Virtual Rehabilitation for Multiple Sclerosis Using a Kinect-Based System: Randomized Controlled Trial

Abstract

BackgroundThe methods used for the motor rehabilitation of patients with neurological disorders include a number of different rehabilitation exercises. For patients who have been diagnosed with multiple sclerosis (MS), the performance of motor rehabilitation exercises is essential. Nevertheless, this rehabilitation may be tedious, negatively influencing patients’ motivation and adherence to treatment.ObjectiveWe present RemoviEM, a system based on Kinect that uses virtual reality (VR) and natural user interfaces (NUI) to offer patients with MS an intuitive and motivating way to perform several motor rehabilitation exercises. It offers therapists a new motor rehabilitation tool for the rehabilitation process, providing feedback on the patient’s progress. Moreover, it is a low-cost system, a feature that can facilitate its integration in clinical rehabilitation centers.MethodsA randomized and controlled single blinded study was carried out to assess the influence of a Kinect-based virtual rehabilitation system on the balance rehabilitation of patients with MS. This study describes RemoviEM and evaluates its effectiveness compared to standard rehabilitation. To achieve this objective, a clinical trial was carried out. Eleven patients from a MS association participated in the clinical trial. The mean age was 44.82 (SD 10.44) and the mean time from diagnosis (years) was 9.77 (SD 10.40). Clinical effectiveness was evaluated using clinical balance scales.ResultsSignificant group-by-time interaction was detected in the scores of the Berg Balance Scale (P=.011) and the Anterior Reach Test in standing position (P=.011). Post-hoc analysis showed greater improvement in the experimental group for these variables than in the control group for these variables. The Suitability Evaluation Questionnaire (SEQ) showed good results in usability, acceptance, security, and safety for the evaluated system.ConclusionsThe results obtained suggest that RemoviEM represents a motivational and effective alternative to traditional motor rehabilitation for MS patients. These results have encouraged us to improve the system with new exercises, which are currently being developed.

Markerless motion capture systems as training device in neurological rehabilitation: a systematic review of their use, application, target population and efficacy

“…Although five of the 18 included studies were RCT’s [2, 3, 21, 32, 33], only one study was single blinded [21]. No studies were double blinded.…”

“…Lozano-Quilis et al only reported a significant improvement on the BBS in the experimental group [21]. One study reported a significant improvement on both subscales of the Tinetti Performance Oriented Mobility Assessment, i.e.…”

“…balance and gait (respectively POMAb and POMAg), and Brunnel Balance Assessment (BBA) in both experimental and control group [33]. Lozano-Quilis et al [21] further showed significant improvement of the POMAb subscale in both groups. Two studies used the 10-m walking test (10MWT) and both reported significant improvement in the experimental as well as in the control group [21, 32].…”

A New Multi-Sensor Fusion Scheme to Improve the Accuracy of Knee Flexion Kinematics for Functional Rehabilitation Movements

“…The use of Kinect sensor has the advantages of portability and low cost which could lead to a home-based rehabilitation solution [4,6,7]. However, the lack of accuracy of joint kinematic estimation is one of the main obstacles for the use of this sensor in a clinical setting.…”

“…These facts led to the establishment of a new research field known as home based rehabilitation, as a complementary tool for therapeutic sessions. Furthermore, a new rehabilitation approach, known as exergames [3,4,5,6,7,8,9,10,11,12,13,14,15], has been proposed to help motivate patients while performing their rehabilitation tasks at home. This new concept incorporates games into the rehabilitation process, to add a motivational and challenging aspect to these programs.…”