At the Ivor Wynne Centre on McMaster’s campus, people with multiple sclerosis (MS) are working to improve their balance in an unexpected way: Playing Tetris.
It’s part of a research program led by McMaster researchers who are building a portfolio of MS studies tailored to the needs and lived experiences of the community. The goal is simple: help people regain strengths, stability and confidence in ways that are meaningful to daily life.
The Tetris study, funded by MS Society of Canada and conducted in partnership with Memorial University, is testing whether electromyography (EMG) biofeedback can help people improve balance and lower-limb function.
Participants wear small sensors on their skin that detect muscle activity. By activating specific muscles, they can move the Tetris piece on the screen.
“We’re comparing two approaches: traditional physiotherapy exercises and the EMG biofeedback-driven Tetris training designed in the lab,” explains Aimee Nelson, professor in the Department of Kinesiology.
“Both interventions are expected to have some benefits. We’re trying to figure out if we’ve made any progress relative to what’s already out there.”
Both groups train over six weeks, with assessments before and after and then again three months later.
While the study is still underway, Nelson says early participation and retention has been strong. “People want to come back. They seem to want to come in and they want it to continue, even when it ends.”
Promising and rapid progress
Diane Bouwman learned about the study through an MS Society newsletter.
Before starting the program, she relied heavily on a rollator and a cane and was experiencing frequent falls.
“I was feeling like I was really getting worse with my age. It was really bringing me down. I was going to the gym, I was eating properly, I had lost weight. I did everything I thought I could do and nothing was making a difference,” she says.
Within weeks, Bouwman says she began noticing changes — first in the lab, then at home.
Today, she climbs stairs more easily, can squat to unload the dishwasher without falling, and no longer needs her ankle brace.
“These might seem like little things, but when you feel like you’re only getting worse and suddenly you start making gains, it’s huge,” she says.
Replicating daily movements
For participant Mary Rivet, the program has been transformative. She was previously dependent on a wheelchair and often avoided leaving the house.
“When you’re disabled or compromised in any way, your world becomes very small,” she explains.
“This has given me confidence and more security — life is so much better.”
She now walks with a cane and recently joined a local gym.
The EMG Tetris system adapts as participants progress. As people learn how to activate the right muscles to control the game, the machine-learning algorithms learn too, giving researchers deeper insight into movement patterns of MS.
Postdoctoral fellow Stephen Toepp, who helped develop the system, says the game allows researchers to generate many movements that work the muscles responsible for maintaining balance during dynamic activities, like moving around a home.
People rarely focus on each step as they go about their daily routines, he explains, and the system is trying to replicate that environment.
And the benefits go beyond physiology.
“The idea is to build confidence so that people can engage in their everyday lives without being worried that they’re going to fall. We’re helping them relearn how to trust their bodies and their ability to catch themselves if they stumble,” says Toepp.
The best coaches
Participants say the one-on-one support from students and researchers is a major benefit.
“They’re like the best coaches,” Bouwman says. “They cheer you on. They normalize the hard days.”
“And that gives you hope — you can make improvements and you can start to feel you have some control back in your life.”
Nelson says this project represents just one part of a broader, growing body of MS research at McMaster. The team is looking for more people in the MS community to help guide where the work goes next.
Researchers encourage anyone living with MS who is interested in contributing to present or future studies to reach out.
“Participation is always, always appreciated,” says Toepp. “I think we have some great ideas for how to help people, but that’s not for us to decide. We really need to have feedback from the community to make sure we’re heading in the right direction.”