments were based on the Purdue Pegboard Test, the Jebsen-Taylor Hand Function Test, and the Grooved Pegboard Test. Clinical improvements were found regarding the precision of movements, the execution times, and the efficiency of certain functional tasks in the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test tests in the OT + VR group. Although significant differences were not found in the manual dexterity between the OT and OT + VR groups, improvements were found regarding the precision and effectiveness of certain functional tasks.
Our study found widespread pressure pain hyperalgesia in individuals with MS as compared with pain-free controls. No differences existed between MS patients with pain and those without pain in the presence of widespread pressure sensitivity. Current results suggest that MS is associated with sensory hyperexcitability of the central nervous system or dysfunction in endogenous pain modulatory systems.
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