title: A telerehabilitation program by virtual reality-video games improves balance and postural control in multiple sclerosis patients.
abstract: BACKGROUND
  Balance and postural control (PC) disorders are frequent motor disorder symptoms associated with multiple sclerosis (MS).
  
  
  OBJECTIVE
  To demonstrate the potential improvements in balance and PC among patients with MS who complete a virtual reality telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available.
  
  
  METHODS
  50 patients was recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received telerehabilitation treatment using the Xbox 360® console monitored via videoconference. Experimental group attended 40 sessions, four sessions per week (20 min per session). The treatment schedule lasted 10 weeks for both groups. A computerised dynamic posturography and clinical outcomes (Berg Balance and Tinettti scales) were used at baseline and at the end of the treatment.
  
  
  RESULTS
  Results showed an improvement over general balance in both groups. Visual preference, the contribution of vestibular information, mean response time and Tinetti test yielded significant differences in the experimental group. An ANOVA revealed significant between-group post-treatment differences in the composite equilibrium score, Berg and Tinetti scales in the experimental group.
  
  
  CONCLUSIONS
  We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Rosa Ortiz
authors.initials: RO
authors.lastname: Gutiérrez
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Galán Del Río
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cano de la Cuerda
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Alguacil Diego
authors.affiliation: Demyelinating Diseases Unit, Neurology Service, Clínico San Carlos University Hospital, Madrid, Spain.
authors.forename: Rafael Arroyo
authors.initials: RA
authors.lastname: González
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain RehabilitationService, Fuenlabrada University Hospital, Madrid, Spain.
authors.forename: Juan Carlos Miangolarra
authors.initials: JC
authors.lastname: Page
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000628:therapy*; D004856:Postural Balance / Q000502:physiology*; D012678:Sensation Disorders / Q000209:etiology / Q000534:rehabilitation*; D017216:Telemedicine; D016896:Treatment Outcome; D018910:Video Games; D063367:Virtual Reality Exposure Therapy / Q000295:instrumentation*; D055815:Young Adult
keywords: Balance; multiple sclerosis; telerehabilitation; video games; virtual reality