Effects of Virtual Reality versus Conventional Balance Training on Balance and Falls in People with Multiple Sclerosis: A Randomized Controlled Trial.
OBJECTIVE To assess the efficacy of Virtual Reality (VR) based versus conventional balance training on the improvement of balance and reduction of falls in people with multiple sclerosis (PwMS) DESIGN Single blinded, randomized, controlled trial. SETTING Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences. PARTICIPANTS Thirty nine PwMS, randomized into VR (n=19) and control (n=20) groups. INTERVENTION The VR group performed exergames using Kinect(r) while control group accomplished conventional balance exercises. Both groups received 18 training sessions for 6 weeks. OUTCOME MEASURES Limits of stability(LOS) Timed Up and Go(TUG) and 10 Meter Walk tests with and without cognitive task and their dual task costs(DTC) Berg Balance Scale, Multiple Sclerosis Walking Scale 12, Fall Efficacy Scale international, Activities specific Balance Confidence scale, and fall history were obtained pre and post intervention, and after a three month follow up. RESULTS At both post intervention and follow up, TUG cognitive and DTC on the TUG were significantly lower and the 10 Meter Walkcognitive was significantly higher in the VR group. At follow up, reaction time and the number of falls demonstrated significant differences favoring the VR group, whereas the directional control revealed significant difference in favor of the control group(p<0.05) The other outcomes showed no statistically significant difference neither at post intervention nor at follow up. CONCLUSIONS Both the VR based and conventional balance exercises improved balance and mobility in PwMS, while each acted better in improving certain aspects. VR based training was more efficacious in enhancing cognitive motor function, and reducing falls, whereas conventional exercises led to better directional control. Further studies are needed to confirm the effectiveness of recruiting VR based exercises in clinical settings.
Archives of physical medicine and rehabilitation