http://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-016-0124-y
- Alon KalronEmail author,
- Ilia Fonkatz,
- Lior Frid,
- Hani Baransi and
- Anat Achiron
Journal of NeuroEngineering and Rehabilitation201613:13
DOI: 10.1186/s12984-016-0124-y
© Kalron et al. 2016
Received: 4 September 2015
Accepted: 11 February 2016
Published: 1 March 2016
Abstract
Background
Multiple sclerosis (MS) is a
multi-focal progressive disorder of the central nervous system often
resulting in diverse clinical manifestations. Imbalance appears in most
people with multiple sclerosis (PwMS). A popular balance training tool
is virtual reality (VR) with several advantages including increased
compliance and user satisfaction. Therefore, the aim of this pilot RCT
(Trial registration number, date: ISRCTN14425615, 21/01/2016) was to
examine the efficacy of a 6-week VR balance training program using the
computer assisted rehabilitation environment (CAREN) system (Motek
Medical BV, Amsterdam, Netherlands) on balance measures in PwMS. Results
were compared with those of a conventional balance exercise group.
Secondary aims included the impact of this program on the fear of
falling.
Methods
Thirty-two PwMS were equally
randomized into the VR intervention group or the control group. Each
group received balance training sessions for 6 consecutive weeks, two
sessions per week, 30 min sessions. Clinical balance tests and
instrumented posturography outcome measures were collected upon
initiation of the intervention programs and at termination.
Results
Final analysis included 30
patients (19 females, 11 males; mean age, (S.D.) = 45.2 (11.6) years;
mean EDSS (S.D.) = 4.1 (1.3), mean disease duration (S.D.) = 11.0 (8.9)
years). Both groups showed a main effect of time on the center of
pressure (CoP) path length with eyes open (F = 5.278, P = .024), sway rate with eyes open (F = 5.852, P = .035), Functional Reach Test (F = 20.841, P = .001), Four Square Step Test (F = 9.011, P = .031) and the Fear of Falls self-reported questionnaire (F = 17.815, P
= .023). In addition, significant differences in favor of the VR program
were observed for the group x time interactions of the Functional Reach
Test (F = 10.173, P = .009) and fear of falling (F = 6.710, P = .021).
Conclusions
We demonstrated that balance training based on the CAREN device is an effective method of balance training for PwMS.
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