Discussion
fullness of the head”, fatigue, fatigability, pronation, generalised, Fatigue
DISEASE, ADVERSE EFFECTS, DEGENERATIVE
The purpose of this study was to investigate the effects of the MYO Armband® sEMG motion capture system, combined with a conventional physical therapy treatment program, on patients with MS. To the best of our knowledge, this is the first RCT that attempts to analyse the effects of using video games with the MYO® capture system on UL function in patients with MS.Our results showed significant inter-group differences in active range of motion in forearm supination (p = 0.004) and manual grip strength (p = 0.004). Additionally, at the intra-group level, statistically significant improvements were observed in active range of motion in wrist flexion, forearm pronation and forearm supination in the EG. On the other hand, clinical improvement in handgrip strength was observed in the more affected side of the EG compared to the CG, whose data showed significant worsening in the follow-up evaluation compared to the post-treatment measurement. Significant intra-group improvements in manual dexterity were also observed throughout the measurements in both groups.In recent years, several studies have been conducted on UL rehabilitation in patients with MS. Cuesta-Gómez et al. [All these findings are consistent with those observed in our study. The statistical analysis showed significant results for the variables of active range of motion and grip strength, as also shown in the work of Cuesta-Gómez et al. [Regarding the results on inter-group differences observed in the pre-intervention evaluation for the forearm pronation variable, our findings indicated that the CG had a wider range of pronation mobility in the more affected side compared to the EG. However, this range of motion in the EG improved over the measurements, reaching similar results in the follow-up evaluation as the CG (Fig. Our study found inter-group differences in terms of coordination and motor dexterity in the post-hoc analysis for all measurements as Table Fatigue, functional abilities of the UL or quality of life variables also did not show significant inter-group differences. This could be due to the duration of each treatment session, the overall duration of the experimental intervention and a hypothetical perceived fatigability [It should also be considered that all patients recruited for this study had a range of disability from moderate (EDSS: 3.0) to wheelchair restricted (EDSS: 7.5), so both the conventional and experimental protocols over the 8-week treatment period could contribute to maintaining stability at a clinical level for the analysed variables, which is also a positive outcome in a degenerative and progressive condition like MS.Furthermore, a low score obtained in the SSQ and NASA-Task Load Index leads us to conclude that the proposed protocol presented as a safe therapeutic approach, with a very low incidence of adverse effects, which included feelings of fatigue, difficulty concentrating and a sense of “fullness of the head”, providing a low sense of workload burden on the patients included in the study.Regarding the usefulness of the MYO® system as measured by the SUS, the items with the highest scores among the participants in the EG were: "Finally, the high satisfaction data with the technology obtained concur with the results of the studies mentioned earlier [This study has several limitations. First, the results cannot be generalised to the entire population with MS or other neurological conditions, as this research was conducted solely with patients with an EDSS score between 3.0 and 7.5 and a specific disease duration. Second, a limited total dose of treatment under MYO® system for each UL could be a potential limitation of our methodology. Third, it would be interesting to explore in future studies the effects in patients with MS with different levels of disability, disease duration, greater functional limitation of forearm and wrist range of motion and with a balanced ratio men/women in the sample. Additionally, the sampling method may have resulted in selection bias as the patients were recruited from a single MS Association in a specific location. Finally, longer follow-up evaluations would be valuable in future studies.