Multiple Sclerosis Clinical Trial
Official title:
Innovative Low-cost Solutions Based on Virtual Reality for Upper Limb Home-based Rehabilitation in Multiple Sclerosis
This study is aimed to test the efficacy and feasibility of an immersive virtual reality (VR)
rehabilitation programs to improve upper-limb motor functions in 24 patients with multiple
sclerosis (pwMS), characterized by moderate to severe upper-limb motor dysfunctions. In
particular, this study will evaluate the efficacy of VR as novel opportunities to increase
treatment engagement and rehabilitation effects.
The effectiveness of the rehabilitation program will be assessed using both clinical tests
and state-of-the art motion capture system for human movement analysis.
Recent studies highlighted the high social and economic burden of rehabilitation in multiple
sclerosis (MS); in fact its cost is approximately 27% of the overall expenses supported by
the national health system. In particular, it has been shown that the physical rehabilitation
is effective in treating functional impairments associated to gait, balance and daily life
activitites. However, most rehabilitative treatments are performed at hospital or in
specialized centers, and this is a factor which strongly reduces the persistence of the
positive effects in the long-term.
In this context, it appears important to highlight that rehabilitative treatments are often
focused on lower limbs functional impairments, while upper limbs dysfunctions seem less
considered although approximately 50% of pwMS complain about issues like reduction of manual
dexterity and fine motor abilities as well as movements' slowness. Moreover, significantly
lower is also the number of the studies focused on upper limbs rehabilitation, if compared to
those about walking or balance and also if compared with upper limbs studies in other
neurologic diseases like stroke.
A support in overcoming such issues might be provided by the adoption of low-cost devices
originally designed for entertainment purposes (e.g. Nintendo Wii or Microsoft Kinect) which
have been shown effective in improving some aspects of disability. Nevertheless, while
rehabilitation protocols which make use of such system often relies on software designed for
healthy individuals, it should be essential to have available routines specifically designed
for the MS needs.
On the basis of these considerations, this project intends to design, develop and test an
innovative low-cost hardware/software platform for home-based upper limbs rehabilitation
based on virtual reality.
In particular, the software will reproduce scenarios of actual daily living activities with
increasing complexity to ensure a good degree of transferability of the training into real
life.
The strength of this approach lies basically on three factors:
1. Use of commercial low-cost VR systems (e.g. Oculus Rift)
2. Use of public domain software for the Virtual Reality package (i.e. Unity 3D)
3. Availability of kinematic data derived from the analysis of the hand trajectories, which
allow clinicians to characterize the performance of the participants as well as his/her
progresses The effectiveness of the platform will be tested in laboratory using
state-of-the-art motion capture system for human movement analysis.
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