Objective: To assess the benefits of vestibular rehabilitation (VR) with virtual reality as a therapeutic tool in individuals with Hereditary Spastic Paraplegia (HSP), comparing two randomized groups: the Balance Group (BG) and the Strength Group (SG).

Background: The HSP is a neurodegenerative disease characterized by weakness and spasticity of the lower limbs.

Method: This is an experimental randomized clinical trial, registered on the Rebec Platform, involving 16 adult patients with HSP, regardless of type (pure or complicated) of both sexes, randomly allocated to two groups: BG and SG. Patients underwent medical history, otorhinolaryngological, and labyrinthine evaluations. Subsequently, assessments were conducted using the Lafayette Dynamometer and questionnaires: QoL-bref (Quality of Life), ABC (Confidence Scale), EVA (Pain Assessment) at three time points: T0 (before starting VR rehabilitation), T1 (after 10 sessions), and T2 (after 20 sessions).

Results: The QoL questionnaire showed significant differences when comparing T0, T1, and T2 in SG for the physical (p ≤ 0.008), psychological (p ≤ 0.009), environmental (p ≤ 0.015), and overall (p ≤ 0.003). Changes in peak force and average force in hip abduction were observed in BG (p ≤ 0.006 and p ≤ 0.01), and for dorsiflexors in BG (p ≤ 0.041). There were no significant changes for ABC and EVA scales. Comparing T1 and T2 virtual reality game scores, highly significant differences were found (p ≤ 0.005) for both BG and SG for all games used.

Conclusion: Patients allocated to SG showed better results in the QoL questionnaire after rehabilitation. The QoL questionnaire contributed to quantifying the effect of the applied therapy and its impact on the daily activities of HSP patients. The dynamometer was easy to use despite lower limb spasticity, but torque, specific gait evaluations, and comparison with spasticity assessment scales would be necessary in future studies to quantify real strength gain and gait conditions. The scores of all games demonstrated improvement in patients, who reported this therapy as a positive experience. Vestibular rehabilitation with virtual reality is easy to use and safe during sessions; however, future research with HSP patients is crucial to assess the effects of long-term training and a larger sample size, encouraging the evaluation of other physical, psychological, and social variables in this population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/virtual-reality-in-patients-with-hereditary-spastic-paraplegia/