Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

Kim, Kyoung Jae; Gimmon, Yoav; Millar, Jennifer; Brewer, Kelly; Serrador, Jorge; Schubert, Michael C.

doi:10.21203/rs.3.rs-42274/v1

Cited by 2 publications

(1 citation statement)

References 41 publications

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“…According to Witchel et al [ 58 ], a lower sit-to-stand transition time could be related to greater balance performance, as reported in our case study. Additionally, a vestibular intervention has been shown to be effective in the achievement of a shorter time to perform 180° turns as measured by the iTUG test [ 59 ]. In this case study, there was a reduction of 0.11 seconds in both turns after the experimental intervention.…”

Section: Discussionmentioning

confidence: 99%

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report

et al. 2022

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Background Dizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS. Objective The aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention. Methods This case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device. Results After implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16% in the physical health area at T2; 33.56% in the mental health area at T2). The patient rated the usability of the system as 90%, based on the System Usability Scale, and gave the system a grade of A. Conclusions Although further research is needed, this study provided initial evidence that the first VRi vestibular protocol for the MS population can improve dizziness, balance, gait, impact of fatigue, quality of life, and muscular tone through an exergame intervention. This study may help establish a standardized VRi protocol for vestibular rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report

et al. 2022

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Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report (Preprint)

García-Muñoz¹,

Cortés-Vega²,

Hernández‐Rodríguez³

et al. 2021

Preprint

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BACKGROUND Background: Dizziness and imbalance are common and disabling symptoms in multiple sclerosis (MS) patients caused by a central, peripheral or mixed vestibulopathy. Central vestibular disorder is the most frequent report in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and its repercussions in quality of life. However, immersive virtual reality (VRi) is a growing tool in this fieldwork, but no previous research has been performed studying its effects in MS. OBJECTIVE Objective: To apply a VRi vestibular training protocol in a patient with MS and assess the effects induced by the experimental intervention. METHODS Methods: Case study of a 54-year-old woman with relapsing remitting multiple sclerosis (RRMS). We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold standard vestibular training of Cawthorne-Cooksey. The 20 session intervention is formed of 10 initial sessions and 10 advanced sessions. Each 50 minute session will be performed 3 times per week for 8 weeks. Four evaluations were carried out over the study period: at baseline (T0), between the two intervention phases (T1), at the end of the intervention and at the one month follow-up (T3). The outcomes of the research were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone and usability of HMD. RESULTS Results: The patient improved DHI (T0=62 points/T2=4), BBS (T0=47/T2=54), iTUG (T0=8.35 sec/T2=5.57 sec), muscular tone of the erector spinae, rectus femoris and soleus, MFIS (T0=61/T2=37) and MSQoL-54 (T2 physical area=67.16%; T2 mental area= 33.56%) after receiving the VRi vestibular protocol. System Usability Scale reached 90% of usability and A grade. CONCLUSIONS Conclusions: This research provided evidence of the first VRi vestibular protocol in the MS population to improve dizziness, balance, gait, impact of fatigue and quality of life and muscular tone through an exergame intervention. This study may help to set a standardized VRi protocol for vestibular rehabilitation.

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Vestibular physical therapy improves turning not straight walking during the inertial sensor-instrumented Timed Up and Go test

Cited by 2 publications

References 41 publications

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report

Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report (Preprint)

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