VR and Orthoses for Rehabilitation in Multiple Sclerosis

The NASA-TLX questionnaire score (National Aeronautics and Space Administration Task Load Index) measures physical and mental workload using six items related to mental load, physical activity, speed of performance, performance, effort, and frustration. Each item is accompanied by a 12 cm line scale divided into 20 equal intervals, anchored by binary descriptors (e.g., low/high), delimited by 21 vertical markers, and then converted to a scale from 0 to 100 points. To calculate the score for each scale, the number of lines marked by a participant is counted, 1 is subtracted, and the result is multiplied by 5. Weights from 0-5 will be assigned to the 15 subscale comparisons, which will be multiplied by the corresponding subscale score. The total score (from 0 to 100 points) is estimated by summing the weighted scores and dividing by 15.

The MSAQ questionnaire assesses motion sickness. It consists of 16 questions divided into four subcategories: Gastrointestinal (G), Central (C), Peripheral (P), and Sopite-related (S). Responses are scored on a scale from 1 to 9 points. Each subcategory is scored individually, contributing to a total score ranging from 11 to 144 points. The overall motion sickness score is calculated as the percentage of total points scored: (sum of all item points / 144) × 100. Subscale scores are calculated similarly as percentages within each factor: (sum of gastrointestinal items / 36) × 100; (sum of central items / 45) × 100; (sum of peripheral items / 27) × 100; (sum of sopite items / 36) × 100.

The IPQ questionnaire assesses the sense of presence (SOP - level of immersion in VR) of a VR user. The IPQ consists of 14 items divided into four subcategories: spatial presence, involvement, perceived realism level, and a "sense of being present." All items are rated on a seven-point scale (0-6), with a higher score indicating greater SOP. The total score is obtained by summing the scores of individual items (from 0 to 84 points).

The MusiQoL questionnaire assesses health-related quality of life specifically in individuals with multiple sclerosis. It consists of 31 items grouped into nine dimensions: daily activities, psychological well-being, symptoms, social relationships, family relationships, relationship with healthcare professionals, emotional well-being, intimate relationships, and leisure activities. Each item is rated on a five-point Likert scale (from 1 = "never" to 5 = "always"). Scores for each dimension are calculated as the mean of the corresponding items, then transformed into a 0-100 scale, with higher scores indicating better quality of life.

The BBS is a clinical assessment tool used to evaluate balance and fall risk in individuals. It consists of 14 functional tasks, each scored on a scale from 0 (unable to perform) to 4 (normal performance), with a maximum total score of 56 points. The items assess the ability to maintain upright standing positions without support (eyes open, closed, feet together, tandem, single-leg stance), perform posture transitions (e.g., sitting to standing, transfers between bed and chair), turn the body, and complete other tasks requiring static and dynamic postural control.

The EDSS is an ordinal rating scale used to quantify disability in individuals with multiple sclerosis. Scores range from 0 (normal neurological status) to 10 (death due to MS), with 0.5-point increments indicating increasing levels of disability. The scale evaluates several functional systems, including motor, sensory, visual, bowel and bladder functions, and cognitive impairments, providing an overall measure of disability.

The MFIS is a 21-item self-report questionnaire that assesses the perceived impact of fatigue on daily life, covering three domains: physical (0-36), cognitive (0-40), and psychosocial (0-8). Each item is rated from 0 to 4. The total score ranges from 0 to 84, with higher scores indicating greater fatigue impact. Subscale scores provide domain-specific insights, useful for monitoring targeted therapeutic interventions.

The MSWS-12 is a self-reported questionnaire designed to measure the impact of MS on walking ability. It consists of 12 items rated on a 5-point scale (1-5), reflecting perceived walking difficulties over the past two weeks. Assessed domains include balance, speed, walking distance, and need for assistance. The total raw score is converted to a 0-100 scale, with higher scores indicating greater walking disability.

The T25FW assesses walking speed and is used to evaluate the walking ability of individuals with multiple sclerosis. The test involves the participant walking 25 feet (approximately 7.62 meters) as quickly as possible, performing two separate trials. The time taken to complete each trial is measured in seconds using a stopwatch. The final score is calculated by averaging the two recorded times.

The 2MWT is a test used to assess walking ability, in which the subject is asked to walk as fast as possible for 2 minutes on a flat surface. The total distance covered during this time is measured. The test evaluates walking speed, as well as the patient's cardiovascular and muscular endurance.

The TAM is a tool used to measure users' acceptance of technology, based on two key components: perceived usefulness (how much the user believes the technology improves their performance) and perceived ease of use (how easy the user finds the technology to use). The test includes 12 items scored from 1 to 4, with a total score of 48. Higher scores indicate lower acceptance of the technology.

The TLSQ-WT is an assessment tool designed to measure patients' satisfaction with telemedicine services. It evaluates six dimensions of the user experience with the wearable component of a system: Benefits, Usability, Self-perception, Privacy and Loss of Control, Quality of Life, and Comfort of Use.

Each area includes five statements rated by the user on a 5-point Likert scale from 0 (strongly disagree) to 4 (strongly agree), for a total of 30 items. The final score ranges from 0 to 120.

The TUG (Podsiadlo \& Richardson, 1991) is a functional test commonly used to assess mobility and fall risk in patients with neurological conditions, including multiple sclerosis. The test involves asking the patient to stand up from a chair, walk 3 meters, turn around, walk back, and sit down again. The time required to complete the task is recorded in seconds using a stopwatch.