Virtual Reality Versus Mental Practice On Balance And Gait In Patients With Multiple Sclerosis

October 30, 2026 updated by: Ola Zaghloul Muhammad Ali Asal, Cairo University

This study is conducted to:

  • Investigate the effect of virtual reality based training on balance and risk of falling.
  • Investigate the effect of virtual reality based training on gait.
  • Investigate the effect of mental practice on balance and risk of falling.
  • Investigate the effect of mental practice on gait.
  • Compare between the effect of virtual reality based training and mental practice on balance and gait

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Background: Multiple sclerosis affects the central integration of sensory afferents that causes disturbance of balance, postural control and gait. Exercise interventions performed through VR applications encourage participants to engage in challenging tasks that integrate motor and cognitive demands, enhance patients' sensory processing and integration systems and allows them to receive information feedback and improve the motivation of training. Mental Practice is a complex cognitive operation that is possible thanks to the use of sensory and perceptive processes that allow an individual to reactivate specific motor actions in the working memory.

Purpose: This study is conducted to Investigate the effect of virtual reality based training on balance and risk of falling, Investigate the effect of virtual reality based training on gait, Investigate the effect of mental practice on balance and risk of falling, Investigate the effect of mental practice on gait and to compare between the effect of virtual reality based training and mental practice on balance and gait.

Methods: Fifty four patients of both sexes with relapsing remitting MS (RRMS). The patients will be diagnosed as having RRMS based on careful clinical examination by neurologist and diagnosis will be confirmed by radiological investigations as magnetic resonance imaging (MRI). Patients will be recruited from the outpatient clinic of Faculty of Physical Therapy, Pharos University in Alexandria and private clinics. Patients in this study will be randomly divided into three groups.

  • Group (I) which will include 18 patients who will receive mental practice in addition to selected physical therapy .
  • Group (II) which will include 18 patients who will receive virtual reality based training in addition to selected physical therapy.
  • Group (III) which will include 18 patients who will receive selected physical therapy.

The treatment will be conducted 3 sessions per week for 6 weeks for 45 minutes.

Results: Data analysis with 2-way mixed Design MANOVA will be used to compare the groups for normally distributed data and Kruskal Wallis and Mann-Whitney tests will be used to compare the groups for non-parametric and not normally distributed data.

Study Type

Interventional

Enrollment (Estimated)

54

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Egypt
    • Giza Governorate
      • Giza, Giza Governorate, Egypt
        • Recruiting
        • Faculty of Physical Therapy, Cairo University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 35 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Patients with RRMS.
  2. Patient's age will be range from 20 - 35 years..
  3. Patients are able to walk 10 meter with or without assistance.
  4. Patients with ≤ 6 according to an Expanded Disability Status Scale (EDSS).
  5. Patients are cognitively able to follow instructions.
  6. Patient's body mass index (BMI) will be ranged from 18.5 to 29.99 Kg/m2.

Exclusion Criteria:

  1. Patients with MS relapse in the last 30 days.
  2. Visual impairments interfering with VR.
  3. Severe spasticity or orthopaedic deformity.
  4. Recent musculoskeletal injury.
  5. History of epilepsy or motion sickness with VR.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Virtual Reality
Other: Virtual Reality

The virtual environment presented via Head Mounted Display (HMD) has three-dimensional presentation and the panoramic view that covers the users' field of view, it facilitates immersion in the virtual and distraction from the real world
Experimental: Mental Practice
Other: Mental Practice

Mental Practice is among the recommended strategies to enhance performance. MP is a symbolic exercise, involving repeated mental imagery in the absence of any visible muscle contraction.
Experimental: Selected Physical Therapy Program
Other: Selected Physical Therapy Program

Dual tasking and Task oriented training in static and dynamic forms

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gait
Time Frame: 6 weeks

spatial, temporal and angular parameters as cadence, step length and range of motion of hip, knee and ankle will be measured using software analysis "Kinovea" Kinovea is a free, open-source 2D video analysis software. It does not generate a single composite "score". Instead, it measures quantitative biomechanical and kinematic metrics from recorded video.
6 weeks
Gait
Time Frame: 6 weeks

"10 minutes walk test" will be performed pre and post treatment by asking the patient to walk through a 12 meter walkway and calculate the time for 10 meters in tha walkway in two walking speeds( normal - fast) for 2 or 3 trials of each speed Speed > 1.2 m/s: Normal / Community AmbulatorAble to safely cross street intersections and navigate crowded environments.

0.8 - 1.2 m/s: Limited Community Ambulator/ Able to walk outdoors independently 0.4 - 0.8 m/s: Household Ambulator/ Mostly restricted to indoor walking; requires assistance or equipment outdoors.

< 0.4 m/s: Severe Functional Limitation
6 weeks
Balance
Time Frame: 6 weeks

static and dynamic balance will be assessed using "Berg Balance Scale" The Berg Balance Scale (BBS) is a 14-item clinical assessment scale designed to measure static balance and dynamic functional mobility, Point Scale: Each of the 14 tasks is rated on a 0 to 4 ordinal scale based on safety, independence, time held, or distance reached, Scores are summed across all items for a overall score ranging from 0 to 56 points (higher scores reflect better balance and mobility).
6 weeks
Balance
Time Frame: 6 weeks

"Timed Up and Go" test giving numerical data pre and post treatment about balance and risk of falling

Test is scored entirely by time (in seconds):

Time < 10 seconds: Normal / Completely IndependentFreely mobile; minimal to no fall risk 10 - 19 seconds: Mostly Independent, Reasonable balance and gait speed, generally low fall risk 20 - 29 seconds: Variable MobilityImpaired mobility, slower gait speed > 30 seconds: Severely Impaired, high fall risk
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Investigators

  • Study Director: Nagwa I Rehab, PhD, Cairo University
  • Study Director: Rania M Tawfik, PhD, Cairo University
  • Study Director: Ebtesam M Fahmy, PhD, Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2026

Primary Completion (Estimated)

March 15, 2027

Study Completion (Estimated)

March 30, 2027

Study Registration Dates

First Submitted

March 17, 2026

First Submitted That Met QC Criteria

October 30, 2026

First Posted (Actual)

November 5, 2026

Study Record Updates

Last Update Posted (Actual)

November 5, 2026

Last Update Submitted That Met QC Criteria

October 30, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/006172

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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