Enabling More Accessible MS Rehabilitation Training Using Virtual Reality

Multiple sclerosis (MS) is an autoimmune disorder caused by damage to the myelin that protects nerve fibres, resulting in demyelinated lesions and causing various symptoms, one of which is muscle weakness. Physical rehabilitation is an integral part of managing MS, as well as its symptoms, and over time, the forms of implementing rehabilitation have changed according to novel technologies. Virtual reality (VR) has already been successfully applied to many fields of life sciences. VR can recreate engaging virtual environments for the specific purpose of physical rehabilitation that one can experience from the home environment. As a proof of concept, three games were developed for multiple sclerosis (MS) through the ground-breaking game engine Unity: a Piano game, a Recycle game and a Tidy Up game. The Piano game had three levels, starting from learning simple keys and ending with small well-known songs, in order to gradually challenge the user as they progress through their rehabilitation. The Recycle game focused on entertainment; it was playful providing a simpler but engaging and fun experience that used items that are seen in everyday life. In addition, a scoring system was implemented in order to motivate the user. Finally, the Tidy Up game had three different levels giving the user goals to work towards; at each level, the time available to complete the game became shorter giving the user less time to tidy up the table. These games were presented to individuals with MS, who had never used VR. Feedback was collected in order to assess the usability and the perceived sense of presence generated by the proposed approach. The testing also aimed to better understand rehabilitation techniques including factors affecting motivation. The games for rehabilitation were warmly received, and feedback was positive regarding both the usability of the system and the perceived sense of presence within digital environments. Although the tested sample size limits were small, a limitation of the validity of the results, these initial findings suggest VR must be beneficial in MS physical rehabilitation of the upper limb although larger, more formal evaluation is required.