Wender Carly L A, DeLuca John, Sandroff Brian M
Kessler Foundation, West Orange, NJ 07052, USA;
Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Rutgers University, Newark, NJ 07103, USA.
NeuroSci. 2022 Apr 3;3(2):200-213. doi: 10.3390/neurosci3020015. eCollection 2022 Jun.
Cognitive impairment is a common and detrimental consequence of multiple sclerosis (MS) and current rehabilitation methods are insufficient. Cognitive rehabilitation (CR) and exercise training (ET) are the most promising behavioral approaches to mitigate cognitive deficits, but effects are small and do not effectively translate to improvements in everyday function. This article presents a conceptual framework supporting the use of virtual reality (VR) as an ideal, common adjuvant traditional CR and ET in MS. VR could strengthen the effects of CR and ET by increasing sensory input and promoting multisensory integration and processing during rehabilitation. For ET specifically, VR can also help incorporate components of CR into exercise sessions. In addition, VR can enhance the transfer of cognitive improvements to everyday functioning by providing a more ecologically valid training environment. There is a clear interest in adding VR to traditional rehabilitation techniques for neurological populations, a stronger body of evidence of this unique approach is needed in MS. Finally, to better understand how to best utilize VR in rehabilitation for cognitive deficits in MS, more systematic research is needed to better understand the mechanism(s) of action of VR with CR and ET.
认知障碍是多发性硬化症(MS)常见且有害的后果,目前的康复方法并不充分。认知康复(CR)和运动训练(ET)是减轻认知缺陷最有前景的行为方法,但效果甚微,且无法有效转化为日常功能的改善。本文提出了一个概念框架,支持将虚拟现实(VR)作为MS中传统CR和ET的理想通用辅助手段。VR可以通过增加感觉输入以及在康复过程中促进多感觉整合与处理来增强CR和ET的效果。具体对于ET而言,VR还可以帮助将CR的组成部分纳入锻炼课程。此外,VR可以通过提供更具生态效度的训练环境,增强认知改善向日常功能的转化。在神经疾病人群中将VR添加到传统康复技术中显然是有意义的,但在MS中还需要更多关于这种独特方法的确凿证据。最后,为了更好地理解如何在MS认知缺陷康复中最佳利用VR,需要进行更系统的研究,以更好地了解VR与CR和ET的作用机制。