Unilateral arm rehabilitation for persons with multiple sclerosis using serious games in a virtual reality approach: Bilateral treatment effect?

Abstract

Impairedarm function and loss of manual dexterity can lead to decreased independence in activities of daily living in persons with Multiple Sclerosis (MS). In this study we verified the feasibility and efficacy of a serious games approach to supervised upper limb rehabilitation of the more affected arm in persons with MS and the cross-over effect to the nontreated arm. MethodsEighteen persons with moderate to severe MS symptoms participated (mean age 56.1 (range 28–73) years; mean disease duration 17.6 (4–35) years). Each participant received 12 supervised sessions of serious games (45 min, 12 sessions) aimed at improving the most affected upper limb. Primary outcomes were the Nine Hole Peg Test (9HPT) and the Box and Blocks Test (BBT). Perceived health was evaluated pre and post intervention with SF-12 and the VAS of the EuroQual-5DL. Non parametric tests were used and P was set at 0.05. ResultsAfter the serious games training participants improved dexterity and arm function bilaterally (10–18%), however, there was a statistically significant improvement only in the treated arm (P<0.05). Perceived menthal health improved follwing training (P<0.05) but not perceived physical health. ConclusionAn in clinic intervention with a serious-games virtual reality approach positively influenced arm recovery in persons moderately to severely affected by MS, improving mainly the treated arm but with positive effects on the nontreated arm. The persons were motivated during the intervention and expressed being willing to continue this kind of training at home as part of continuity of care.