Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
Demyelinating Diseases Unit, Neurology Service, Clínico San Carlos University Hospital, Madrid, Spain.
NeuroRehabilitation. 2013;33(4):545-54. doi: 10.3233/NRE-130995.
Balance and postural control (PC) disorders are frequent motor disorder symptoms associated with multiple sclerosis (MS).
To demonstrate the potential improvements in balance and PC among patients with MS who complete a virtual reality telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available.
50 patients was recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received telerehabilitation treatment using the Xbox 360® console monitored via videoconference. Experimental group attended 40 sessions, four sessions per week (20 min per session). The treatment schedule lasted 10 weeks for both groups. A computerised dynamic posturography and clinical outcomes (Berg Balance and Tinettti scales) were used at baseline and at the end of the treatment.
Results showed an improvement over general balance in both groups. Visual preference, the contribution of vestibular information, mean response time and Tinetti test yielded significant differences in the experimental group. An ANOVA revealed significant between-group post-treatment differences in the composite equilibrium score, Berg and Tinetti scales in the experimental group.
We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.
平衡和姿势控制（PC）障碍是与多发性硬化症（MS）相关的常见运动障碍症状。
展示完成虚拟现实远程康复计划的 MS 患者平衡和 PC 能力的潜在改善，该计划代表了在常规治疗不可用的情况下对物理治疗的可行替代方案。
招募了 50 名患者。对照组（n = 25）接受每周两次的物理治疗（每次 40 分钟）。实验组（n = 25）使用 Xbox 360®控制台通过视频会议接受远程康复治疗。实验组参加了 40 次会议，每周 4 次（每次 20 分钟）。两组的治疗计划持续 10 周。在基线和治疗结束时使用计算机动态姿势图和临床结果（伯格平衡和 Tinetti 量表）进行评估。
结果显示两组的总体平衡都有所改善。在实验组中，视觉偏好、前庭信息的贡献、平均反应时间和 Tinetti 测试都有显著差异。方差分析显示，实验组在综合平衡评分、伯格和 Tinetti 量表方面存在治疗后组间的显著差异。
我们建议我们的虚拟现实计划能够实现预期的 PC 和反应机制，并且可能成为常规治疗不可用时的成功治疗替代方案。
