Cost-effectiveness analysis of the MYO Armband® device in combination with specifically designed video games for upper limb rehabilitation in people with multiple sclerosis

Abstract

Introduction The rapid and extensive expansion of virtual reality (VR) across all medical specialties, including neurorehabilitation, has significantly enhanced and broadened the treatment options for individuals with neurological disorders. The objective of the present study was to carry out an economic analysis of the MYO Armband® device in combination with specifically designed video games for upper limb (UL) rehabilitation in people with multiple sclerosis (MS).

Methods A randomized controlled trial was conducted. The sample was randomly assigned to two groups: an experimental group (EG) that received UL rehabilitation through serious games developed by the research team and controlled with the MYO Armband® gesture sensor plus conventional therapy, and a control group (CG) that received conventional therapy. Both groups underwent two 60-minute sessions per week for eight weeks. Wrist and forearm range of motion, grip muscle strength and coordination and gross UL dexterity were evaluated pre-treatment, post-treatment and during a follow-up period of 2 weeks without receiving any treatment. Also, satisfaction and compliance (attendance) were recorded in both groups. The healthcare provider’s perspective was used to identify, measure, and assess resource use across multiple scenarios. Differences in health outcomes and direct healthcare costs were compared from baseline to the end of follow-up in both groups. The aim was to estimate the incremental cost-effectiveness ratio (ICER) in order to assess the efficiency of the MYO Armband in improving participants’ health outcomes.

Results The total costs in the CG amounted to 5,721.1 euros compared to 6,240.4 euros for the EG, with a cost difference between intervention and control of 35 euros per patient. The MYO Armband® intervention showed a favorable cost-effectiveness ratio on the more affected side in the active range of motion, with statistically significant gains costing 7.5 euros extra per point (grade) increment in palmar flexion, 13.5 euros extra in pronation, and 5.4 euros extra in supination. One additional point (grade) gained in dorsiflexion had an incremental cost of 6.2 euros, although this difference was not statistically significant. Furthermore, the incremental costs for gaining one point in treatment adherence (percentage) were 5.9 euros.

Conclusion The use of MYO Armband® in the therapy of patients with MS offers promising results in maintaining their range of motion of the UL at a relatively modest additional cost. While these preliminary results will need to be corroborated by future works, the intervention appears to be cost-effective.

Trial registration This randomised controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908.