Comparative effects of sensory motor and virtual reality interventions to improve gait, balance and quality of life MS patients

Abstract

Multiple sclerosis (MS) is a neurological disorder that affects the central nervous system, causing inflammation and damage to the myelin sheath, leading to balance and gait impairments. Sensorymotor (SN) and virtual reality (VR) interventions have shown promise in addressing these balance issues by engaging all three components of the balance control systems. This study aimed to compare the effectiveness of sensory-motor and virtual reality training on the functional status and quality of life of MS patients. In this study, 36 MS patients receiving Rituximab therapy with an Expanded Disability Status Scale (EDSS) of 2 to 6 were randomly assigned to three groups: SN (n=10), VR (n=8), and a control group (n=10). The SN and VR groups underwent 8 weeks of intervention, with 3 sessions per week, while the control group continued routine care. Assessments using the Timed Up and Go (TUG) test, the Timed 25-Foot Walk (T25FW) test, the Multiple Sclerosis Quality of Life 54 Instrument (MSQOL54), and the Pittsburgh Sleep Quality Index (PSQI) were conducted at baseline and after 8 weeks. Significant within-group improvements were observed in both SN and VR groups for primary outcomes, including the T25FW (P=0.002 for SN; P=0.001 for VR) and TUG (P=0.005 for SN; P=0.001 for VR), as well as secondary outcomes such as overall (P<0.001 for both), physical (P<0.001 for both), and mental (P<0.001 for both) MSQOL-54 components, and PSQI (P<0.001 for SN; P=0.046 for VR). However, no significant differences emerged between SN and VR groups for primary outcomes, except for PSQI, which favored SN (P=0.02). Compared to the control group, the SN group demonstrated significant improvements in primary outcomes—T25FW (P<0.001) and TUG (P=0.01)—and secondary outcomes, including overall (P<0.001), physical (P<0.001), and mental (P=0.002) MSQOL-54 components, and PSQI (P=0.007). Similarly, compared to the control group, the VR group demonstrated significant improvements in the T25FW (P=0.02) and TUG (P=0.05) tests, as well as in secondary outcomes, including overall (P=0.005), physical (P=0.003), and mental (P=0.01) MSQOL-54 components. However, no significant improvement in PSQI was observed (P=0.9). This study highlights the significant transformative potential of integrating VR and SN interventions as innovative therapeutic modalities for addressing critical motor impairments, specifically balance and gait, in individuals with MS. By employing task-oriented paradigms, dual-task methodologies, and multisensory frameworks, these interventions not only yield substantial improvements in functional mobility and quality of life but also represent a groundbreaking synthesis of immersive, technologydriven motivation with the pragmatic adaptability of evidence-based SN techniques. Further longitudinal investigations are warranted to delineate their sustained effects, refine their application in broader MS populations, and assess their scalability to establish patient-centered, cost-effective, and outcome-driven neurorehabilitation models.