31
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The effect of balance training on postural control in people with multiple sclerosis using the CAREN virtual reality system: a pilot randomized controlled trial

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Multiple sclerosis (MS) is a multi-focal progressive disorder of the central nervous system often resulting in diverse clinical manifestations. Imbalance appears in most people with multiple sclerosis (PwMS). A popular balance training tool is virtual reality (VR) with several advantages including increased compliance and user satisfaction. Therefore, the aim of this pilot RCT (Trial registration number, date: ISRCTN14425615, 21/01/2016) was to examine the efficacy of a 6-week VR balance training program using the computer assisted rehabilitation environment (CAREN) system (Motek Medical BV, Amsterdam, Netherlands) on balance measures in PwMS. Results were compared with those of a conventional balance exercise group. Secondary aims included the impact of this program on the fear of falling.

          Methods

          Thirty-two PwMS were equally randomized into the VR intervention group or the control group. Each group received balance training sessions for 6 consecutive weeks, two sessions per week, 30 min sessions. Clinical balance tests and instrumented posturography outcome measures were collected upon initiation of the intervention programs and at termination.

          Results

          Final analysis included 30 patients (19 females, 11 males; mean age, (S.D.) = 45.2 (11.6) years; mean EDSS (S.D.) = 4.1 (1.3), mean disease duration (S.D.) = 11.0 (8.9) years). Both groups showed a main effect of time on the center of pressure (CoP) path length with eyes open (F = 5.278, P = .024), sway rate with eyes open (F = 5.852, P = .035), Functional Reach Test (F = 20.841, P = .001), Four Square Step Test (F = 9.011, P = .031) and the Fear of Falls self-reported questionnaire (F = 17.815, P = .023). In addition, significant differences in favor of the VR program were observed for the group x time interactions of the Functional Reach Test (F = 10.173, P = .009) and fear of falling (F = 6.710, P = .021).

          Conclusions

          We demonstrated that balance training based on the CAREN device is an effective method of balance training for PwMS.

          Related collections

          Most cited references34

          • Record: found
          • Abstract: found
          • Article: not found

          Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review.

          In a recent study of 655 physical therapists working with a stroke population, the Berg Balance Scale (BBS) was identified as the most commonly used assessment tool across the continuum of stroke rehabilitation. Given the widespread popularity of the BBS, it is important to critically appraise the BBS for its use with a stroke population. The purposes of this study were to conduct a systematic review of the psychometric properties of the BBS specific to stroke and to identify strengths and weaknesses in its usefulness for stroke rehabilitation. Twenty-one studies examining the psychometric properties of the BBS with a stroke population were retrieved. Internal consistency was excellent (Cronbach alpha=.92-.98) as was interrater reliability (intraclass correlation coefficients [ICCs]=.95-.98), intrarater reliability (ICC=.97), and test-retest reliability (ICC=.98). Sixteen studies focused on validity and generally found excellent correlations with the Barthel Index, the Postural Assessment Scale for Stroke Patients, Functional Reach Test, the balance subscale of Fugl-Meyer Assessment, the Functional Independence Measure, the Rivermead Mobility Index (except for weight shift and step-up items), and gait speed. Berg Balance Scale scores predicted length of stay, discharge destination, motor ability at 180 days poststroke, and disability level at 90 days, but these scores were not predictive of falls. Eight studies focused on responsiveness; all reported moderate to excellent sensitivity. Three studies found floor or ceiling effects. The BBS is a psychometrically sound measure of balance impairment for use in poststroke assessment. Given the floor and ceiling effects, clinicians may want to use the BBS in conjunction with other balance measures.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Virtual environments for motor rehabilitation: review.

            In this paper, the current "state of the art" for virtual reality (VR) applications in the field of motor rehabilitation is reviewed. The paper begins with a brief overview of available equipment options. Next, a discussion of the scientific rationale for use of VR in motor rehabilitation is provided. Finally, the major portion of the paper describes the various VR systems that have been developed for use with patients, and the results of clinical studies reported to date in the literature. Areas covered include stroke rehabilitation (upper and lower extremity training, spatial and perceptual-motor training), acquired brain injury, Parkinson's disease, orthopedic rehabilitation, balance training, wheelchair mobility and functional activities of daily living training, and the newly developing field of telerehabilitation. Four major findings emerge from these studies: (1) people with disabilities appear capable of motor learning within virtual environments; (2) movements learned by people with disabilities in VR transfer to real world equivalent motor tasks in most cases, and in some cases even generalize to other untrained tasks; (3) in the few studies (n = 5) that have compared motor learning in real versus virtual environments, some advantage for VR training has been found in all cases; and (4) no occurrences of cybersickness in impaired populations have been reported to date in experiments where VR has been used to train motor abilities.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Risk factors for falling among people aged 45 to 90 years with multiple sclerosis.

              To determine the factors associated with an increased likelihood of reporting a fall in the past 6 months among people between the ages of 45 and 90 who have multiple sclerosis (MS). Cross-sectional descriptive design by using telephone surveys. States of Minnesota, Wisconsin, Illinois, Indiana, and Michigan. Total of 1089 people with MS identified through the National Multiple Sclerosis Society and the MS registry maintained by the North American Research Committee on Multiple Sclerosis. Not applicable. Self-reported fall to the ground in the past 6 months. Exactly 52.2% of participants reported a fall in the past 6 months. Factors associated with an increased risk of a fall included being male, fear of falling, variable or deteriorating MS status in the past year, never or occasional use of a wheelchair, problems with balance or mobility, poor concentration or forgetfulness, and incontinence of bladder. There are a number of factors associated with an increased risk of falling among people aging with MS that are amenable to intervention and therefore warrant the attention of health care providers serving that population.
                Bookmark

                Author and article information

                Contributors
                alkalron@gmail.com
                Ilia.Fonkatz@sheba.health.gov.il
                Lior.Frid@sheba.health.gov.il
                Hani.Baransi@sheba.health.gov.il
                Anat.Achiron@sheba.health.gov.il
                Journal
                J Neuroeng Rehabil
                J Neuroeng Rehabil
                Journal of NeuroEngineering and Rehabilitation
                BioMed Central (London )
                1743-0003
                1 March 2016
                1 March 2016
                2016
                : 13
                : 13
                Affiliations
                [ ]Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
                [ ]The Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel
                [ ]The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel-Hashomer, Israel
                [ ]Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
                Article
                124
                10.1186/s12984-016-0124-y
                4772661
                26925955
                58e78d25-7489-4ce0-b836-ab29d6d3fb11
                © Kalron et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 September 2015
                : 11 February 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000890, National Multiple Sclerosis Society (US);
                Award ID: PP2208
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Neurosciences
                multiple sclerosis,balance,postural control,virtual reality,caren
                Neurosciences
                multiple sclerosis, balance, postural control, virtual reality, caren

                Comments

                Comment on this article