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Video game therapy on mobility and dual tasking in multiple sclerosis: study protocol for a randomised controlled
Andrea Baroni1, Giulia Fregna1, Giada Milani2
1Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy.
Introduction:
Multiple sclerosis (MS) is one of the major causes of disability in young adults and affects mobility, compromising daily living activities and participation in social life. Cognitive domain is also frequently impaired in people with MS (PwMS), particularly the capacity to perform dual-task activities. Impaired cognitive processing abilities need to be treated, and motor and cognitive aspects need to be considered together. Recently, video game therapy (VGT) has been used in rehabilitation to improve motor outcomes and cognitive processing speed. The aim of this study is to test the efficacy of commercially available VGT on mobility and dual tasking in PwMS compared with standardised balance platform training (BPT).
Methods And Analysis:
This will be a parallel-assignment, double-blinded, randomised control trial. Forty-eight (24 per arm) PwMS with Expanded Disability Status Scale 4-5.5 will be randomly assigned to receive 1 hour training session over 4 weeks (three sessions/week) of either: (1) VGT on commercial video game console to train balance and mobility-related activities or (2) BPT to perform balance, postural stability and weight-shifting exercises with and without visual feedback. The same assessor will evaluate outcome measures at points: before and after the 12 training sessions and at 3 months of follow-up. The primary outcome will be functional mobility, assessed by the Timed Up and Go test. We will also evaluate gait, risk of fall, fatigue and health-related quality of life as well as cognitive and psychological aspects (depression, anxiety and attentional performance) and stability through posturographic evaluation. Dual-tasking assessment will be performed combining posturographic and neuropsychological tests. Data analysis will be performed to compare the efficacy of the two treatments.
Ethics And Dissemination:
Ethical approval have been granted from the local Ethics Committee. Study results will be communicated through high-quality journals and national and international conferences.
Trial Registration Number:
NCT03353974.
Insights
Video game therapy (VGT) shows promise for improving mobility and dual-tasking in people with multiple sclerosis (PwMS). This study compares VGT with balance platform training (BPT) to assess its rehabilitation efficacy.
Area of Science:
- Neurorehabilitation
- Clinical Trials
- Disability Studies
Background:
- Multiple sclerosis (MS) significantly impacts mobility and cognitive function, particularly dual-tasking abilities, affecting daily life.
- Current rehabilitation strategies require innovative approaches to address both motor and cognitive impairments in people with MS (PwMS).
- Video game therapy (VGT) has emerged as a potential tool to enhance motor outcomes and cognitive processing speed in rehabilitation settings.
Purpose of the Study:
- To evaluate the efficacy of commercially available video game therapy (VGT) for improving mobility and dual-tasking performance in people with multiple sclerosis (PwMS).
- To compare the effects of VGT against a standardized balance platform training (BPT) program in PwMS.
- To assess the impact of VGT on various functional, cognitive, and psychological outcomes in PwMS.
Main Methods:
- A parallel-assignment, double-blinded, randomized controlled trial involving 48 PwMS (Expanded Disability Status Scale 4-5.5).
- Participants received 12 training sessions over 4 weeks: either VGT or BPT.
- Outcome measures, including functional mobility (Timed Up and Go test), gait, fall risk, fatigue, quality of life, cognitive function, and postural stability, were assessed pre- and post-intervention and at 3-month follow-up.
Main Results:
- The study is designed to compare the efficacy of VGT and BPT through rigorous data analysis.
- Primary outcome is functional mobility measured by the Timed Up and Go test.
- Secondary outcomes include gait, fall risk, fatigue, quality of life, cognitive performance, and posturographic stability, with dual-tasking assessed via combined methods.
Conclusions:
- The findings will elucidate the effectiveness of VGT as a rehabilitation tool for PwMS.
- Results will inform clinical practice regarding the integration of VGT for managing MS-related functional and cognitive deficits.
- The study aims to provide evidence for VGT's role in improving dual-tasking abilities and overall well-being in PwMS.
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