Effects of a 6-Week Treadmill Training With and Without Virtual Reality on Frailty in People With Multiple Sclerosis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Gerontology

Background:

• Multiple sclerosis (MS) is a chronic neurological condition often leading to frailty.
• Frailty, characterized by decreased physiological reserve, increases vulnerability to adverse health outcomes.
• Cognitive and motor impairments are common in people with MS (pwMS), contributing to frailty.

Purpose of the Study:

• To evaluate the efficacy of a cognitive-motor rehabilitation program using treadmill training augmented by virtual reality (TT+VR) in reducing frailty among pwMS.
• To compare the effects of TT+VR versus traditional treadmill training (TT) on frailty indices.

Main Methods:

• A secondary analysis of a multicenter randomized controlled trial involving 83 pwMS.
• Participants were randomized to either TT+VR or TT groups, undertaking 3 weekly sessions for 6 weeks.
• Frailty was assessed using a 40-item frailty index (FI), with additional analyses of cognitive (FI-cognitive) and physical (FI-physical) domains.

Main Results:

• Both TT+VR and TT groups showed significant improvements in overall frailty (mean ΔFI).
• No significant group-by-time interaction was observed for the overall frailty index.
• A significant group-by-time interaction favored the TT+VR group for improvements in the cognitive domain of frailty (FI-cognitive).

Conclusions:

• Treadmill training, with or without virtual reality, is effective in reducing frailty in pwMS.
• TT+VR demonstrates a specific advantage in improving the cognitive components of frailty compared to TT alone.
• TT+VR may be a valuable strategy for addressing frailty, particularly its cognitive aspects, in individuals with MS.