Effects of a 6-Week Treadmill Training With and Without Virtual Reality on Frailty in People With Multiple Sclerosis
Year: 2024
Type: article
Abstract: Objective To examine the effects of a cognitive-motor rehabilitation program consisting of treadmill training (TT) augmented by virtual reality (TT+VR) on frailty in people with multiple sclerosis (pwMS). Design Secondary analysis from a multicenter randomized controlled trial investigating the effects of TT+VR, compared with TT only, on measures of mobility and cognitive function in pwMS. Setting Four university research laboratories in 3 countries. Participants A total of 124 pwMS were randomized into the parent trial. Here, we studied a subset of n=83 participants (mean age, 49.4±9.3y; 73.5% female; expanded disability status scale range, 2.0-6.0), who completed the intervention and had complete preintervention and postintervention frailty data. Interventions Participants were randomly allocated to TT+VR (n=44) or TT (n=39). Both groups trained 3 times a week for 6 weeks. Main Outcome Measures Frailty was assessed using a 40-item frailty index (FI) through standard validated procedures and represented the primary study outcome. Two exploratory frailty indices were also computed by isolating health-related deficits involving the cognitive (FI-physical) or physical (FI-cognitive) domains from the main FI. The assessments were performed at baseline and after 6 weeks, upon intervention completion. Results The mean FI of study participants at baseline was 0.33±0.13, indicating a moderate average level of frailty. FI scores improved in both TT+VR and TT groups participants (pooled mean ΔFI, 0.024; 95% CI, 0.010-0.038; F=10.49; P= .002; η p 2 =0.115), without any group-by-time interaction (F=0.82; P= .367; η p 2 =0.010 ) . However, a significant group-by-time interaction was found for pretraining and posttraining changes in FI-cognitive (F=5.74; P= .019; η p 2 =0.066), suggesting a greater improvement for TT+VR group participants than for TT group participants. Conclusions TT with or without virtual reality can reduce frailty levels in pwMS. While both TT and TT+VR had a positive effect on overall frailty, only TT+VR improved cognitive aspects of frailty and may represent an appropriate strategy for counteracting frailty in pwMS.
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
Funders: National Multiple Sclerosis Society, Sanofi, Biogen, Alexion Pharmaceuticals, Celgene, European Federation of Pharmaceutical Industries and Associations, Union Chimique Belge, Multiple Sclerosis Society, European Commission, Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, Innovative Medicines Initiative, National Institutes of Health, Genentech, Sanofi Genzyme, National Institute on Aging, National Institute on Disability, Independent Living, and Rehabilitation Research
OpenAlex ID: W4402858540