Effects of virtual reality associated with serious games for upper limb rehabilitation inpatients with multiple sclerosis: randomized controlled trial

Alicia Cuesta-Gómez, Patricia Sánchez-Herrera-Baeza, Edwin Daniel Oña-Simbaña, Alicia Martínez-Medina, Carmen Ortiz-Comino, Carlos Balaguer-Bernaldo-de-Quirós, Alberto Jardón-Huete, Roberto Cano-de-la-Cuerda, Alicia Cuesta-Gómez, Patricia Sánchez-Herrera-Baeza, Edwin Daniel Oña-Simbaña, Alicia Martínez-Medina, Carmen Ortiz-Comino, Carlos Balaguer-Bernaldo-de-Quirós, Alberto Jardón-Huete, Roberto Cano-de-la-Cuerda

Abstract

Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance.

Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of 1 month without receiving any treatment.

Results: In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side.

Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.

Trial registration: This randomized controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908 , Nov 2019.

Keywords: Dexterity; Leap motion controller; Multiple sclerosis; Rehabilitation; Serious games; Upper limb; Virtual reality.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Set of video games designed for the Leap Motion® System used in this protocol. Screen translation: Please adjust the distance and thickness of the keys and the height of the hands as you want, using the corresponding bars. Height, distance and thickness of the keys
Fig. 2
Fig. 2
a Piano Game. Screen translation: Piano: both hands. b Reach Game. Screen translation: Reach: right hand. c Grab Game. Screen translation: Grab: right hand. You caught it! without opening your hand, transport the cube to the red point. d Pinch Game. Screen translation: Pinch: right hand. e. Flip Game. Screen translation: Flip: both hands. Please place your hand in the corresponding blue table position

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