Mixed Reality for Upper Limb Rehabilitation in People With Multiple Sclerosis (VIRTUALDOMUS)

Summary

Although virtual reality has attracted the attention of health professionals and neurorehabilitation field, research about mixed reality (MR) in people with neurological disorders, particularly multiple sclerosis (MS), is very limited. Furthermore, to our knowledge, studies about the effects of MR in upper limb (muscle strength and fatigability, coordination and dexterity, functionality and quality of life) in people with MS are nonexistent.

The main objective of our study are:

To know the clinical effects of mixed reality environments and re-training activities linked to their spaces (kitchen, bathroom, living room, bedroom and terrace-garden), designed for the treatment of upper limb impairments in people with MS, in combination with a conventional physiotherapy program, on manipulative skills, functionality and quality of life in people with MS.

The secundary objectives are:

To study the clinical effects on range of motion, muscle strength, coordination and manual dexterity, fatigue, functionality and quality of life in people with MS.

To analyze satisfaction and adherence to treatment, the occurrence of adverse effects and the level of workload perceived by participants.

A double-blind randomized controlled trial is proposed. The sample will be randomly divided into two groups: the experimental group will receive treatment based on mixed reality for MMSS, designed by the research team and using Meta Quest 3.0 glasses, in combination with conventional physiotherapy; and the control group will receive the same conventional therapy. Both groups will receive 2 sessions/week, 60min/session, for 10 weeks. The mixed reality environments to be designed will be a kitchen, a bathroom, a living room, a bedroom and a terrace-garden, with the tasks to be performed in each location. The pre, post-treatment and one-month follow-up outcome measures will be: range of motion, manual grip strength, manual dexterity, fatigue, functionality, quality of life, satisfaction with the technology, adherence, adverse effects and perceived workload. A statistical comparison study will be carried out establishing as an inter-subject factor the group parameter and as intra-subject factors each of the measurements and the treated side.

Conditions

• Multiple Sclerosis

Interventions

OTHER

Conventional Upper Limb Treatment

Control group (CG) will receive two 60-minute sessions per week for a period of ten weeks (a total of 20 sessions per group). The CG will receive a specific conventional physiotherapy intervention by a physiotherapist with expertise in the care of people with MS. This intervention will be based on conventional physiotherapy exercises \[23\], including shoulder, elbow, wrist and finger joint mobilization, forearm and hand muscle strengthening exercises, gross and fine motor work and functional task practice with the aim of mimicking the movements included in the settings specifically designed for the experimental intervention.

OTHER

Experimental intervention with mixed reality

Experimental group will receive the same conventional physiotherapy treatment (40 minutes) in addition to a mixed reality protocol, using Meta Quest 3.0. glasses (20 minutes), by retraining on tasks specifically designed for this project and linked to the specific locations (kitchen, bathroom, living room, bedroom and garden-terrace. The intervention will be carried out by a physiotherapist skilled in the use of the technology. The patient's initial position will be seated facing a table at mid-trunk height, with the elbow at 90° of flexion and the forearm in neutral pronation-supination. The therapist will provide manual assistance as needed, moving to upright-high seated or standing positions as the protocol progresses and as tasks require, and work will be done bilaterally.

Sponsors & Collaborators

• Universidad Rey Juan Carlos

  lead OTHER

Principal Investigators

• Roberto Cano de la Cuerda, PhD · Universidad Rey Juan Carlos

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-01

Primary Completion

2026-12-31

Completion

2027-12-31

Countries

• Spain

Study Locations