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Video Games Therapy on Balance and Cognitive Functions in Mild to Moderate Impaired Multiple Sclerosis Patients.

Not Applicable
Completed
Conditions
Multiple Sclerosis
Registration Number
NCT03353974
Lead Sponsor
University Hospital of Ferrara
Brief Summary

Multiple Sclerosis (MS) is often characterized by the presence of balance and cognitive impairments. Cognitive functions play a key role in balance control. Simultaneously performing cognitive tasks decreases walking and balance ability (Dual-Task cost). Rehabilitative treatment of patients with MS does not have to consider separately the motor and cognitive aspects. Video-Game Therapy (VGT) is a novel tool that allows a multimodal training approach. VGT typically provides augmented feedback during training that can contribute to learning motor skills. The main objective of this exploratory study will be to test the effects of a commercially available VGT on balance and cognitive function in ambulatory MS patients compared to a standardized balance platform training (BPT). Secondary, we will explore the effects of VGT and BPT on other domains that are usually impaired in MS population and that can be improved by motor rehabilitation, such as psychological well-being, fatigue and Quality of Life.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  • diagnosis of MS (primary or secondary progressive, relapsing-remitting), without relapses in the preceding 3 months
  • mild to moderate balance impairments with increased fall risk, defined as TUG > 8.4s
  • disability rate definited by Kurtzke Expanded Disability Status Scale (EDSS) score from 4 to 5.5,
Exclusion Criteria
  • other conditions that may affect motor function
  • impaired cognitive functioning (Mini Mental Status Examination score less than 24)
  • visual impairments (daltonism and visual acuity deficit)
  • medical conditions that might interfere with the ability to complete the study protocol safely.

A group of healthy subjects matched for age and sex will be involved for a comparison on the instrumental data (force platforms).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Timed Up and Go (TUG) testChanges from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

TUG measures balance and functional mobility.

Secondary Outcome Measures
NameTimeMethod
Beck Depression Inventory-Second Edition (BDI-II)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

This is a 21-item self-report instrument that serves to assess depression severity

Dynamic Gait Index (DGI)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

Clinical tool to assess gait, balance and risk of fall.

Modified Fatigue Impact Scale (MFIS)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

Questionnaire which evaluates the perceived impact of fatigue on the subscales physical, cognitive and psychosocial functioning.

Multiple Sclerosis Walking Scale-12 (MSWS-12)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

This questionnaire assesses the impact of MS on walking ability.

Multiple Sclerosis Impact Scale-29 (MSIS-29)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

This is an health-rated quality of life questionnaire that assesses the impact of MS on physical and psychological functions.

Go-No Go - Test of Attentional Performance T.A.P.Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

Go-No Go task examine the specific capacity to suppress an inadequate reaction.

Symbol Digit Modalities Test (SDMT)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

The SDMT consists of orally substituting a number for a pseudorandom sequence of geometric figures as quickly as possible for testing executive functions.

Four Square Step Test (FSST)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

The FSST is a timed test, intended to challenge the rapid change in direction while stepping forward, backward and sideways over a low obstacle.

Functional Reach Test (FRT)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

The FRT assesses the subject's stability by measuring the maximum distance an individual can reach forward while standing in a fixed position.

Instrumented Basic Balance Evaluation (IBBE)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

Force platform measurement are used as objective markers of subjects' balance ability.

State Trait Anxiety Inventory (STAI-Y)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

STAI-Y is an easy-to-use and interpretative tool to detect and measure anxiety.

Stroop Color-Word Test (SCWT)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

The SCWT explores sustained attention and some aspects of executive function.

Test of Attentional Performance T.A.P.Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

In this task divided attention can be explored with computerized "dual-task" test where two stimuli (visual and acoustic) are required simultaneously

Instrumented Dual Task (IDT)Changes from baseline to end of treatment (4 weeks), following changes after 12 weeks follow up

Dual cognitive-motor tasks are often used in clinical practice to evaluate the interaction between patients' cognitive and motor ability .

Trial Locations

Locations (2)

Sofia Straudi

🇮🇹

Ferrara, Emilia Romagna, Italy

Ferrara University Hospital

🇮🇹

Ferrara, Italy

Sofia Straudi
🇮🇹Ferrara, Emilia Romagna, Italy

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