Vestibular rehabilitation in hereditary spastic paraplegia: a randomized pilot study.

BACKGROUND: Hereditary spastic paraplegia (HSP) is a neurodegenerative disorder characterized by spasticity, lower limb weakness, impaired balance, and increased risk of falls. OBJECTIVE: To evaluate the effect of vestibular rehabilitation associated with virtual reality (VRi) on functional balance in patients with HSP. METHODS: A randomized pilot clinical trial was conducted with 16 patients who were diagnosed with HSP and divided into two groups: GI (balance games) and GII (balance + strength games). Interventions were performed via the Wii console and the Wii Balance Board platform (Nintendo Co, Ltd.). The Berg balance scale (BBS) and physiological profile assessment (PPA) were administered at T0 (prerehabilitation), T1 (after 10 sessions), and T2 (after 20 sessions). The Friedman test and Wilcoxon test were used to analyze temporal changes, the Mann-Whitney test was used to compare the groups. RESULTS: All patients reported imbalance and muscle fatigue, whereas heaviness in the lower limbs and weakness were more common in GII. The visual contrast domain showed a significant change from T0 to T2, with scores increasing by a median of 2.0 (18.5-20.5) units. CONCLUSION: The use of VRi showed potential as a therapeutic adjunct in HSP rehabilitation, with improvements in balance and fall risk. However, larger studies are needed to corroborate these results. CLINICAL TRIAL REGISTRATION: ReBEC (RBR-3JMX67, 01/29/2020). https://ensaiosclinicos.gov.br/rg/RBR-3jmx67.