Conventional Vestibular Training Versus Immersive Virtual Reality- Based Vestibular in Multiple Sclerosis
Multiple Sclerosis, Vestibular Disease, Dizziness
About this trial
This is an interventional treatment trial for Multiple Sclerosis
Eligibility Criteria
Inclusion Criteria:
- Both male and female subjects from 18-65 years old
- Clinically diagnosed with any type of multiple sclerosis in accordance with the revised McDonald criteria
- With walking ability according to the Expanded Disability Status Scale score (EDSS =6)
- With the objective presence of dizziness symptoms (Dizziness Handicap Inventory = 16)
Exclusion Criteria:
- Blurred vision
- Cognitive impairment (Mini Mental State Examination =24)
- Another neurologic disorder contributing to balance impairment
- Relapse within the last 3 months
- Changes in pharmacotherapy within the last 3 months
- History of vestibular rehabilitation within the last 6 months
- Acute cardiovascular of respiratory illness
- Any other contraindication to physical activity
Sites / Locations
- Universidad de Sevilla
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Immersive virtual reality-based vestibular training.
Conventional vestibular training.
Subjects in this group will receive the same intervention than the other group of study, but they will wear a 3D head mounted display (Oculus Quest glasses) and will receive real-time gaming feedback in terms of visual and audio output while using the training system. Participants will receive a total of 20 sessions (3 sessions of 50 minutes per week, 7 weeks). These sessions will be divided in 10 initial sessions (based on the three first blocks of Cawthorne-Cooksey protocol) and 10 advanced sessions in which vestibular exercises are gradually get more complicated by modifiying the following exercise parameters: base of support width, standing on unstable surface, alternatives single leg support, tandem position, increased velocity of head movements, higher head range motion and coordinated movements with arms and trunk. Same location, tailoring parameters and physical therapist supervision than conventional vestibular training.
Subjects in the control group will receive a total of 20 sessions of 50 minutes (3 sessions per week, 7 weeks). They will receive traditional "Cawthorne-Cooksey" vestibular rehabilitation exercises. This program improves vestibular compensation through a mechanism of neuroplasticity known as adaptation, habituation and substitution. Just like the virtual reality intervention it will be divided in 10 initial sessions and 10 advanced sessions. For the advanced phase of intervention exercises parameters were the same described for the virtual vestibular rehabilitation intervention. A physical therapy with at least two years of expertise in vestibular rehabilitation will adjust the difficulty level. The intervention will be conducted at the Physical Therapy Department of the University of Sevilla (Spain).