Virtual reality in multiple sclerosis rehabilitation: A review on cognitive and motor outcomes

Maggio, Maria Grazia; Russo, Margherita; Cuzzola, Marilena Foti; Destro, Massimo; Rosa, Gianluca La; Molonia, Francesco; Bramantı, Placido; Lombardo, Giuseppe; Luca, Rosaria De; Calabrò, Rocco Salvatore

doi:10.1016/j.jocn.2019.03.017

Cited by 147 publications

(112 citation statements)

References 56 publications

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“…VR is the multisensory and interactive simulation of ecological scenarios, generally presented in a three-dimensional way, with which the patient can interact [ 15 , 58 , 59 , 60 , 61 ]. The VR devices use specific software with input-output peripherals that make the experience complex and engaging, promoting the improvement of the bodily functions of patients with motor/cognitive disabilities, as well as their well-being and participation [ 62 , 63 , 64 ]. VR allows being at the center of rehabilitation training, through two perceptive conceptions, i.e., immersion and presence [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality Based Cognitive Rehabilitation in Minimally Conscious State: A Case Report with EEG Findings and Systematic Literature Review

et al. 2020

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Chronic disorders of consciousness cause a total or partial and fluctuating unawareness of the surrounding environment. Virtual reality (VR) can be useful as a diagnostic and/or a neurorehabilitation tool, and its effects can be monitored by means of both clinical and electroencephalography (EEG) data recording of brain activity. We reported on the case of a 17-year-old patient with a disorder of consciousness (DoC) who was provided with VR training to improve her cognitive-behavioral outcomes, which were assessed using clinical scales (the Coma Recovery Scale-Revised, the Disability Rating Scale, and the Rancho Los Amigos Levels of Cognitive Functioning), as well as EEG recording, during VR training sessions. At the end of the training, significant improvements in both clinical and neurophysiological outcomes were achieved. Then, we carried out a systematic review of the literature to investigate the role of EEG and VR in the management of patients with DoC. A search on PubMed, Web of Science, Scopus, and Google Scholar databases was performed, using the keywords: “disorders of consciousness” and “virtual reality”, or “EEG”. The results of the literature review suggest that neurophysiological data in combination with VR could be useful in evaluating the reactions induced by different paradigms in DoC patients, helping in the differential diagnosis. In conclusion, the EEG plus VR approach used with our patient could be promising to define the most appropriate stimulation protocol, so as to promote a better personalization of the rehabilitation program. However, further clinical trials, as well as meta-analysis of the literature, are needed to be affirmative on the role of VR in patients with DoC.

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Section: Discussionmentioning

confidence: 99%

Virtual Reality Based Cognitive Rehabilitation in Minimally Conscious State: A Case Report with EEG Findings and Systematic Literature Review

et al. 2020

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“…Cepeda-Zapata et al [69] proposed a system for performing conventional visual therapy exercises (Brock cord, approach technique, or convergencedivergence stimulation) into VR environments, validating it in a sample of 45 students who confirmed its simplicity and Occasionally, some patients felt tired after the use of the immersive device and reported a sensation of pulling behind the amblyopic eye that subsided over time, without major side effects. ere are also nonimmersive VR systems that have shown a potential to improve cognitive and motor abilities, even in advanced stages of several neurological disorders [75][76][77]. ese systems that allow interaction with the environment via mouse or joystick are cheaper and easier to be understood by users [78].…”

Section: Previous Research Of the Use Of Vr On Amblyopiamentioning

confidence: 99%

The Potential of Virtual Reality for Inducing Neuroplasticity in Children with Amblyopia

Coco-Martín

Piñero

Leal-Vega

et al. 2020

Journal of Ophthalmology

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In recent years, virtual reality (VR) has emerged as a new safe and effective tool for neurorehabilitation of different childhood and adulthood conditions. VR-based therapies can induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages, leading to contrasted improvements in motor and functional skills. The use of VR for the visual rehabilitation in amblyopia has been investigated in the last years, with the potential of using serious games combining perceptual learning and dichoptic stimulation. This combination of technologies allows the clinician to measure, treat, and control changes in interocular suppression, which is one of the factors leading to cortical alterations in amblyopia. Several clinical researches on this issue have been conducted, showing the potential of promoting visual acuity, contrast sensitivity, and stereopsis improvement. Indeed, several systems have been evaluated for amblyopia treatment including the use of different commercially available types of head mounted displays (HMDs). These HMDs are mostly well tolerated by patients during short exposures and do not cause significant long-term side effects, although their use has been occasionally associated with some visual discomfort and other complications in certain types of subjects. More studies are needed to confirm these promising therapies in controlled randomized clinical trials, with special emphasis on the definition of the most adequate planning for obtaining an effective recovery of the visual and binocular function.

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“…In such VR-based rehabilitation, patients are immersed in interactive scenarios mimicking real-world environments, and this immersion may offer a more straightforward transfer from the rehabilitation to activities of daily living (Rose et al, 2000;Schultheis and Rizzo, 2001). VR has been used for rehabilitation following stroke (Souza Barbosa de et al, 2011;Imam and Jarus, 2014), cerebral palsy (Ravi et al, 2017), and several neurodegenerative disorders (Dockx et al, 2016;Doniger et al, 2018;Maggio et al, 2019), including PD.…”

Section: Introductionmentioning

confidence: 99%

“…Although multiple studies have reported positive results of VR on gait and balance (Ghai and Ghai, 2019;Kim et al, 2019;Maggio et al, 2019), there is still limited evidence of improvements in balance for persons with PD (van den Heuvel et al, 2014;Liao et al, 2015;Wang et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Short-Term Virtual Reality Balance Intervention to Improve Mobility Smoothness in Parkinson's Disease

Schuch

Balbinot

Bonilla

et al. 2020

Front. virtual real.

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Parkinson's disease (PD) is a neurodegenerative condition that is often associated with movement impairments, such as reduced balance and gait control. Virtual reality (VR) is a promising intervention for enhancing rehabilitation efficiency and may assist in overcoming functional limitations imposed by the disability. The objective of this study was to evaluate the feasibility, safety, and efficacy of a 5-weeks VR intervention in increasing mobility smoothness in participants with PD. Participants were assessed using functional mobility tasks-Timed Up and Go (TUG) and 10-m walking test (10MWT) and cognitive function tests. A total of 23 participants with a diagnosis of PD were randomly assigned to groups of VR or control interventions. In the VR group, for each session, participants received a VR-based balance training, i.e., tightrope simulator, for 20 min, preceded by 8 min of total body warm-up (total of 10 sessions over 5 weeks). Participants in the control group received 20 min of psychoeducation without a structured exercise program (twice a week). All screened participants engaged and completed a total of 10 VR-based intervention sessions. VR-based balance training caused no significant improvement in mobility smoothness for TUG or 10MWT (p > 0.05). Similarly, cognitive function was not affected by the VR intervention (p > 0.05). The outcomes of this study suggest that 10-20 min of VR-based intervention is a feasible and safe rehabilitation activity. However, it was insufficient to promote improvement in mobility smoothness and cognitive function in participants with PD. A combination of task-specific training in the virtual and physical environments in a more intensive approach is warranted for future study designs.

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Virtual reality in multiple sclerosis rehabilitation: A review on cognitive and motor outcomes

Cited by 147 publications

References 56 publications

Virtual Reality Based Cognitive Rehabilitation in Minimally Conscious State: A Case Report with EEG Findings and Systematic Literature Review

Virtual Reality Based Cognitive Rehabilitation in Minimally Conscious State: A Case Report with EEG Findings and Systematic Literature Review

The Potential of Virtual Reality for Inducing Neuroplasticity in Children with Amblyopia

Feasibility of a Short-Term Virtual Reality Balance Intervention to Improve Mobility Smoothness in Parkinson's Disease

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