Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report

Background: Dizziness 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. V...

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Autores: García-Muñoz, Cristina, Cortés Vega, María Dolores, Hernández Rodríguez, Juan Carlos, Fernández Seguín, Lourdes María, Escobio Prieto, Isabel, Casuso-Holgado, María Jesús
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/140463
Acceso en línea:https://hdl.handle.net/11441/140463
https://doi.org/10.2196/31020
Access Level:acceso abierto
Palabra clave:Immersive virtual reality
Vestibular rehabilitation
Multiple sclerosis
Exergames
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spelling Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case ReportGarcía-Muñoz, CristinaCortés Vega, María DoloresHernández Rodríguez, Juan CarlosFernández Seguín, Lourdes MaríaEscobio Prieto, IsabelCasuso-Holgado, María JesúsImmersive virtual realityVestibular rehabilitationMultiple sclerosisExergamesBackground: Dizziness 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. Objective: The 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. Methods: This 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. Results: After 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. Conclusions: Although 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.JMIR PublicationsFisioterapia2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/140463https://doi.org/10.2196/31020reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésJMIR serious games, 10 (1), e31020.https://games.jmir.org/2022/1/e31020info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1404632026-06-17T12:51:07Z
dc.title.none.fl_str_mv Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
title Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
spellingShingle Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
García-Muñoz, Cristina
Immersive virtual reality
Vestibular rehabilitation
Multiple sclerosis
Exergames
title_short 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_sort Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report
dc.creator.none.fl_str_mv García-Muñoz, Cristina
Cortés Vega, María Dolores
Hernández Rodríguez, Juan Carlos
Fernández Seguín, Lourdes María
Escobio Prieto, Isabel
Casuso-Holgado, María Jesús
author García-Muñoz, Cristina
author_facet García-Muñoz, Cristina
Cortés Vega, María Dolores
Hernández Rodríguez, Juan Carlos
Fernández Seguín, Lourdes María
Escobio Prieto, Isabel
Casuso-Holgado, María Jesús
author_role author
author2 Cortés Vega, María Dolores
Hernández Rodríguez, Juan Carlos
Fernández Seguín, Lourdes María
Escobio Prieto, Isabel
Casuso-Holgado, María Jesús
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Fisioterapia
dc.subject.none.fl_str_mv Immersive virtual reality
Vestibular rehabilitation
Multiple sclerosis
Exergames
topic Immersive virtual reality
Vestibular rehabilitation
Multiple sclerosis
Exergames
description Background: Dizziness 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. Objective: The 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. Methods: This 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. Results: After 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. Conclusions: Although 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/140463
https://doi.org/10.2196/31020
url https://hdl.handle.net/11441/140463
https://doi.org/10.2196/31020
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv JMIR serious games, 10 (1), e31020.
https://games.jmir.org/2022/1/e31020
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv JMIR Publications
publisher.none.fl_str_mv JMIR Publications
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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