Physical therapy and exercise are important components of any multiple sclerosis (MS) care plan to help maintain mobility and functionality.

MS is caused by lesions in the brain or spinal cord that affect the way your nerves send signals to one another. This can affect the way your body moves and may lead to issues with balance and fatigue. It can also affect your ability to complete daily activities.

Since MS is a progressive disease, these symptoms often become worse over time. The goal of physical therapy is to strengthen your muscles so that you can keep doing your regular activities as much as possible with minimal disruption from your MS symptoms.

As virtual reality (VR) and motion capture devices have become more popular, medical professionals have started to integrate these technologies into physical therapy for many types of neurological diseases, including MS.

This practice uses exergames — or video games that involve physical exertion — to help with rehabilitation and promote physical activity.

To some people, it can be hard to believe that playing a video game can help improve your MS symptoms. In this article, we take a look at the evidence to see the effects of exergaming on symptoms of MS.

A 2022 review of randomized clinical trials found that overall, VR-based exergaming provides benefits over conventional exercise in MS rehabilitation and physical therapy.

These benefits can be observed across multiple aspects of well-being, including:

  • physical abilities
  • cognitive function
  • psychosocial health
  • fatigue

These results are mostly in line with another systematic review of MS exergaming studies that was published in 2021, which also found positive effects of VR-based exergaming on fatigue, quality of life, and balance compared with conventional exercise.

However, that review did not find that exergaming provides a significant benefit over conventional therapy with regard to functional mobility.

Limitations in the research

Why the different conclusions? Does exergaming actually help with physical function?

One of the challenges of understanding the effects of exergaming in MS is that everyone who has MS experiences it differently. The symptoms that bother one person may not affect another. There are also many “invisible” symptoms of MS, such as dizziness or fatigue, that can be difficult to quantify.

Exergaming as a concept is also relatively new, which means that there haven’t been many studies done yet in MS. And those that have been done are relatively small.

Combined, these factors can make it more challenging to determine the specific benefits of exergaming in MS. Additional research may help us more fully understand how exergaming may impact MS.

Several individual studies suggest that exergaming can help improve many aspects of physical ability and functionality in MS. These may include:

Importantly, these studies suggest benefits in a clinical test setting. How these physical benefits relate to functionality at home and ability to complete daily tasks remains to be determined.

Balance and fall risk

Balance is an important measure of physical function. Impaired balance in MS can increase the risk for falling, which can lead to injury and increased disability. This can result in more activity restrictions. It may also affect work ability, leading to additional social, economic, and psychological stress.

In clinical trials, VR and exergaming have been found to improve measures of walking ability and balance, similar to or even better than what is seen with conventional physical rehabilitation in MS.

Notably, VR-based exergaming has been found to be more effective at improving cognitive-motor function — that is, the ability to balance while distracted by another task — which is associated with a lower likelihood of falling compared with conventional exercise.

In contrast, conventional exercise therapy may be better for improving directional control compared with exergaming.

Another benefit of exergaming versus conventional exercise therapy is adherence, or sticking to the routine. Research suggests that people are more likely to stick to home-based exergaming therapy than conventional balance training.

This is an important consideration when determining whether exergaming may benefit people with MS outside of a clinical trial setting.

Emotional health and quality of life are important to consider in MS care. The physical effects of MS, its impact on daily life, and the direct effects of lesions on brain health can negatively impact psychosocial health.

In one clinical trial, exercise therapy, and especially exergaming, was found to improve self-reported quality of life in people with MS.

Similar results were seen in another clinical trial, which found that exergaming actually improved quality of life more than conventional physical therapy alone.

A 2016 meta-analysis of multiple clinical trials found that exergaming can help significantly reduce symptoms of depression, including in those with neurological disorders. These results suggest that quality of life benefits in MS may be related to a combination of improvements to both physical and emotional health.

Additionally, exergaming has been found to reduce the fear of falling in people with MS, which may provide emotional relief.

That said, more research is needed to fully evaluate how exergaming may improve emotional health.

The effects of exergaming on cognitive function have not been well-studied in MS.

One 2018 review of 13 studies involving 465 participants with various neurological disorders, including MS, found that exergaming is linked to improvements in both executive function and spatial reasoning compared with conventional rehabilitation alone.

However, more research is needed to assess the impact exergaming may have on cognitive function.

Exergaming is a new tool that is increasingly being used in the care of people with neurological and mobility disorders, including MS.

Although more research is needed to understand how exergaming compares with traditional physical therapy, early evidence suggests it may provide a variety of physical, emotional, and potential cognitive benefits that can improve the well-being of people with MS.