Do exergames combined with physical exercise improve upper limb motor function in people with multiple sclerosis? Randomized clinical trial

Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system that has a major impact on upper limb motor function. It significantly limits performance in basic and instrumental activities of daily living and impairs independence in this population. Intensive, specific, and functional exercises in a dual-task context can be performed through exergames, helping to recover the sensorimotor function of the upper limb. In this way, the study's objective was to analyze the effects of physical exercises combined with Nintendo Wii on fine and gross manual dexterity, upper limb functionality, and muscle strength in people with multiple sclerosis (PwMS), comparing these outcomes to physical exercises performed alone. Fourteen people with multiple sclerosis participated in a randomized, blinded, controlled clinical trial of combined Nintendo Wii exergames and physical exercise training (NWG) and isolated physical exercise training (PTG). The primary outcome was fine manual dexterity assessed by the Nine-hole Peg test. Secondary outcomes were gross manual dexterity assessed by the Box and Block test; daily upper limb functions assessed by the Test d'Evaluation de la performance des Membres Supérieurs des Personnes Âgées; and muscle strength assessed by the handgrip strength test with dynamometry. After 16 training sessions, twice a week, combined exergame training with physical exercises and isolated physical exercise training brought similar effects in PwMS.