An innovative training program based on virtual reality and treadmill: effects on gait of persons with multiple sclerosis.
In this single blind randomized controlled trial, we examined the effect of a virtual reality-based training on gait of people with multiple sclerosis.



Twenty-five individuals with multiple sclerosis with mild to moderate disability were randomly assigned to either the control group (n = 11) or the experimental group (n = 14). The subjects in the control group received treadmill training. Subjects in the experimental group received virtual reality based treadmill training. Clinical measures and gait parameters were evaluated.



Subjects in both the groups significantly improved the walking endurance and speed, cadence and stride length, lower limb joint ranges of motion and powers, during single and dual task gait. Moreover, subjects in the experimental group also improved balance, as indicated by the results of the clinical motor tests (p < 0.05). Between-group comparisons revealed that the experimental group improved significantly more than control group in hip range of motion and hip generated power at terminal stance at post-training.



Our results support the perceived benefits of training programs that incorporate virtual reality to improve gait measures in individuals with multiple sclerosis. Implication of rehabilitation Gait deficits are common in multiple sclerosis (85%) and worsen during dual task activities. Intensive and progressive treadmill training, with and without virtual reality, is effective on dual task gait in persons with multiple sclerosis. Virtual reality-based treadmill training requiring obstacle negotiation increases the range of motion and the power generated at the hip, consequently allowing longer stride length and, consequently, higher gait speed.
a Information Engineering Unit, POLCOMING Department , University of Sassari , Sassari , Italy.|b Interuniversity Center of Bioengineering of the Human Neuromusculoskeletal System , Sassari , Italy.
Agnese
A
Peruzzi
c Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
Ignazio Roberto
IR
Zarbo
a Information Engineering Unit, POLCOMING Department , University of Sassari , Sassari , Italy.|b Interuniversity Center of Bioengineering of the Human Neuromusculoskeletal System , Sassari , Italy.
Andrea
A
Cereatti
a Information Engineering Unit, POLCOMING Department , University of Sassari , Sassari , Italy.|b Interuniversity Center of Bioengineering of the Human Neuromusculoskeletal System , Sassari , Italy.
Ugo
U
Della Croce
d Laboratory for Gait Analysis & Neurodynamics, Movement Disorders Unit, Department of Neurology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel.
Anat
A
Mirelman
D000328:Adult; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007558:Italy; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D063367:Virtual Reality Exposure Therapy
Rehabilitation; dual task; gait; joint kinematics; joint kinetics; virtual reality