Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
BackgroundDizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population d...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-02-01
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| Series: | JMIR Serious Games |
| Online Access: | https://games.jmir.org/2022/1/e31020 |
| _version_ | 1827858643199983616 |
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| author | Cristina García-Muñoz María-Dolores Cortés-Vega Juan-Carlos Hernández-Rodríguez Lourdes M Fernández-Seguín Isabel Escobio-Prieto María Jesús Casuso-Holgado |
| author_facet | Cristina García-Muñoz María-Dolores Cortés-Vega Juan-Carlos Hernández-Rodríguez Lourdes M Fernández-Seguín Isabel Escobio-Prieto María Jesús Casuso-Holgado |
| author_sort | Cristina García-Muñoz |
| collection | DOAJ |
| description |
BackgroundDizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS.
ObjectiveThe aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention.
MethodsThis case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device.
ResultsAfter implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16% in the physical health area at T2; 33.56% in the mental health area at T2). The patient rated the usability of the system as 90%, based on the System Usability Scale, and gave the system a grade of A.
ConclusionsAlthough further research is needed, this study provided initial evidence that the first VRi vestibular protocol for the MS population can improve dizziness, balance, gait, impact of fatigue, quality of life, and muscular tone through an exergame intervention. This study may help establish a standardized VRi protocol for vestibular rehabilitation. |
| first_indexed | 2024-03-12T12:58:02Z |
| format | Article |
| id | doaj.art-ef6b4b8d000e40788e61205286f80307 |
| institution | Directory Open Access Journal |
| issn | 2291-9279 |
| language | English |
| last_indexed | 2024-03-12T12:58:02Z |
| publishDate | 2022-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Serious Games |
| spelling | doaj.art-ef6b4b8d000e40788e61205286f803072023-08-28T20:48:48ZengJMIR PublicationsJMIR Serious Games2291-92792022-02-01101e3102010.2196/31020Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case ReportCristina García-Muñozhttps://orcid.org/0000-0003-2621-2098María-Dolores Cortés-Vegahttps://orcid.org/0000-0002-9514-8811Juan-Carlos Hernández-Rodríguezhttps://orcid.org/0000-0003-2525-4069Lourdes M Fernández-Seguínhttps://orcid.org/0000-0001-7727-1915Isabel Escobio-Prietohttps://orcid.org/0000-0001-8523-767XMaría Jesús Casuso-Holgadohttps://orcid.org/0000-0002-4217-6827 BackgroundDizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS. ObjectiveThe aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention. MethodsThis case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device. ResultsAfter implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16% in the physical health area at T2; 33.56% in the mental health area at T2). The patient rated the usability of the system as 90%, based on the System Usability Scale, and gave the system a grade of A. ConclusionsAlthough further research is needed, this study provided initial evidence that the first VRi vestibular protocol for the MS population can improve dizziness, balance, gait, impact of fatigue, quality of life, and muscular tone through an exergame intervention. This study may help establish a standardized VRi protocol for vestibular rehabilitation.https://games.jmir.org/2022/1/e31020 |
| spellingShingle | Cristina García-Muñoz María-Dolores Cortés-Vega Juan-Carlos Hernández-Rodríguez Lourdes M Fernández-Seguín Isabel Escobio-Prieto María Jesús Casuso-Holgado Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report JMIR Serious Games |
| title | Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report |
| title_full | Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report |
| title_fullStr | Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report |
| title_full_unstemmed | Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report |
| title_short | Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report |
| title_sort | immersive virtual reality and vestibular rehabilitation in multiple sclerosis case report |
| url | https://games.jmir.org/2022/1/e31020 |
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