Title: Influence of Interactive Therapy on Improving Balance Outcomes in Patients with Multiple Sclerosis
Authors: Wanees M Badawy, Hoda M Zakaria, Bassam A El-Nassag
DOI: http://dx.doi.org/10.18535/jmscr/v3i12.43
Background: Multiple sclerosis (MS) is a chronic progressive auto-immune disease that results in demyelination of the central nervous system. The symptoms and complications in addition to impairments and disability in MS patient often reduce the balance outcomes. Purpose: To determine the influence of using the Wii interactive video game as a treatment program to improve the balance outcomes in MS patient. Materials and methods: Thirty MS patients were randomly allocated to two equal groups. The control group received a traditional balance program for 45 minutes and the study group received a virtual reality rehabilitation based on the Nintendo® Wii Balance Board® (WBB) for 30 minutes in addition to the balance exercises given to the control group. The training was three times per week for 4 successive weeks. The outcome measures: Berg Balance Scale (BBS), Timed Up and Go test (TUG), the overall dynamic limits of stability measured by the Biodex Balance System, and the Activities-Specific Balance Confidence Scale (ABC). Results: There was an improvement in all measures in both groups. But the improvement in the balance outcomes was more in the study group. Conclusion: Wii rehabilitation appears to be a useful tool in improving balance outcomes in MS. Further studies have to be carried out to assess the retention of results and generalization. Keywords: Multiple sclerosis, Balance, Wii interactive video game 1. Plow M, Finlayson M, Motl RW, Bethoux F. Randomized controlled trial of a teleconference fatigue management plus physical activity intervention in adults with multiple sclerosis: rationale and research protocol. BMC Neurol. 2012: Oct 16: 12:122. 2. Induruwa I, Constantinescu CS, Gran B. Fatigue in multiple sclerosis - a brief review. J Neurol Sci. 2012: Dec 15: 323(1-2):9-15. 3. Cameron MH, Lord S. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neuro Sci Rep. 2010: Sep 10(5):407-12. 4. Cattaneo D, Jonsdottir J, Zocchi M, Regola A. Effects of balance exercises on people with multiple sclerosis: a pilot study. ClinRehabil. 2007: Sep 21(9):771-81. 5. Gardner B. Effectiveness of The Nintendo® Wii Fit™ Games on The Balance of a Community-Dwelling Older Adult in Eastern North Carolina. Unpublished master's thesis, East Carolina University, Department of Occupational Therapy. 2011 Jun. 6. Deutsch JE, Borbely M, Filler J, et al. Use of a low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy. PhysTher 2008: 88: 1196–07. 7. Herz NB, Mehta SH, Sethi KD, Jackson P, Hall P, Morgan JC. Nintendo Wii rehabilitation ("Wii-hab") provides benefits in Parkinson's disease. Parkinsonism Relat Disord. 2013 Nov: 19(11): 1039-42. 8. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology.1983: 33(11):1444–52. 9. Pangman VC, Sloan J, Guse L. An Examination of Psychometric Properties of the Mini-Mental State Examination and the Standardized Mini-Mental State Examination: Implications for Clinical Practice. Applied Nursing Research. 2000: 13 (4): 209–213. 10. Cattaneo D, Regola A, Meotti M. Validity of six balance disorders scales in persons with multiple sclerosis. Disabil Rehabil. 2006: Jun 30: 28(12):789-95. 11. Cattaneo D, Jonsdottir J, Repetti S. Reliability of four scales on balance disorders in persons with multiple sclerosis. Disabil Rehabil. 2007: Dec 30;29(24):1920-5. 12. Nilsagård Y, Carling A, Forsberg A. Activities-specific balance confidence in people with multiple sclerosis. Mult Scler Int. 2012:613925. doi: 10.1155/2012/613925. Epub 2012 Aug 7. 13. Perron M, Hébert LJ, McFadyen BJ, Belzile S, Regniére M. The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain. Clin Rehabil. 2007: Jan 21(1): 73-81. 14. Miller WC, Deathe AB, Speechley M. Psychometric properties of the Activities-specific Balance Confidence Scale among individuals with a lower-limb amputation. Arch Phys Med Rehabil. 2003: May 84(5): 656-61. 15. Whitehead C, Miller M, Crotty M. Falls in community-dwelling older persons following hip fracture: impact on self-efficacy, balance and handicap. Clin Rehabil. 2003: Dec 17(8): 899-906. 16. Bayouk JF, Boucher JP, Leroux A. Balance training following stroke: effects of task-oriented exercises with and without altered sensory input. Int J Rehabil Res. 2006: 29: 51-9. 17. Gil-Gómez JA1, Lloréns R, Alcañiz M, Colomer C. Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. J Neuroeng Rehabil. 2011: May 23: 8:30. doi: 10.1186/1743-0003-8-30. 18. McGough R, Paterson K, Bradshaw E, Bryant A, Ross C. The Use Of Nintendo Wii Balance Board For Real-Time Investigation Of Weight Bearing Asymmetry. Portuguese Journal of Sport Sciences. 2011:11 (Suppl.2). 19. Bieryla KA, Dold NM. Feasibility of Wii fit training to improve clinical measures of balance in older adults. Clin Inter Aging. 2013: 8: 775-81. 20. Stuifbergen AK, Blozis SA, Harrison TC, Becker HA. Exercise, functional limitations, and quality of life: a longitudinal study of persons with multiple sclerosis. Arch Phys Med Rehabil. 2006: Jul 87(7):935-43.Abstract
References