The development and pilot evaluation of virtual reality balance scenarios in people with multiple sclerosis (MS): A feasibility study

Khalil, Hanan; Al‐Sharman, Alham; El‐Salem, Khalid; AA, Alghwiri; Al-Shorafat, Duha; Khazaaleh, Shada; L, Abu Foul

doi:10.3233/nre-182471

Cited by 28 publications

(60 citation statements)

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“…The novel VR scenario was developed as part of a previous conducted study. Details are published elsewhere (Khalil, Al-Sharman, Kazaaleh, & El-Salem, 2016). In brief, the aim of the game that was used in this study was to steer an avatar skiing down a track to collect coins and avoid obstacles.…”

Section: Task Descriptionmentioning

confidence: 99%

Motor performance improvement through virtual reality task is related to fatigue and cognition in people with multiple sclerosis

Al‐Sharman

Khalil

El‐Salem

et al. 2019

Physiotherapy Res Intl

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Background and Purpose People with multiple sclerosis (MS) who undergo rehabilitation need to perform new motor skills or relearn old motor skills. It is not clear whether people with MS retain the ability to improve motor performance or learning. Furthermore, factors that influence motor performance in people with MS need to be investigated. This study explored motor performance in people with MS using virtual reality (VR). The effect of fatigue and cognitive function on motor performance improvement in people with MS was investigated. Methods Twenty MS participants and 20 controls were recruited into the study. To assess motor performance, each participant was asked to perform a VR game for five times (blocks). The main outcome was time to complete the VR game and number of recorded errors. To assess fatigue level and cognitive function, participants were asked to complete the Arabic versions of the Modified Fatigue Impact Scale (MFIS) and the Montréal Cognitive Assessment (MOCA), respectively. Results MS participants and controls demonstrated a practice‐related improvement in performance as shown by the main effect of block for each of the outcome measures (p < .001, time required to complete VR game; p < .001, errors recorded). Strong and significant negative correlations between recorded errors and MOCA (r = .75, p < .001) and between recorded errors and MFIS (r = .55, p = .011) were found in people with MS. Conclusions Ability to improve motor performance in people with MS is preserved and related to cognitive function and fatigue impact. Health‐care professionals should be made aware of the negative impact of cognitive function and fatigue on motor performance. A multicomponent intervention that targets these factors is advisable. Future research, however, is required to determine the content and potential benefits of such an intervention in the MS population.

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Section: Task Descriptionmentioning

confidence: 99%

Motor performance improvement through virtual reality task is related to fatigue and cognition in people with multiple sclerosis

Al‐Sharman

Khalil

El‐Salem

et al. 2019

Physiotherapy Res Intl

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“…Changes from the baseline visit (V 1 ) to month 6 (V 3 ) and from the baseline visit (V 1 ) to month 1 (V 2 ) will be collected as secondary and exploratory variables, respectively. ClinROs were selected on the basis of previous studies of rehabilitation that reported statistically significant improvements by using VRR in disability ( 17 , 18 ), spasms and spasticity ( 40 ), and balance ( 19 , 24 , 33 ).…”

Section: Methodsmentioning

confidence: 99%

“…Changes from the baseline visit (V 1 ) to month 6 (V 3 ) and from the baseline visit (V 1 ) to month 1(V 2 ) will be collected as secondary and exploratory variables, respectively. PROs were selected on the basis of previous studies of rehabilitation that reported statistically significant improvements by using VRR in HRQoL ( 22 , 26 , 47 , 48 ), fatigue ( 19 , 49 ), and ADL ( 26 ). The evaluation of depression and anxiety after VRR has received little attention, despite the fact that the prevalence of these disorders has increased ( 50 ).…”

Section: Methodsmentioning

confidence: 99%

“…Despite VRR programs having been shown to be feasible and accepted by MS patients ( 17 , 19 , 23 , 24 ), the evidence on MS patient satisfaction with VRR programs is scarce ( 26 ). Satisfaction, together with effectiveness and efficiency in a quantified context of use, define the usability of a system or product ( 27 ).…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, most of the studies evaluating VRR programs in MS have used technologies such as Nintendo Wii Balance Board System and Microsoft Kinect Sensor Xbox 360 ( 22 , 24 , 30 – 33 ), which were created for entertainment of the general population (exergames) and were not specifically designed for rehabilitation of impaired functions (serious games). Furthermore, the feasibility of VRR in MS has usually been assessed after a 6-weeks ( 18 , 19 , 26 , 34 ) or 10-weeks program ( 24 ), which might not be enough time to confirm patient acceptance of VRR in the long term.…”

Section: Introductionmentioning

confidence: 99%

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A Pilot Study to Explore Patient Satisfaction With a Virtual Rehabilitation Program in Multiple Sclerosis: The RehabVR Study Protocol

Meca-Lallana

Prefasi

Alabarcez³

et al. 2020

Front. Neurol.

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Background: Virtual reality (VR) has emerged as a promising treatment approach in rehabilitation for patients with multiple sclerosis (MS) due to its potential to increase patient motivation and rehabilitation adherence. One of the key features for rehabilitation adherence is patient satisfaction with the VR rehabilitation (VRR) program, and information on user satisfaction and not only effectiveness is required to systematically include VRR in routine clinical practice. Given that information on patient satisfaction with VRR is scarce, the primary objective of this study is to assess long-term patient satisfaction with a novel VRR program. This program has been specifically designed for MS patients by a multidisciplinary team of specialists, based on an effective conventional rehabilitation (CR) program. Secondarily, discomfort with VRR will be evaluated, and therapy adherence and changes in a variety of domains typically affected by MS will be compared between patients receiving VRR and patients receiving CR. Methods: In this prospective single-center 6-months follow-up study, 32 and 16 MS patients will receive VRR or CR, respectively. Patients will attend twice weekly rehabilitation sessions on site during 4 weeks, and they will continue with rehabilitation at home for five additional months. Satisfaction, assessed by the User Satisfaction Evaluation Questionnaire (USEQ), at 6 months of the VRR program initiation will be the primary outcome. Secondary outcomes include adherence, disability, spasms and spasticity, balance, fatigue, activities of daily living (ADLs), depression, anxiety, work status, cognition, demographic, and clinical characteristics (in the VRR and CR groups), and discomfort (in the VRR group). Outcome measures will be assessed at baseline, and at 1 and 6 months of rehabilitation initiation. Discussion: The study is intended to provide a better understanding of long-term patient satisfaction with a VRR program specifically designed for MS patients. Additionally, the study will provide information on long-term adherence, changes in motor symptoms, cognitive functions and patient-reported outcomes after the rehabilitation program. The results from this study will help to gather valuable knowledge on the use of rehabilitation with a new VR tool in MS patients.

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Dropout rate in randomised controlled trials of balance and gait rehabilitation in multiple sclerosis: is it expected to be different for virtual reality-based interventions? A systematic review with meta-analysis and meta-regression

et al. 2022

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To assess and meta-analyse the pooled dropout rate from the randomised control trilas that use virtual reality for balance or gait rehabilitation in people with multiple sclerosis. A systematic review of randomised control trials with meta-analysis and meta-regressions was performed. A search was conducted in PubMed, Scopus, Web of Science, the Physiotherapy Evidence Database, the Cochrane Database, CINHAL, LILACS, ScienceDirect, and ProQuest. It was last updated in July 2022. After the selection of studies, a quality appraisal was carried out using the PEDro Scale and the Revised Cochrane risk-of-bias tool for randomised trials. A descriptive analysis of main characteristics and dropout information was performed. An overall proportion meta-analysis calculated the pooled dropout rate. Odds ratio meta-analysis compared the dropout likelihood between interventions. The meta-regression evaluated the influence of moderators related to dropout. Sixteen studies with 656 participants were included. The overall pooled dropout rate was 6.6% and 5.7% for virtual reality and 9.7% in control groups. The odds ratio (0.89, p = 0.46) indicated no differences in the probability of dropouts between the interventions. The number, duration, frequency, and weeks of sessions, intervention, sex, multiple sclerosis phenotype, Expanded Disability Status Scale score, and PEDro score were not moderators ( p > 0.05). Adverse events were not reported and could not be analysed as moderators. Dropouts across the virtual reality and control comparators were similar without significant differences. Nonetheless, there is a slight trend that could favour virtual reality. Standardisation in reporting dropouts and adverse events is recommended for future trials. PROSPERO database, registration number ID CRD42021284989. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-022-00733-4.

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The development and pilot evaluation of virtual reality balance scenarios in people with multiple sclerosis (MS): A feasibility study

Cited by 28 publications

References 28 publications

Motor performance improvement through virtual reality task is related to fatigue and cognition in people with multiple sclerosis

Motor performance improvement through virtual reality task is related to fatigue and cognition in people with multiple sclerosis

A Pilot Study to Explore Patient Satisfaction With a Virtual Rehabilitation Program in Multiple Sclerosis: The RehabVR Study Protocol

Dropout rate in randomised controlled trials of balance and gait rehabilitation in multiple sclerosis: is it expected to be different for virtual reality-based interventions? A systematic review with meta-analysis and meta-regression

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