Using a virtual reality system to improve balance for those with multiple sclerosis

The Journal of NeuroEngineering and Rehabilitation has published research looking at the use of virtual reality to help patients with multiple sclerosis maintain their balance, a common issue for those with the disease. Co-author Alon Kalron explains more.

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What is multiple sclerosis?

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Healthy nerves are coated in a fatty casing (called the myelin sheath) which helps messages to travel quickly and smoothly along nerves.

When a person is suffering from MS, the immune system, which normally helps to protect against infection, attacks the myelin sheath, stripping it from the nerves (demyelination).

This demyelination means that messages cannot travel along the nerves effectively, causing a range of disabilities like muscle weakness, walking difficulties, fatigue, thinking problems, numbness and blurred vision.

Helping MS patients with their balance

The aim of this study was to look at the effects of training with a new virtual reality system on balance in people with MS and compare it with traditional physical therapy.

Many people suffering from MS suffer from problems with balance. The aim of this study was to look at the effects of training with a new virtual reality system on balance in people with MS and compare it with traditional physical therapy. The study was performed in the Sheba Multiple Sclerosis Center and the Center of Advanced Technologies in Rehabilitation at Tel-HaShomer, Israel.

Participants were randomly allocated to one of two groups. Those in the first group complete a 6 week virtual reality training program using the computer assisted rehabilitation environment (CAREN) system.

The participants took part in two sessions a week which included around 30 minutes of balance training. Participants were asked to stand on a moving platform and look at a screen with a road on it.

The road itself includes flat, bumpy and tilting sections and the moving platform moves in sync with the image of the road on the screen (i.e. when the road tilts, the platform tilts).

Participants are asked to ‘walk’ along the road whilst keeping their balance. The video below is not the exact CAREN system used in the present study but it does give you an impression on how the virtual reality system operates.

Participants in the second group took part in a conventional exercise program (traditional physical therapy), which consists of balancing on an uneven surface (foam), an unstable base (wobble board) and by catching balls thrown at them from different directions but stepping forward or sideways.

At the start of the study and then again at the end of the six week training programs, participants in both groups complete a number of assessments and questionnaires in order to find out if their balance has improved.

What did the study find?

Following six weeks of the training program, both groups improved their balance abilities. However, better improvements were found in the virtual reality group. Patients in this group improved their ability to reach farther while standing and reported less fear of falls compared to patients in the conventional group.

We have successfully demonstrated that balance training based on the CAREN virtual reality system is an effective method in balance training for people with MS. While traditional therapy methods will continue to be used in the clinic, virtual reality balance training has proved to improve balance in people with MS.

However, it is worth noting that while the CAREN system has many clinical advantages, the high costs and space requirements for the system may prevent this device from being a rehabilitation tool in several medical centers and in cases of MS patients treated in the community and/or restricted to their homes.

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Mike Bradford

Thanks Alon for sharing this great post. Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. I hope the work of Journal of NeuroEngineering and Rehabilitation will really helps many patients to lead their normal life.

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