Feasibility of virtual reality-based balance rehabilitation in adults with spinocerebellar ataxia

Abstract

Objective: To test the effects of a virtual reality (VR) balance rehabilitation program in patients diagnosed with SCAs. Materials and methods: A prospective observational study was carried out with a cohort of 28 patients diagnosed with SCAs, including eight females and 20 males, 15–70 years of age (mean, 41.5 ± 16.9 years). Patients were submitted to otorhinolaryngological assessment to exclude any kind of middle ear impairments that may hinder exam results, and vestibular evaluation to verify the existence of vestibular disorders, kind and site of the lesion. The Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and 36-item Short-form Health Survey (SF-36) questionnaires were applied before and after VR rehabilitation. The criterion for significance in before versus after VR training comparisons was p < .05. Results: Regarding to baseline, the participants showed significant improvements posttraining in their DHI and BBS scores. These improvements were accompanied by improvements in perceived quality of life (QoL) as measured by the SF-36. There were significant improvements in balance and gait, fall frequency, and patients’ self-confidence. Conclusions: Showed consistent improvement postrehabilitation in their ability to play VR games (i.e. Soccer Heading, Tightrope, Table Tilt, and Ski Slalom). VR rehabilitation may be an effective SCA therapy. The breadth of improvements evidenced here should promote physical and psychological recovery, while fostering a better QoL.

The Use of New Mobile and Gaming Technologies for the Assessment and Rehabilitation of People with Ataxia: a Systematic Review and Meta-analysis

“…Four studies were experimental studies, with 1 controlled trial [26] and 3 single-group trials [27][28][29]. Two studies were categorized as diagnostic studies [30,31].…”

“…Two studies were categorized as diagnostic studies [30,31]. All included experimental studies investigated the effectiveness of either available video games for both Nintendo Wii and Microsoft Xbox Kinect [27][28][29] or specifically developed exergames adopting the Kinect sensor in both children and adults with different ataxias [26].…”

“…The overall methodological quality of all included studies was medium-low, with 1 trial reaching a score of 4 [26], 2 trials having a score of 3, 1 trial having a score of 1 [29], and both diagnostic studies having a score of 4.…”

“…The main reason for low scores in trials was that 3 studies did not include a control group [27][28][29]; thus, patients were not randomized nor blinded. All trials included small samples (ranging from 9 to 28 participants), and the only randomized study [26] applied a block randomization in 9 subjects, thus leading to significant differences (e.g., Walking speed, Ninehole peg test) in the characteristics of subjects between the experimental and the control group.…”

“…All trials included small samples (ranging from 9 to 28 participants), and the only randomized study [26] applied a block randomization in 9 subjects, thus leading to significant differences (e.g., Walking speed, Ninehole peg test) in the characteristics of subjects between the experimental and the control group. Moreover, 1 trial [29] reported and analyzed data in an unclear way, leading to a high risk of incomplete and selective reporting (e.g., means and ICs are not reported). However, ataxias are relatively rare conditions, the technologies tested are difficult to standardize, and it is relatively difficult to blind participants to them.…”