Exploring the Role of Virtual Reality in Multiple Sclerosis Rehabilitation: Tobias Nef, PhD

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"I think the hardest challenge is to motivate not only patients [with multiple sclerosis], but also everyone, to do these types of exercises. I mean, we all know that from ourselves: it’s not so easy to do these tasks every day and to motivate yourself to do them.”

Virtual reality–based rehabilitation has been proposed as a strategy to support motor and functional outcomes in patients with multiple sclerosis (MS). In a recently published review, findings showed that virtual reality–based interventions may be more effective than no intervention for improving upper limb function in patients with MS.¹ Moreover, results revealed that compared with conventional therapy, virtual reality training could provide greater improvements in balance and postural control. Researchers noted that the evidence was insufficient to draw conclusions regarding the effects of virtual reality on global motor function, activity limitations, or adverse events in MS.

This topic was further explored at the 2025 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held September 24-26, in Barcelona, Spain, in the hot topic session titled “Well-being in MS.” Chaired by Robert Motl, PhD, and Bernhard Hemmer, MD, the session highlighted nonpharmacologic strategies to support health and quality of life in patients with MS. During the session, Lars Hvid, PhD, reviewed current evidence and recommendations for exercise in MS, while Caroline Pot, MD, discussed dietary considerations and their potential role in disease management. Tobias Nef, PhD, closed the presentation by showcasing data on virtual reality and digital tools in rehabilitation, including emerging technologies and implementation challenges.

At the Congress, NeurologyLive^® spoke with Nef, a professor of biomedical engineering at the University of Bern, who delved into his presentation. He noted some of the advantages and limitations of these approaches as well as summarized available clinical evidence. In his presentation, Nef also discussed ongoing challenges, including uncertainty around which technologies yield the greatest clinical benefit, usability barriers, and the need to better understand the mechanisms that drive rehabilitation outcomes. Furthermore, he also underscored motivation as a critical, nontechnical barrier to sustained patient engagement.

Click here for more coverage of ECTRIMS 2025.

REFERENCES
1. De Keersmaecker E, Guida S, Denissen S, et al. Virtual reality for multiple sclerosis rehabilitation. Cochrane Database Syst Rev. 2025;1(1):CD013834. Published 2025 Jan 7. doi:10.1002/14651858.CD013834.pub2
2. Nef T. Virtual reality and digital tools in rehabilitation. Presented at ECTRIMS Congress; September 24-26, 2025; Barcelona, Spain. Hot Topic 8: Well-being in MS.