Comparison of the effects of two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis: A randomized controlled trial

Background: Balance disorders, fatigue, and walking impairments are the most common symptoms of multiple sclerosis (MS), which lead to a decrease in quality of life. To cope with these disability-increasing symptoms, it is important to select and regularly apply appropriate rehabilitation approaches. In recent years, virtual reality approaches have been suggested as a potentially useful tool in rehabilitation. Exergaming systems are used in the treatment of symptoms associated with MS, but there are few randomized controlled studies investigating the efficacy of these systems. Objective: To investigate and compare the effects of exercise training with two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis (PwMS). Methods: Forty-seven volunteer PwMS were included in the study and randomized to the group I (Nintendo Wii Fit), group II (Balance Trainer), and group III (control group). The participants in the study groups underwent an exercise program under the supervision of a physiotherapist on 2 days a week for 8 weeks. Outcome measures were the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Six-Minute Walk Test (6MWT), Fatigue Severity Scale (FSS), and Multiple Sclerosis International Quality of Life Questionnaire (MusiQol), which were performed before and after the treatment. Results: Forty-two participants completed the study protocol. All parameters evaluated in group I and II showed statistically significant improvement after treatment. Changes in all outcome measures were found to be superior in group I compared with group III. Similarly, all measures except the 6MWT were found to be superior in group II compared with group III. Changes in BBS and MusiQol were found to be superior in group I compared with group II. Conclusion: In comparison with no intervention, exergaming with Nintendo Wii Fit and Balance Trainer improves balance, increases functionality, reduces fatigue severity, and increases quality of life in PwMS.