Evaluation of the level of spasticity in individuals in wheelchairs following movement in virtual reality - Case Study

Methods: This is a pilot study of probands diagnosed with spastic paraplegia due to incomplete spinal cord lesions. Seven probands (5 males and 2 females) aged 49 ± 8 years from the Paraple Centre clients participated in the study. They underwent the usual rehabilitation program of the Paraple Center and in addition were subjected to a virtual reality therapy program, where each intervention included 10 minutes in the given therapy program. After the first intervention, 3 probands withdrew. The interventions continued for 5 consecutive days. The degree of spasticity was assessed using the modified Tariue scale at the plantar flexors of the ankle joint and the flexors of the knee joint of both lower limbs. In addition, a modified subjective spasticity scale was created to monitor each proband`s own subjective sensations, using which probands rated their feelings of spasticity on a 0-10 scale (0 = no spasticity, 10 = intolerable spasticity) during each measurement. This took place on the first day of the intervention before the intervention itself and then on the third and fifth day of the intervention each time before and after the intervention.

Results: Seven hypotheses were defined, two of which were confirmed. Subjective ratings of the probands were the most significant, with an immediate change in the probands` mean ratings from 3.5 ± 1.5 to 2.5 ± 0.9 on the third day of the ongoing study and from 2 ± 1.9 to 1.25 ± 1.1 on the fifth day of the study. Within the modified Tardiué scale, the difference in R1-R2 angles is the most significant. Here, there was a decrease in three of the four muscle groups studied after five days of intervention, compared to the baseline measurement, and a decrease in the mean values on days 3 and 5 of the intervention for all muscle groups studied immediately after virtual reality application.