Motor and cognitive effects of video game training in people with multiple sclerosis: a randomized controlled trial

BACKGROUND Dual-task activities are frequently impaired in people with MS (PwMS), with a high impact on daily life activities. Exergaming may represent a valuable treatment for dual-task abilities as it involves motor and cognitive task. AIM To evaluate whether a video game training (VGT) improves mobility, balance, cognitive functions, and dual tasking more than a standardized balance platform training (BPT). DESIGN Single-blinded, randomized control trial. SETTING Outpatient. POPULATION People with multiple sclerosis (PwMS). METHODS Forty-eight PwMS were allocated to either VGT or BPT group. VGT was delivered using a commercially available video game console, BPT using a rehabilitative balance platform. Both groups received twelve 1-hour sessions over four weeks. All subjects were evaluated before (T0), after treatment (T1) and at the three-month follow-up (T2). The primary outcome was functional mobility assessed with the Timed Up and Go test. Secondary outcomes included balance, patient-reported measures, cognitive functions, and posturographic assessment in single and dual-task condition. RESULTS Mobility significantly improved after treatment in the BPT group. Fatigue and perceived walking ability improved after treatment only in the VGT group. Both treatments significantly improved static and dynamic balance (after treatment and at the three-month follow-up) and quality of life (after treatment). Between-group analysis revealed a significant improvement in reaction time only in people who received VGT. CONCLUSIONS Both VGT and BPT were effective in improving balance and quality of life in PwMS. Although no changes in dual-task performance were observed, VGT led to specific improvements in attentional performance. CLINICAL REHABILITATION IMPACT Video game rehabilitation may offer a useful and engaging option for improving balance, quality of life, and attention in PwMS. As no improvements were found in dual-task performance, longer-term studies are needed before conclusions can be drawn about its broader rehabilitative impact.