Using virtual reality to improve balance and gait in individuals with multiple sclerosis is at least as effective as standard rehabilitation practices, according to a study recently published in Clinical Rehabilitation.
This meta-analysis and systematic review examined the results of 11 quasi-randomized clinical trials and randomized controlled trials, which produced 466 patients (65.8% female) with a multiple sclerosis diagnosis. Functional balance, walking speed, and control over posture were the primary outcomes of interest, and secondary outcomes included self-reported measures, mobility, and navigation through obstacles. Study researchers pooled data using a random-effects model to allow for these outcomes.
The trials for this study came from an electronic search through databases that included Physiotherapy Evidence Database (PEDro), MEDLINE (Pubmed), Cochrane Database of Systematic Reviews (CDSR) and CINHAL, after which the PEDro scale was used to assess the quality of the trials. The researchers followed guidelines laid out in Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Control over posture improvements via virtual reality training was more effective than no intervention (standard mean difference [SMD]=–0.64; 95% confidence interval [CI], –1.05 to –0.24; P =.002), but showed no significant difference compared with standard training (SMD=−0.04; 95% CI, −0.70 to 0.62; P =.90). No significant differences were observed between virtual reality and control groups for functional balance, walking speed, mobility, and navigation through obstacles. Improvements in self-reported measures included walking ability (P <.001) and perceived distress over the disease (P =.023) compared with no intervention, and in flow experience (P ≤.05), fear of falling (P =.021), and fatigue (P <.05) compared with standard training.
Researchers conclude that “[this] meta-analysis supports that virtual reality training could be considered at least as effective as conventional training and more effective than no intervention in improving balance and gait abilities in patients with multiple sclerosis.”
Casuso-Holgado MJ, Martín-Valero R, Carazo AF, Medrano-Sánchez EM, Cortés-Vega MD, Montero-Bancalero FJ. Effectiveness of virtual reality training for balance and gait rehabilitation in people with multiple sclerosis: a systematic review and meta-analysis[published online April 1, 2018]. Clin Rehabil. doi: 10.1177/0269215518768084