VR-based Dexterity Training in MS

NCT07193602 | Not Yet Recruiting

• 1 other identifier: LUKSKAMM003
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 2

Brief Summary

The aim of the study is to investigate if a specifically developed home-based dexterity training intervention using a Virtual Reality (VR) Headset (Meta quest 2) improves impaired manual dexterity in persons with multiple sclerosis.

Conditions

Multiple Sclerosis

Keywords

Headset-based dexterity training; Multiple Sclerosis

Outcome Measures

Primary Outcomes (1)

• Arm Function Score in Multiple Sclerosis Questionnaire

  The Arm Function in Multiple Sclerosis Questionnaire (AMSQ) measures manual dexterity in patients with MS. It contains 31 questions on a unidimensional scale. One final sum score is obtained with higher scores indicating more dexterous difficulties. The minimum score is 31 (no limitation) and a maximum score of 186 (extreme limitation).

  4 weeks

Secondary Outcomes (5)

• Time for completing the Nine-hole-Peg-Test (9HPT)

  4 weeks

• Time for completion the Coin rotation task (CRT)

  4 Weeks

• The highest strength value resulting from the Handheld JAMAR dynamometer

  4 Weeks

• Value resulting from the Multiple Sclerosis Impact Scale 29 (MSIS 29)

  4 Weeks

• Scores of the Electronic Neurostatus-Expanded Disability Status Scale (eEDSS) (D'Souza M et al. 2020)

  4 Weeks

Study Arms (2)

Experimental intervention = training intervention (Group1)

EXPERIMENTAL

Eight training programs will be performed addressing different key movements of the hand/arm. All training programs will be performed in sitting position. Training will be performed for 4 weeks, 5 days/week. All 8 training programs will be performed on every training day which corresponds to approximately 20min training/day.

Device: VR-based dexterity training in MS

Control inervention = Sham-Intervention (Group2)

SHAM COMPARATOR

The Sham-Intervention will be the commercially available meditations App "Tripp®". During a period of four weeks, patients will perform the Sham intervention 3 times a week, each session being approximately 20 minutes.

Other: mediation program

Interventions

VR-based dexterity training in MS DEVICE

Training of limited manual dexterity in people with multiple sclerosis through a specially developed home-based dexterity training programm using a virtual headset

Experimental intervention = training intervention (Group1)

mediation program OTHER

Sham Training is the comparator. The Sham group is performing a commercially available mediation programm TRIPP:

Control inervention = Sham-Intervention (Group2)

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• MS patients with relapsing-remitting MS (RRMS), secondary-progressive MS (SPMS) or primary progressive MS (PPMS) according to the revised McDonald's criteria (Thompson et al. 2017)
• Age between 18 and 75 years
• Written informed consent signed by the subject must be obtained prior to study start
• Patient must complain about MS related impaired manual dexterity negatively affecting ADL and/or QoL
• Patients must have Arm function in multiple sclerosis questionnaire (AMSQ) score \>41

You may not qualify if:

• A relapse that started within 60 days prior to screening
• Rapidly progressive disease
• Any disease/condition that impaired manual dexterity besides MS
• Any disease other than MS that could possibly explain the patient's signs and symptoms
• Medical or psychiatric conditions that compromise the ability to comply with the protocol, or to complete the study
• History of epilepsy or epileptic seizures
• A history of drug abuse in the 12 months prior to screening

Sponsors & Collaborators

• Christian Kamm: lead
• University Hospital, Basel, Switzerland: collaborator

Study Sites (2)

MS Centre, Neurology, University hospital Basel

Basel, Basel, 4031, Switzerland

Location

Lucerne Cantonal Hospital

Lucerne, Canton of Lucerne, 6000, Switzerland

Location

Related Publications (30)

• Yancosek KE, Howell D. A narrative review of dexterity assessments. J Hand Ther. 2009 Jul-Sep;22(3):258-69; quiz 270. doi: 10.1016/j.jht.2008.11.004. Epub 2009 Feb 12.

  PMID: 19217254 BACKGROUND

• Winberg C, Kylberg M, Pettersson C, Harnett T, Hedvall PO, Mattsson T, Mansson Lexell E. The Use of Apps for Health in Persons with Multiple Sclerosis, Parkinson's Disease and Stroke - Barriers and Facilitators. Stud Health Technol Inform. 2017;242:638-641.

  PMID: 28873864 BACKGROUND

• Vanbellingen T, van Beek J, Nyffeler T, Urwyler P, Nef T, Bohlhalter S. Tablet app-based dexterity-training in patients with Parkinson's disease: Pilot feasibility study. Ann Phys Rehabil Med. 2021 Jul;64(4):101419. doi: 10.1016/j.rehab.2020.06.004. Epub 2020 Oct 6. No abstract available.

  PMID: 32755640 BACKGROUND

• van Beek JJW, van Wegen EEH, Rietberg MB, Nyffeler T, Bohlhalter S, Kamm CP, Nef T, Vanbellingen T. Feasibility of a Home-Based Tablet App for Dexterity Training in Multiple Sclerosis: Usability Study. JMIR Mhealth Uhealth. 2020 Jun 9;8(6):e18204. doi: 10.2196/18204.

  PMID: 32515747 BACKGROUND

• van Beek JJW, van Wegen EEH, Bol CD, Rietberg MB, Kamm CP, Vanbellingen T. Tablet App Based Dexterity Training in Multiple Sclerosis (TAD-MS): Research Protocol of a Randomized Controlled Trial. Front Neurol. 2019 Feb 11;10:61. doi: 10.3389/fneur.2019.00061. eCollection 2019.

  PMID: 30804879 BACKGROUND

• Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, Correale J, Fazekas F, Filippi M, Freedman MS, Fujihara K, Galetta SL, Hartung HP, Kappos L, Lublin FD, Marrie RA, Miller AE, Miller DH, Montalban X, Mowry EM, Sorensen PS, Tintore M, Traboulsee AL, Trojano M, Uitdehaag BMJ, Vukusic S, Waubant E, Weinshenker BG, Reingold SC, Cohen JA. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018 Feb;17(2):162-173. doi: 10.1016/S1474-4422(17)30470-2. Epub 2017 Dec 21.

  PMID: 29275977 BACKGROUND

• Thirumalai M, Rimmer JH, Johnson G, Wilroy J, Young HJ, Mehta T, Lai B. TEAMS (Tele-Exercise and Multiple Sclerosis), a Tailored Telerehabilitation mHealth App: Participant-Centered Development and Usability Study. JMIR Mhealth Uhealth. 2018 May 24;6(5):e10181. doi: 10.2196/10181.

  PMID: 29798832 BACKGROUND

• Tacchino A, Pedulla L, Bonzano L, Vassallo C, Battaglia MA, Mancardi G, Bove M, Brichetto G. A New App for At-Home Cognitive Training: Description and Pilot Testing on Patients with Multiple Sclerosis. JMIR Mhealth Uhealth. 2015 Aug 31;3(3):e85. doi: 10.2196/mhealth.4269.

  PMID: 26323749 BACKGROUND

• Steinheimer S, Wendel M, Vanbellingen T, Westers LT, Hodak J, Blatter V, Uitdehaag BMJ, Kamm CP. The Arm Function in Multiple Sclerosis Questionnaire was successfully translated to German. J Hand Ther. 2018 Jan-Mar;31(1):137-140.e1. doi: 10.1016/j.jht.2017.09.010. No abstract available.

  PMID: 29102479 BACKGROUND

• Riazi A, Hobart JC, Lamping DL, Fitzpatrick R, Thompson AJ. Multiple Sclerosis Impact Scale (MSIS-29): reliability and validity in hospital based samples. J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):701-4. doi: 10.1136/jnnp.73.6.701.

  PMID: 12438473 BACKGROUND

• Peolsson A, Hedlund R, Oberg B. Intra- and inter-tester reliability and reference values for hand strength. J Rehabil Med. 2001 Jan;33(1):36-41. doi: 10.1080/165019701300006524.

  PMID: 11480468 BACKGROUND

• Paltamaa J, West H, Sarasoja T, Wikstrom J, Malkia E. Reliability of physical functioning measures in ambulatory subjects with MS. Physiother Res Int. 2005;10(2):93-109. doi: 10.1002/pri.30.

  PMID: 16146327 BACKGROUND

• Oxford Grice K, Vogel KA, Le V, Mitchell A, Muniz S, Vollmer MA. Adult norms for a commercially available Nine Hole Peg Test for finger dexterity. Am J Occup Ther. 2003 Sep-Oct;57(5):570-3. doi: 10.5014/ajot.57.5.570.

  PMID: 14527120 BACKGROUND

• McGuigan C, Hutchinson M. The multiple sclerosis impact scale (MSIS-29) is a reliable and sensitive measure. J Neurol Neurosurg Psychiatry. 2004 Feb;75(2):266-9.

  PMID: 14742602 BACKGROUND

• Marrie RA, Leung S, Tyry T, Cutter GR, Fox R, Salter A. Use of eHealth and mHealth technology by persons with multiple sclerosis. Mult Scler Relat Disord. 2019 Jan;27:13-19. doi: 10.1016/j.msard.2018.09.036. Epub 2018 Oct 2.

  PMID: 30296732 BACKGROUND

• Mokkink LB, Knol DL, van der Linden FH, Sonder JM, D'hooghe M, Uitdehaag BMJ. The Arm Function in Multiple Sclerosis Questionnaire (AMSQ): development and validation of a new tool using IRT methods. Disabil Rehabil. 2015 Dec;37(26):2445-2451. doi: 10.3109/09638288.2015.1027005. Epub 2015 Mar 24.

  PMID: 25801923 BACKGROUND

• Lamers I, Kelchtermans S, Baert I, Feys P. Upper limb assessment in multiple sclerosis: a systematic review of outcome measures and their psychometric properties. Arch Phys Med Rehabil. 2014 Jun;95(6):1184-200. doi: 10.1016/j.apmr.2014.02.023. Epub 2014 Mar 13.

  PMID: 24631802 BACKGROUND

• Kamm CP, Uitdehaag BM, Polman CH. Multiple sclerosis: current knowledge and future outlook. Eur Neurol. 2014;72(3-4):132-41. doi: 10.1159/000360528. Epub 2014 Jul 30.

  PMID: 25095894 BACKGROUND

• Kamm CP, Mattle HP, Muri RM, Heldner MR, Blatter V, Bartlome S, Luthy J, Imboden D, Pedrazzini G, Bohlhalter S, Hilfiker R, Vanbellingen T. Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial. Mult Scler. 2015 Oct;21(12):1546-56. doi: 10.1177/1352458514565959. Epub 2015 Jan 26.

  PMID: 25623246 BACKGROUND

• Kamm CP, Blattler R, Kueng R, Vanbellingen T. Feasibility and usability of a new home-based immersive virtual reality headset-based dexterity training in multiple sclerosis. Mult Scler Relat Disord. 2023 Mar;71:104525. doi: 10.1016/j.msard.2023.104525. Epub 2023 Jan 20.

  PMID: 36738693 BACKGROUND

• Kamm CP, Kueng R, Blattler R. Development of a new immersive virtual reality (VR) headset-based dexterity training for patients with multiple sclerosis: Clinical and technical aspects. Technol Health Care. 2024;32(2):1067-1078. doi: 10.3233/THC-230541.

  PMID: 37545286 BACKGROUND

• Kalkers NF, Galan I, Kerbrat A, Tacchino A, Kamm CP, O'Connell K, McGuigan C, Edan G, Montalban X, Uitdehaag BM, Mokkink LB. Differential item functioning of the Arm function in Multiple Sclerosis Questionnaire (AMSQ) by language, a study in six countries. Mult Scler. 2021 Jan;27(1):90-96. doi: 10.1177/1352458519895450. Epub 2019 Dec 17.

  PMID: 31845614 BACKGROUND

• Jonsdottir J, Perini G, Ascolese A, Bowman T, Montesano A, Lawo M, Bertoni R. Unilateral arm rehabilitation for persons with multiple sclerosis using serious games in a virtual reality approach: Bilateral treatment effect? Mult Scler Relat Disord. 2019 Oct;35:76-82. doi: 10.1016/j.msard.2019.07.010. Epub 2019 Jul 20.

  PMID: 31352180 BACKGROUND

• Johansson S, Ytterberg C, Claesson IM, Lindberg J, Hillert J, Andersson M, Widen Holmqvist L, von Koch L. High concurrent presence of disability in multiple sclerosis. Associations with perceived health. J Neurol. 2007 Jun;254(6):767-73. doi: 10.1007/s00415-006-0431-5. Epub 2007 Apr 2.

  PMID: 17401746 BACKGROUND

• Hollywood RA, Poyade M, Paul L, Webster A. Proof of Concept for the Use of Immersive Virtual Reality in Upper Limb Rehabilitation of Multiple Sclerosis Patients. Adv Exp Med Biol. 2022;1356:73-93. doi: 10.1007/978-3-030-87779-8_4.

  PMID: 35146618 BACKGROUND

• Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A. The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain. 2001 May;124(Pt 5):962-73. doi: 10.1093/brain/124.5.962.

  PMID: 11335698 BACKGROUND

• Heldner MR, Vanbellingen T, Bohlhalter S, Mattle HP, Muri RM, Kamm CP. Coin rotation task: a valid test for manual dexterity in multiple sclerosis. Phys Ther. 2014 Nov;94(11):1644-51. doi: 10.2522/ptj.20130252. Epub 2014 Jun 19.

  PMID: 24947199 BACKGROUND

• Goodkin DE, Hertsgaard D, Seminary J. Upper extremity function in multiple sclerosis: improving assessment sensitivity with box-and-block and nine-hole peg tests. Arch Phys Med Rehabil. 1988 Oct;69(10):850-4.

  PMID: 3178453 BACKGROUND

• D'Souza M, Heikkila A, Lorscheider J, Haller V, Kravalis K, Gysin S, Fuertes NAC, Fricker E, Lam E, Higgins P, Tomic D, Papadopoulou A, Kappos L. Electronic Neurostatus-EDSS increases the quality of expanded disability status scale assessments: Experience from two phase 3 clinical trials. Mult Scler. 2020 Jul;26(8):993-996. doi: 10.1177/1352458519845108. Epub 2019 May 7.

  PMID: 31060429 BACKGROUND

• Bertoni R, Mestanza Mattos FG, Porta M, Arippa F, Cocco E, Pau M, Cattaneo D. Effects of immersive virtual reality on upper limb function in subjects with multiple sclerosis: A cross-over study. Mult Scler Relat Disord. 2022 Sep;65:104004. doi: 10.1016/j.msard.2022.104004. Epub 2022 Jun 30.

  PMID: 35797804 BACKGROUND

MeSH Terms

Conditions

Multiple Sclerosis

Condition Hierarchy (Ancestors)

Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases; Immune System Diseases

Central Study Contacts

Christian Kamm, Prof. Dr. med.

CONTACT

0041 41 205 29 69; Christian.Kamm@luks.ch

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Raters will not be involved in the screening and randomisation process and blinded with regard to the treatment group
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Prof. Dr. med.

Model Details: Prospective, randomized-controlled, home-based, multi-center, rater-blinded parallel-arm pilot study. Randomisation will be performed 1:1 to the Training-Intervention group (Group 1) or Sham group (Group 2) matched for EDSS within the last 6 month using the REDCap Randomisation Tool. The EDSS-groups are: 0-2.5 3-5.5 \> 5.5

Study Record Dates

• First Submitted: September 18, 2025
• First Posted: September 26, 2025
• Study Start: May 1, 2026
• Primary Completion (Estimated): May 1, 2028
• Study Completion (Estimated): May 1, 2028
• Last Updated: April 13, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

CH (2)