Effects of Immersive Virtual Reality on Balance, Mobility, and Fatigue in Patients With Multiple Sclerosis
Gait disorder, imbalance, and fatigue are the most frequently reported complaints in Multiple Sclerosis (MS), a chronic neurodegenerative disease. The first symptoms in patients with MS are emerging in the age range 20-50 and these patients need long-term rehabilitation. The virtual reality applications developed for these problems which affect the quality of life negatively and cause disability in the following periods may be a good alternative for conventional rehabilitation applications. In this long-term where motivation is important, virtual reality applications in different environments provide patients with the opportunity to do many different tasks amused. In recent years, the vividness has been increased by the 3D virtual reality headsets.
The aim of this study is to investigate the effects of immersive virtual reality on the balance, mobility, and fatigue in patients with MS.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study was designed as a prospective, randomized controlled study. The patients will be randomly assigned to three groups, the "immersive virtual reality (IVR)" group, the "dynamic balance training (DBT)" group and the control group. The trainings will be twice a week for 8 weeks. In the IVR group, firstly 30 minutes of Pilates training, 10 minutes of rest and then 20 minutes of virtual reality will be applied. In the DBT group, 20 minutes of dynamic balance exercises will be applied after Pilates training. In dynamic balance training, exercises will consist of similar movements required by virtual reality games. The control group will be taught relaxation exercises and will be asked to perform the exercises 2 times for 8 weeks at home.
Statistical analyses will be performed using the SPSS software version 15 (SPSS Inc. Chicago, IL, USA). The pre-training and post-training measurements of groups will be compared with the Wilcoxon Test. The significance level was set at p< 0.05.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ankara, Turkey
- Gazi University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Participants who are ambulatory and volunteer to participate to the study, in a stable phase of the disease, without relapses in the last 1 month, with an EDSS between 0-5,5.
Exclusion Criteria:
- Participants who have orthopedic, vision, hearing, or perception problems
- Patients who have any cardiovascular or pulmonary disease in which exercise is contraindicated
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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EXPERIMENTAL: Virtual reality group
In virtual reality group, 30 minutes of Pilates training, 10 minutes of rest and then 20 minutes of virtual reality will be applied.
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Immersive virtual reality training protocol consisted of "Football" and "Guillotine" games.
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ACTIVE_COMPARATOR: Dynamic Balance Training
In the "Dynamic Balance Training" group, 20 minutes of dynamic balance exercises will be applied after Pilates training.
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Dynamic balance training protocol consisted of holding the ball and running away from the ball with a physiotherapist.
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NO_INTERVENTION: Control group
The control group will be taught relaxation exercises and will be asked to perform the exercises at home.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Berg Balance Scale
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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Berg Balance Scale (BBS) rates performance from 0 (cannot perform) to 4 (normal performance) on 14 items.
It has shown to be a valid measure with high inter and interrater reliability for people with MS.
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Change between baseline and after 8 weeks of intervention will be assessed
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Timed Up and Go Test
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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Timed up and go test measures the time taken in seconds to arise from a standard chair, walk 3 m, turn through 180 degrees, walk back, and sit down again.
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Change between baseline and after 8 weeks of intervention will be assessed
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Modified Sensory Organization Test
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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The Modified Sensory Organization Test, which is performed using computerized posturography, measures postural sway in response to 4 different sensory conditions is measured using a force platform.
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Change between baseline and after 8 weeks of intervention will be assessed
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One-leg standing duration
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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One-leg standing duration is measured using chronometer.
The time is started when participants lifted a foot from the ground to knee level.
The test is terminated when the position disappears or 180 seconds passed.
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Change between baseline and after 8 weeks of intervention will be assessed
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Activities-specific Balance Confidence
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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Activities-specific Balance Confidence (ABC) is a scale in which the patient rates his perceived level of confidence while performing 16 daily living activities.
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Change between baseline and after 8 weeks of intervention will be assessed
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Fatigue Severity Scale
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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In the Fatigue Severity Scale (FSS), participants are asked to rate their fatigue level between 1 and 7 in the 9 statements (including motivation, exercise, physical functioning, carrying out duties, and interfering with work, family, or social life) during the last week.
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Change between baseline and after 8 weeks of intervention will be assessed
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Fatigue Impact Scale
Time Frame: Change between baseline and after 8 weeks of intervention will be assessed
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Fatigue impact scale consists of forty questions and evaluates the effects of fatigue on the 3 dimensions of daily life activities; cognitive function, physical function and psychosocial function.
Each question is graded between 0 (no problem) and 4 (maximum problem).
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Change between baseline and after 8 weeks of intervention will be assessed
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Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008;31(1):32-7. doi: 10.1519/00139143-200831010-00006.
- Yelnik A, Bonan I. Clinical tools for assessing balance disorders. Neurophysiol Clin. 2008 Dec;38(6):439-45. doi: 10.1016/j.neucli.2008.09.008. Epub 2008 Oct 18.
- Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, Karabudak R. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007 Mar;30(1):81-5. doi: 10.1097/MRR.0b013e3280146ec4.
- Armutlu K, Keser I, Korkmaz N, Akbiyik DI, Sumbuloglu V, Guney Z, Karabudak R. Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients. J Neurol Sci. 2007 Apr 15;255(1-2):64-8. doi: 10.1016/j.jns.2007.01.073. Epub 2007 Mar 6.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 228
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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