The effect of balance training on postural control in people with multiple sclerosis using the CAREN virtual reality system: a pilot randomized controlled trial

被引:113
作者
Kalron, Alon [1 ]
Fonkatz, Ilia [2 ]
Frid, Lior [2 ]
Baransi, Hani [3 ]
Achiron, Anat [2 ,4 ]
机构
[1] Tel Aviv Univ, Sackler Fac Med, Sch Hlth Profess, Dept Phys Therapy, IL-69978 Tel Aviv, Israel
[2] Chaim Sheba Med Ctr, Multiple Sclerosis Ctr, IL-52621 Tel Hashomer, Israel
[3] Chaim Sheba Med Ctr, Ctr Adv Technol Rehabil, IL-52621 Tel Hashomer, Israel
[4] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
关键词
Multiple sclerosis; Balance; Postural control; Virtual reality; CAREN; ASSISTED REHABILITATION ENVIRONMENT; OLDER-ADULTS; MOBILITY; STROKE; FALLS; INTERVENTION; INDIVIDUALS; DISABILITY; EFFICACY; GAMES;
D O I
10.1186/s12984-016-0124-y
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Background: Multiple sclerosis (MS) is a multi-focal progressive disorder of the central nervous system often resulting in diverse clinical manifestations. Imbalance appears in most people with multiple sclerosis (PwMS). A popular balance training tool is virtual reality (VR) with several advantages including increased compliance and user satisfaction. Therefore, the aim of this pilot RCT (Trial registration number, date: ISRCTN14425615, 21/01/2016) was to examine the efficacy of a 6-week VR balance training program using the computer assisted rehabilitation environment (CAREN) system (Motek Medical BV, Amsterdam, Netherlands) on balance measures in PwMS. Results were compared with those of a conventional balance exercise group. Secondary aims included the impact of this program on the fear of falling. Methods: Thirty-two PwMS were equally randomized into the VR intervention group or the control group. Each group received balance training sessions for 6 consecutive weeks, two sessions per week, 30 min sessions. Clinical balance tests and instrumented posturography outcome measures were collected upon initiation of the intervention programs and at termination. Results: Final analysis included 30 patients (19 females, 11 males; mean age, (S.D.) = 45.2 (11.6) years; mean EDSS (S.D.) = 4.1 (1.3), mean disease duration (S.D.) = 11.0 (8.9) years). Both groups showed a main effect of time on the center of pressure (CoP) path length with eyes open (F = 5.278, P=.024), sway rate with eyes open (F = 5.852, P=.035), Functional Reach Test (F = 20.841, P=.001), Four Square Step Test (F = 9.011, P=.031) and the Fear of Falls self-reported questionnaire (F = 17.815, P=.023). In addition, significant differences in favor of the VR program were observed for the group x time interactions of the Functional Reach Test (F = 10.173, P=.009) and fear of falling (F = 6.710, P=.021). Conclusions: We demonstrated that balance training based on the CAREN device is an effective method of balance training for PwMS.
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页数:10
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共 38 条
[1]  
[Anonymous], COCHRANE DATABASE SY
[2]   Dynamic stability of individuals with transtibial amputation walking in destabilizing environments [J].
Beurskens, Rainer ;
Wilken, Jason M. ;
Dingwell, Jonathan B. .
JOURNAL OF BIOMECHANICS, 2014, 47 (07) :1675-1681
[3]   Usefulness of the berg balance scale in stroke rehabilitation: A systematic review [J].
Blum, Lisa ;
Korner-Bitensky, Nicol .
PHYSICAL THERAPY, 2008, 88 (05) :559-566
[4]  
Browne J, 2000, PHYSIOL MEAS, V21, P217
[5]   Effects of balcance exercises on people with multiple sclerosis: a pilot study [J].
Cattaneo, D. ;
Jonsdottir, J. ;
Zocchi, M. ;
Regola, A. .
CLINICAL REHABILITATION, 2007, 21 (09) :771-781
[6]   Sensory impairments in quiet standing in subjects with multiple sclerosis [J].
Cattaneo, D. ;
Jonsdottir, J. .
MULTIPLE SCLEROSIS JOURNAL, 2009, 15 (01) :59-67
[7]  
Chan Leighton, 2014, Annals of Physical and Rehabilitation Medicine, V57, P558, DOI 10.1016/j.rehab.2014.09.011
[8]   Is Nintendo Wii an Effective Intervention for Individuals With Stroke? A Systematic Review and Meta-Analysis [J].
Cheok, Gary ;
Tan, Dawn ;
Low, Aiying ;
Hewitt, Jonathan .
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2015, 16 (11) :923-932
[9]   A systematic literature review of the use and effectiveness of the Computer Assisted Rehabilitation Environment for research and rehabilitation as it relates to the wounded warrior [J].
Collins, John-David ;
Markham, Amanda ;
Service, Kathrine ;
Reini, Seth ;
Wolf, Erik ;
Sessoms, Pinata .
WORK-A JOURNAL OF PREVENTION ASSESSMENT & REHABILITATION, 2015, 50 (01) :121-129
[10]   Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review [J].
Darekar, Anuja ;
McFadyen, Bradford J. ;
Lamontagne, Anouk ;
Fung, Joyce .
JOURNAL OF NEUROENGINEERING AND REHABILITATION, 2015, 12