Mixed Reality for Upper Limb Rehabilitation in People With Multiple Sclerosis (VIRTUALDOMUS)

MS is a neurological pathology that currently affects approximately 36 people per 100,000 inhabitants (2.8 million people affected in the world) and has various clinical manifestations, such as alterations in balance and coordination, fatigue or alterations in sensitivity, with alterations in the motor control of the MMSS being one of the main problems faced by people with MS from the time of diagnosis, the main consequence of which is an alteration in their ability to perform ADLs, reducing their quality of life. Although new drugs aimed at modifying the course of the disease have appeared in recent years, there is currently no curative treatment for MS. For this reason, pharmacological therapy is complemented by rehabilitative treatment in order to maintain functional capacity and favor adaptation to the changes produced by the evolution of the disease itself. However, conventional rehabilitation treatment of people with MS is sometimes referred to as systematic, so that patients may lose motivation and adherence to it. This is why in recent years new intervention strategies have been introduced, such as VR, which encourage patient motivation through the practice of functional tasks in virtual environments that provide feedback on the results obtained and the possibility of increasing repetitions and work intensity through simulated ADL training. The development of these technologies has offered professionals working in the field of neurological rehabilitation to extend the care of MS patients as a complement to their conventional rehabilitation program, reaching a higher intensity of treatment and sometimes at a sustainable cost. However, studies on the effects of VR on manipulative skills in people with MS are still scarce and, to our knowledge, quality studies proposing the use of mixed reality as a tool for the treatment of MMSS impairments in people with MS are nonexistent. For the reasons described above, an RCT is justified to investigate the effects of the application of a treatment protocol through mixed reality environments that simulate the re-training of activities in the locations of a house (from the Latin, "domus") and, therefore, facilitate its transfer from learning to the real world, on manipulative skills, functionality and quality of life in people with MS (VIRTUAL-DOMUS), following international recommendations on the design of virtual environments for therapeutic purposes in neurorehabilitation.