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VR and Orthoses for Rehabilitation in Multiple Sclerosis (VIRTUE)

A

Azienda Usl di Bologna

Status

Begins enrollment in 1 month

Conditions

Multiple Sclerosis

Treatments

Other: VR and walking brace-based gait rehabilitation

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

This non-drug, non-medical device, interventional study explores the feasibility of integrating virtual reality (VR) with wearable sensors to support gait training using a passive orthosis in individuals with multiple sclerosis (MS). The aim is to determine whether this approach can enhance clinical gait assessment and facilitate orthosis adaptation by replicating real-life scenarios within a safe and controlled environment. The virtual environment, accessed through a head-mounted display, will be delivered via a custom simulator incorporating standardized gait tasks embedded in everyday settings. This system is designed to minimize the artificial influence of clinical settings on walking performance, while providing clinicians with objective gait data for more comprehensive evaluation.

Full description

Patients with multiple sclerosis (MS) often experience significant gait impairments that impact their autonomy and overall quality of life. One of the primary rehabilitation strategies involves the use of walking braces. While these orthotic devices can support ambulation, their effective integration into daily life typically requires a period of adaptation and specific training. Traditionally, gait training and orthosis prescription occur in clinical settings, which may not fully reflect the real-world challenges that patients encounter. Moreover, current clinical assessments rely primarily on subjective observations and standardized scales, which may lack the sensitivity and objectivity needed to capture the full complexity of gait performance.

virtual reality (VR) offers a promising opportunity to simulate realistic walking environments in a controlled and safe setting, such as an outpatient clinic, potentially enhancing the outcomes of gait rehabilitation. Another promising technology in this domain is the use of wearable inertial sensors, which have been shown to effectively measure gait and postural parameters in people with MS. A further challenge associated with the use of orthotic devices is the physical and psychological stress they may cause, which can lead patients to discontinue their use. To evaluate such discomfort more objectively, recent studies have explored the use of physiological signal analysis and machine learning (ML) algorithms as an alternative or complement to self-reported questionnaires.

The integration of VR with wearable inertial and physiological sensors may allow for a more comprehensive and objective assessment of a patient's adaptation to walking braces. However, no validated system currently exists that combines these technologies for gait assessment and training with passive orthoses in people with MS.

The VIRTUE study aims to address this gap by developing and evaluating a VR-based platform (VIRTUE4MS) that replicates real-life scenarios, such as navigating through a museum, park, or grocery store, and enables standardized gait assessments within immersive environments. The system will employ both inertial and physiological wearable sensors to gather data on gait dynamics and user experience, ultimately supporting clinical decision-making regarding orthotic use. In this study, 12 patients with MS will perform walking and balance tasks over three sessions (T1, T2, T3), both with and without the Exoband brace, in VR and real-world conditions. Ultimately, this study seeks to explore an innovative, technology-supported approach to orthosis assessment and gait training that could complement traditional clinical tools and contribute to more effective, personalized rehabilitation strategies for individuals with MS.

Enrollment

12 estimated patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Confirmed diagnosis of multiple sclerosis
  • Age between 18 and 65 years
  • Both sexes
  • Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS > 100)
  • Expanded Disability Status Scale (EDSS between 3 and 6 inclusive)
  • Berg Balance Scale (BBS ≥ 46)
  • Indication for the use of the Exoband orthosis for gait assistance
  • Modified Fatigue Impact Scale (MFIS) physical subscale ≤ 20
  • Signed informed consent

Exclusion criteria

  • Presence of severe or current visual or auditory impairments
  • Relapses within the last 3 months
  • Presence of severe anxiety or depression
  • Severe spasticity patterns in the lower limbs or fixed distal tendon contractures
  • Presence of motion sickness symptoms induced by virtual reality (VR)

Trial design

Primary purpose

Screening

Allocation

N/A

Interventional model

Single Group Assignment

Masking

None (Open label)

12 participants in 1 patient group

VR - Multiple Sclerosis
Other group
Description:
Twelve adults with multiple sclerosis who require a walking brace to support ambulation and are compatible with Virtual Reality
Treatment:
Other: VR and walking brace-based gait rehabilitation

Trial contacts and locations

1

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Central trial contact

Loredana Sabattini; Kevin Marcaccini

Data sourced from clinicaltrials.gov

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