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Abstract
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Background Multiple sclerosis (MS) is the most common disabling disease of CNS among young adults. Pain is a common symptom among people with MS (pwMS). Despite a wide range of pain management interventions that have been applied in pwMS, still many of them are experiencing moderate to severe pain sometimes during their disease course. The benefits of physical activity for pwMS have been recognized. However, not all of them are able to attend physical activity sessions due to different barriers they may face. In recent years, virtual reality (VR) has become popular in clinical settings as an innovative pain distractor technique that can be used safely at home by pwMS and may propose alternative benefits. GOALS The objective of this study was to investigate the effectiveness of VR intervention (VR) in comparison to combined physical activity & VR training (PA&VR), physical activity alone (PA), and no training in reducing pain in pwMS. METHODS This was a randomized controlled trial (RCT). Sixty women with MS (EDSS < 4) were randomized to one of the VR (Nintendo Wii), PA, PA&VR, or control groups (15 per each group). The experimental groups performed the assigned intervention for 12 weeks (2 sessions per week, each 40 minutes). Outcomes included bodily pain intensity (pain subscale of RAND-36), pain severity (0-10 NRS), pain distribution (Margolis drawing rating system), and pain duration and frequency measured at baseline and 12 weeks later. Fatigue (Vitality subscale of RAND-36), MS severity (EDSS) and mood (0-10 NRS) were considered as explanatory variables. RESULTS The mean age of participants was 43 ± 6.2 and mean years since diagnosis was 5.6± 9.0 years. The majority of participants (82%) were in relapsing-remitting course of MS. There were significant differences among study groups on pain related outcomes (p< 0.05) except for pain frequency. The post hoc analysis further showed that the PA&VR did better in all pain related outcomes followed by either PA or VR.
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