Effect of virtual walking on chronic pain, tone and spasticity in incomplete spinal cord injury

To assess the effect of combining virtual walking (VW) with physical exercise (PE) compared to PE alone in people with incomplete spinal cord injury (iSCI).

A randomised controlled trial was designed. Thirty-eight people with iSCI performed 18 sessions (6 weeks) according to assigned group: i. Experimental Intervention (EI): VW with PE; or ii. Control intervention (CI): Placebo VW with PE. Chronic pain, muscle tone, and spasticity were assessed at baseline (T1), after the intervention (T2) and at 4 (T3) and 12 weeks (T4) follow-up.

The EI group exhibited a decrease in pain severity at T2 (p = 0.02), and a reduction in interference with mood and walking at T2 (p = 0.02 and p = 0.04). In the CI group, pain interference with mood and work decreased at T3 (p = 0.03 and p = 0.04). For spasticity, the EI group showed a reduction at T2 (p = 0.02), T3 (p = 0.01) and T4 (p = 0.03) compared to T1, whereas the CI group only showed a decrease at T3 (p = 0.02) compared to T1. No changes were found in tone at rest.

Combined use of VW and PE is effective in the short term in reducing pain and spasticity, unlike the application of PE alone, in individuals with iSCI. However, this intervention is not effective for improving muscle tone.