Hsieh K L, Mirelman A, Shema-Shiratzky S, Galperin I, Regev K, Shen S, Schmitz-Hübsch T, Karni A, Paul F, Devos H, Sosnoff J J, Hausdorff J M
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Contemp Clin Trials. 2020 Oct;97:106122. doi: 10.1016/j.cct.2020.106122. Epub 2020 Aug 26.
Gait and cognitive impairments are common in individuals with Multiple Sclerosis (MS) and can interfere with everyday function. Those with MS have difficulties executing cognitive tasks and walking simultaneously, a reflection of dual-task interference. Therefore, dual-task training may improve functional ambulation. Additionally, using technology such as virtual reality can provide personalized rehabilitation while mimicking real-world environments. The purpose of this randomized controlled trial is to establish the benefits of a combined cognitive-motor virtual reality training on MS symptoms compared to conventional treadmill training.
This study will be a single-blinded, two arm RCT with a six-week intervention period. 144 people with MS will be randomized into a treadmill training alone group or treadmill training with virtual reality group. Both groups will receive 18 sessions of training while walking on a treadmill, with the virtual reality group receiving feedback from the virtual system. Primary outcome measures include dual-task gait speed and information processing speed, which will be measured prior to training, one-week post-training, and three months following training.
This study will provide insight into the ability of a multi-modal cognitive-motor intervention to reduce dual-task cost and to enhance information processing speed in those with MS. This is one of the first studies that is powered to understand whether targeted dual-task training can improve MS symptoms and increase functional ambulation. We anticipate that those in the virtual reality group will have a significantly greater increase in dual-task gait speed and information processing speed than those achieved via treadmill training alone.
步态和认知障碍在多发性硬化症(MS)患者中很常见,会干扰日常功能。MS患者在同时执行认知任务和行走时存在困难,这是双重任务干扰的一种表现。因此,双重任务训练可能会改善功能性步行能力。此外,使用虚拟现实等技术可以在模拟现实环境的同时提供个性化康复训练。这项随机对照试验的目的是确定与传统跑步机训练相比,认知-运动相结合的虚拟现实训练对MS症状的益处。
本研究将是一项单盲、双臂随机对照试验,干预期为六周。144名MS患者将被随机分为单纯跑步机训练组或跑步机训练加虚拟现实组。两组在跑步机上行走时都将接受18次训练,虚拟现实组将从虚拟系统接收反馈。主要结局指标包括双重任务步态速度和信息处理速度,将在训练前、训练后一周和训练后三个月进行测量。
本研究将深入了解多模式认知-运动干预降低双重任务成本和提高MS患者信息处理速度的能力。这是首批有足够样本量来了解针对性双重任务训练是否能改善MS症状并提高功能性步行能力的研究之一。我们预计,虚拟现实组的双重任务步态速度和信息处理速度的提升幅度将明显大于单纯跑步机训练组。