A telerehabilitation program by virtual reality-video games improves balance and postural control in multiple sclerosis patients

Abstract

BACKGROUND: Balance and postural control (PC) disorders are frequent motor disorder symptoms associated with multiple sclerosis (MS). OBJECTIVE: To demonstrate the potential improvements in balance and PC among patients with MS who complete a virtual reality telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. METHODS: 50 patients was recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received telerehabilitation treatment using the Xbox 360 ® console monitored via videoconference. Experimental group attended 40 sessions, four sessions per week (20 min per session). The treatment schedule lasted 10 weeks for both groups. A computerised dynamic posturography and clinical outcomes (Berg Balance and Tinettti scales) were used at baseline and at the end of the treatment. RESULTS: Results showed an improvement over general balance in both groups. Visual preference, the contribution of vestibular information, mean response time and Tinetti test yielded significant differences in the experimental group. An ANOVA revealed significant between-group post-treatment differences in the composite equilibrium score, Berg and Tinetti scales in the experimental group. CONCLUSION: 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.

A Pilot Study of an Exercise-Based Patient Education Program in People with Multiple Sclerosis

“…The authors conducted an introduction seminar and a following internet-based e-training providing an online community to interact with others or a therapist in order to modify physical activity in daily living. Gutiérrez et al [ 41 ] examined the usefulness and effectiveness of a telerehabilitation program for PwMS using virtual reality-video games. The authors concluded that those virtual reality-video games might be a possible training therapeutic alternative if conventional treatment is not available [ 41 ].…”

“…Gutiérrez et al [ 41 ] examined the usefulness and effectiveness of a telerehabilitation program for PwMS using virtual reality-video games. The authors concluded that those virtual reality-video games might be a possible training therapeutic alternative if conventional treatment is not available [ 41 ].…”

Virtual Reality Therapy for Balance Training in Aging and Neurological Disorders

“…Other studies also found increased specific balance benefits of Kinect based telerehabilitation over standard rehabilitation [43,46], although both approaches led to improved general balance.…”

“…Considering that balance and postural control are often impaired in Multiple Sclerosis [43] (MS), trials have been conducted in aims of assessing the efficacy of balance training in this pathology.…”

“…Normal Aging Improvements in balance [10,11,12]; reduction of falls and fear of falling [12] TBI, Stroke Improvements in static [18] and dynamic postural stability [20,28], gait and balance [23,24,25,26,28] Parkinson's disease Improvements in mobility [32,33,38], gait and balance [34,35,36,37,38], quality of life [32,33]; reduction of freezing of gait [42] Multiple Sclerosis Reduction of fall risk [44]; improvements in postural stability [44], balance [43,45,46]; microstructural brain changes [48] Cerebral Palsy Preliminary evidence of benefits in balance, postural control, gait, upper limb function and selective joint control [49] Incomplete Spinal Cord Injury Improvements in balance, walking speed, ambulation, and muscle strength; brain changes [50] Cerebellar Ataxia Further research is needed [51] Diabetes Mellitus -Diabetic neuropathy Improvements in balance, gait speed and postural stability [52,53,54] Dementia Further research is needed [55] Metachromatic Leukodystrophy Improvements in balance, walking speed, mobility and functionality [56] Preliminary findings also suggest VR balance training, even short-duration programs, may lead to neural changes, perhaps related to the systematic training, functional and biological activation they allow [48].…”