The Complementary Role of the Kinect Virtual Reality Game Training in a Patient With Metachromatic Leukodystrophy

Abstract

Metachromatic leukodystrophy (MLD) is a lysosomal storage disease characterized by demyelination of the peripheral and central nerves. Patients with MLD can present with gait disturbances, progressive spastic quadriparesis, diffuse muscle atrophy, and areflexia attributable to central or peripheral nerve involvements. The rehabilitation of patients with MLD generally focuses on gait disturbances, balance impairments, and muscle weaknesses. Here, we present a case of MLD in which virtual reality (VR) training was used as an adjunctive therapy. We also discuss the complementary role of VR therapy, which was successfully integrated with a conventional rehabilitation program for a young patient with MLD who had impaired balance and gait. After completion of the integrated rehabilitation program, the patient demonstrated improvements in functional independency, mobility, walking speed, and balance. His total Functional Independence Measure score increased from 97 to 109, 6-minute walk test increased from 342 to 396 m, 10-minute walk test decreased from 11 to 7 seconds, and Berg Balance Scale score increased from 38 to 42 points. Moreover, 6 weeks after completion of the therapy, these improvements were sustained for the most part. Adding VR to a conventional rehabilitation program is an emerging trend in neurologic rehabilitation. Our patient with MLD demonstrated considerable improvements with a high level of enjoyment and satisfaction.

An Approach to Gesture Recognition with Skeletal Data Using Dynamic Time Warping and Nearest Neighbour Classifier

“…Another approach is applied to automatic diet monitoring system for elderly [11]. In [27], authors proposed using Kinect for rehabilitation of patients with Metachromatic leu kodystrophy. For fu rther reading, a thorough review of the recent works with Kinect and their impact on physical therapy and rehabilitation can be found in [28].…”

Virtual Reality Therapy for Balance Training in Aging and Neurological Disorders

“…VR therapy has also been explored in Metachromatic Leukodystrophy, with a case study reporting improvements in balance, walking speed, mobility and functionality [56].…”

“…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].…”

A Review on Technical and Clinical Impact of Microsoft Kinect on Physical Therapy and Rehabilitation

“…Also, Pompeu et al [ 62 ] showed that 7 patients with PD improved their g -minute walk test after playing Kinect-based games for 14 hours during 4 1/2 weeks. Ulaşli et al [ 63 ] examined the utility of Kinect in training patients with leukodystrophy. Only one patient participated who demonstrated improvements in functional independency, mobility, walking speed, and balance as measured by standard quantitative assessments.…”