Accepted for/Published in: JMIR Serious Games
Date Submitted: Jun 7, 2021
Date Accepted: Oct 12, 2021
Date Submitted to PubMed: Nov 12, 2021
Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
ABSTRACT
Background:
Background:
Dizziness and imbalance are common and disabling symptoms in multiple sclerosis (MS) patients caused by a central, peripheral or mixed vestibulopathy. Central vestibular disorder is the most frequent report in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and its repercussions in quality of life. However, immersive virtual reality (VRi) is a growing tool in this fieldwork, but no previous research has been performed studying its effects in MS.
Objective:
Objective:
To apply a VRi vestibular training protocol in a patient with MS and assess the effects induced by the experimental intervention.
Methods:
Methods:
Case study of a 54-year-old woman with relapsing remitting multiple sclerosis (RRMS). We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold standard vestibular training of Cawthorne-Cooksey. The 20 session intervention is formed of 10 initial sessions and 10 advanced sessions. Each 50 minute session will be performed 3 times per week for 8 weeks. Four evaluations were carried out over the study period: at baseline (T0), between the two intervention phases (T1), at the end of the intervention and at the one month follow-up (T3). The outcomes of the research were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone and usability of HMD.
Results:
Results:
The patient improved DHI (T0=62 points/T2=4), BBS (T0=47/T2=54), iTUG (T0=8.35 sec/T2=5.57 sec), muscular tone of the erector spinae, rectus femoris and soleus, MFIS (T0=61/T2=37) and MSQoL-54 (T2 physical area=67.16%; T2 mental area= 33.56%) after receiving the VRi vestibular protocol. System Usability Scale reached 90% of usability and A grade.
Conclusions:
Conclusions:
This research provided evidence of the first VRi vestibular protocol in the MS population to improve dizziness, balance, gait, impact of fatigue and quality of life and muscular tone through an exergame intervention. This study may help to set a standardized VRi protocol for vestibular rehabilitation.
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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.