Therapeutic effects of virtual reality video gaming on functional mobility, balance, and gait speed in individuals with tropical spastic paraparesis: A randomized crossover clinical trial

Abstract

INTRODUCTION: Individuals with human T-cell lymphotropic virus 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) experience sensorimotor alterations, which can affect functional performance. Virtual reality (VR) videogaming is a therapeutic option, though there is scarce evidence for its use in this population. We aimed to investigate the therapeutic effects of a VR video game on functional mobility, balance, and gait speed in individuals with HAM/TSP. METHODS: We conducted a blinded, crossover clinical trial comprising 29 individuals with HAM/TSP and randomized them into two groups: (1) early therapy: rehabilitative protocol started immediately after the initial evaluation and (2) late therapy: rehabilitative protocol started 10 weeks later. We assessed all participants for balance using the Berg Balance Scale (BBS) scores, functional mobility using the Timed Up and Go (TUG) test, and gait speed using video camera and CvMob software. Differences were considered significant if p <0.05. RESULTS: The early therapy group individuals presented with higher BBS scores ( p =0.415), less TUG times ( p =0.290), and greater gait speed ( p =0.296) than the late therapy group individuals. CONCLUSIONS: VR videogaming is a useful option for rehabilitative therapy in individuals with HAM/TSP; it positively affects balance, functional mobility, and gait speed.

Nonpharmacological interventions and outcomes in the management of complications of human T-cell lymphotropic virus type 1-related myelopathy/tropical spastic paraparesis: A systematic review

“…Of 288 retrieved articles, 11 were eligible for data extraction, representing data on the final volume of 266 patients published between 2014[ 11 12 13 14 ] and 2021. [ 15 ] The study place is in all articles in Brazil, which is one of the endemic regions of the virus in the world, so the studies have a desirable and valid scientific background that strengthens the accuracy and robustness of the findings.…”

“…Of the 11 studies extracted, 1 was a quasi-experimental study,[ 16 ] 5 were a randomized clinical trial,[ 14 17 18 19 20 ] and 5 were a randomized crossover clinical trial. [ 11 12 13 15 21 ] Furthermore, 18/18% of articles (2 cases) were of low quality[ 16 17 ] and 81/81% of articles (9 cases) were of high quality[ 11 12 13 14 15 18 19 20 21 ] [ Table 2 ].…”

Patient research priority setting partnership in human T‐cell lymphotropic virus type I

“…Clinical care is focused on symptomatic management of spasticity, pain, and bladder and bowel problems 12 . Physiotherapy may have a positive impact on impairments, disability, participation and quality of life 14,15 . A broad range of potentially disease‐modifying therapies have been tried, usually in observational studies, and the best results to date have been with corticosteroids, which may improve pain and motor function acutely and slow disease progression over the long term 12,16 …”

“…12 Physiotherapy may have a positive impact on impairments, disability, participation and quality of life. 14,15 A broad range of potentially disease-modifying therapies have been tried, usually in observational studies, and the best results to date have been with corticosteroids, which may improve pain and motor function acutely and slow disease progression over the long term. 12,16 3 | ATLL ATLL is an aggressive cancer with a poor prognosis and limited treatment options.…”

Factors Involved in Pain Perception and Quality of Life in Patients with Tropical Spastic Paraparesis

“…Therefore, the participant's psychiatric condition would influence the measurement of the questions' variables. Thus, other researchers such as Da Fonseca et al excluded patients with psychiatric and neurological conditions when they tested an exercise program with the aid of virtual reality in the motor and cognitive improvement of patients with the same disease 5 .…”