Interventions to improve balance in patients with multiple sclerosis (MS) have produced varying results, but a small clinical trial showed that balance training using a virtual reality tool could help people with relapsing-remitting MS (RRMS) and might improve adherence to training.
Virtual reality tools are a popular training approach, not least because compliance to training and patient satisfaction is usually high. The method has also shown good results in other patient groups, such as people recovering from stroke or suffering from Parkinson’s disease.
A few studies have investigated the possibilities of virtual reality balance training in MS, but most lacked a comparison group and, like this one, involved a small group of people.
Researchers from Tel Aviv University, Israel, set up a randomized clinical trial using the computer assisted rehabilitation environment (CAREN) system. The trial included 30 MS patients, who performed either virtual reality balance training or conventional exercise. The patients trained two times a week for six weeks, and every session took 30 minutes.
While both groups of participants performed better in balance tests and showed some improvement in posture, the patients who were exposed to virtual reality training performed better on a number of tests after six weeks.
According to the authors, it is important to distinguish between studies using commercially available virtual reality devices originally created to entertain healthy children, and those developed for rehabilitation. “It is questionable whether the playing scenarios offered by these devices are relevant for the rehabilitation needs of patients with mobility difficulties,” the team wrote. Nevertheless, while the CAREN device is clinically superior, its costs and space requirements might prevent it from becoming a generally accessible training device for MS patients.
Also, the improvement in balance was measured directly after the intervention with no long-term follow-up, so it is not known whether it persisted once training was discontinued. Future trials, involving more patients and a longer study and follow-up period, will shed more light on the benefits of virtual reality training for MS patients.
The study, “The effect of balance training on postural control in people with multiple sclerosis using the CAREN virtual reality system: a pilot randomized controlled trial,“ was published in the Journal of NeuroEngineering and Rehabilitation.
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