Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Arch Phys Med Rehabil. 2021 Feb;102(2):290-299. doi: 10.1016/j.apmr.2020.09.395. Epub 2020 Nov 5.
To assess the efficacy of virtual reality (VR)-based vs conventional balance training on the improvement of balance and reduction of falls in people with multiple sclerosis (PwMS).
Single-blinded, randomized, controlled trial.
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences.
PwMS (N=39), randomized into VR (n=19) and control (n=20) groups.
The VR group performed exergames using Kinect, while the control group accomplished conventional balance exercises. Both groups received 18 training sessions for 6 weeks.
Limits of stability, timed Up and Go (TUG) test, and 10-m walk tests with and without cognitive task and their dual-task costs (DTCs), Berg Balance Scale, Multiple Sclerosis Walking Scale-12, Fall Efficacy Scale-International, Activities-specific Balance Confidence Scale, and fall history were obtained pre- and post intervention and after a 3-month follow-up.
At both post intervention and follow-up, TUG and DTCs on the TUG were significantly lower and the 10-m walk was significantly higher in the VR group. At follow-up, reaction time and the number of falls demonstrated significant differences favoring the VR group, whereas the directional control revealed significant difference in favor of the control group (P<.05). The other outcomes showed no statistically significant difference at post intervention or follow-up.
Both the VR-based and conventional balance exercises improved balance and mobility in PwMS, while each acted better in improving certain aspects. VR-based training was more efficacious in enhancing cognitive-motor function and reducing falls, whereas conventional exercises led to better directional control. Further studies are needed to confirm the effectiveness of recruiting VR-based exercises in clinical settings.
评估基于虚拟现实（VR）与传统平衡训练对多发性硬化症（MS）患者平衡改善和跌倒减少的疗效。
单盲、随机、对照试验。
阿瓦兹 Jundishapur 大学医学科学肌骨康复研究中心。
MS 患者（N=39），随机分为 VR 组（n=19）和对照组（n=20）。
VR 组使用 Kinect 进行健身游戏，对照组完成传统平衡练习。两组均接受 18 次、为期 6 周的训练。
稳定性极限、计时起立行走测试（TUG）、10 米步行测试（有/无认知任务及其双重任务成本[DTC]）、伯格平衡量表、多发性硬化步行量表-12、跌倒效能量表-国际、活动特异性平衡信心量表以及跌倒史，于干预前、干预后和 3 个月随访时进行评估。
在干预后和随访时，VR 组的 TUG 和 TUG 的 DTC 均显著降低，10 米步行速度显著提高。在随访时，VR 组的反应时间和跌倒次数有显著差异，而对照组的方向控制有显著差异（P<.05）。其他结果在干预后或随访时均无统计学差异。
基于 VR 的平衡训练和传统平衡训练均能改善 MS 患者的平衡和移动能力，且各有侧重。基于 VR 的训练在增强认知运动功能和减少跌倒方面更有效，而传统训练在改善方向控制方面更有效。需要进一步的研究来确认在临床环境中招募基于 VR 的训练的有效性。
