Benefits of a Perceived High-Intensity Exercise Program with Immersive Virtual Reality Combined with Usual...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Exercise Science

Background:

• Multiple sclerosis (MS) presents significant motor and cognitive challenges, impacting patient quality of life.
• Traditional rehabilitation methods may face adherence and accessibility limitations.
• Exergames and virtual reality (VR) offer innovative, engaging approaches to exercise and rehabilitation.

Purpose of the Study:

• To assess the feasibility and safety of a supervised high-intensity exercise program using immersive virtual reality (IVR) in individuals with MS.
• To explore the effects of this IVR program on physical, cognitive, and functional domains.
• To investigate changes in the serum biomarker neurofilament light chain (sNfL) as an indicator of axonal damage.

Main Methods:

• An 8-week, pre-post exploratory study involving five MS patients from a local association.
• Participants engaged in two 10-minute supervised IVR boxing exergame sessions weekly, alongside usual rehabilitation.
• Evaluated safety (SSQ), usability (SUS), disability (EDSS), gait (25FWT), manual dexterity (9HPT), cognition (SDMT), and sNfL levels.

Main Results:

• The IVR program demonstrated high feasibility and safety, with 100% adherence and no adverse events reported.
• Significant positive changes were observed in Expanded Disability Status Scale (EDSS), 25-Foot Walk Test (25FWT), and manual dexterity (right 9HPT).
• A notable reduction in serum neurofilament light chain (sNfL) was observed, suggesting a potential neuroprotective effect, though cognitive improvements (SDMT) were not significant.

Conclusions:

• A brief, supervised IVR exergame intervention combined with standard rehabilitation is feasible and safe for people with MS.
• While preliminary results are promising for physical function and axonal damage markers, further controlled studies with larger sample sizes are needed to establish efficacy.
• This study opens avenues for future research into high-intensity exercise programs utilizing IVR for MS rehabilitation.