Comparison of the Effects of an Exergame-Based Program with Conventional Physiotherapy Protocol Based on Core Areas of the European Guideline on Postural Control, Functional Mobility, and Quality of Life in Patients with Parkinson's Disease: Randomized Clinical Trial

Silva, Keyte Guedes da; Nuvolini, Rosemeyre Alcarde; Bacha, Jéssica Maria Ribeiro; Freitas, Tatiana Beline de; Doná, Flávia; Torriani‐Pasin, Camila; Pompeu, José Eduardo

doi:10.1089/g4h.2022.0039

Cited by 8 publications

(9 citation statements)

References 68 publications

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“…The study is part of a larger clinical trial, which lasts seven weeks and includes a follow-up assessment one month postintervention 29,33 . The number of sessions used in this study follows the experimental condition of the clinical trial (14 experimental sessions), where the first session was used as our pre-test and the second to last the post-test and the last session the short-term retention test (that it was performed once week after the post-test).…”

Section: Experimental Designmentioning

confidence: 99%

Learning of a postural control task in a virtual environment with Parkinson´s disease individuals

Freitas¹,

Bacha

Nuvolini

et al. 2023

BJMB

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BACKGROUND: Recent studies have shown individuals with Parkinson’s disease (PD) are able to learn tasks with postural control demand, however, they need more practice, more sensory information, and extrinsic feedback for this improvement. These aspects could be provided by task performance on virtual environment. In addition, the retention interval found in these studies was short. AIM: To investigate the extent to which the learning of tasks involving a high demand for postural control is impacted in individuals with PD, and to determine the impact of the learning process on both cognition and postural control. METHOD: The Experimental Group comprised 13 participants with PD and the Control Group comprises 14 healthy elderly. Participants took part in 13 one-hour sessions, which involved four Kinect system games, with high postural and cognitive demands. The short-term retention test was performed one week after the post-test, whereas the long-term retention test was performed one month after the post-test. RESULTS: Individuals with PD learned the tasks with a high demand of postural control and demonstrated both short and long-term retention. The skill learning of the four tasks led to an improvement in cognitive functions specifically in memory. There was an improvement of reactive aspects of postural control in the elderly and with the individuals with PD, also better gait stability in the elderly. CONCLUSION:Despite the degeneration in striatum, responsible of consolidation of motor learning, individuals with PD are able to learn motor skills with a high demand for postural control, retaining them in the long term.

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Section: Experimental Designmentioning

confidence: 99%

Learning of a postural control task in a virtual environment with Parkinson´s disease individuals

Freitas¹,

Bacha

Nuvolini

et al. 2023

BJMB

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“…When combined with exercise, virtual reality and exergaming have demonstrated e cacy comparable to that of traditional physiotherapy [12,17,18]. Additionally, they offer potential supplementary bene ts related to motor disability, automaticity, gait, and balance performance [12,14,15,17,[19][20][21][22][23][24]. Moreover, virtual reality and exergaming training provide the advantage of being adaptable for home use, with or without supervision (telerehabilitation) [18, [25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Brain modulation after exergaming training in advanced forms of Parkinson’s disease: a randomized controlled study

Skrzatek,

Nuic,

Cherif

et al. 2024

Preprint

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Background. Physical activity combined with virtual reality and exergaming has emerged as a new technique to improve engagement and provide clinical benefit for gait and balance disorders in people with Parkinson’s disease (PD). Objective. To investigate the effects of a training protocol using a home-based exergaming system on brain volume and resting-state functional connectivity (rs-FC) in persons with PD. Methods. A single blind randomized controlled trial was conducted in people with PD with gait and/or balance disorders. The experimental (active) group performed 18 training sessions at home by playing a custom-designed exergame with full body movements, standing in front of a RGB-D Kinect® motion sensor, while the control group played using the computer keyboard. Both groups received the same training program. Clinical scales, gait recordings, and brain MRI were performed before and after training. We assessed the effects of both training on both the grey matter volumes (GVM) and resting-state functional connectivity (rsFC), within and between groups. Results. Twenty-three patients were enrolled and randomly assigned to either the active (n = 11) or control (n = 12) training groups. Comparing pre- to post-training, the active group showed significant improvements in gait and balance disorders, with decreased rs-FC between the sensorimotor, attentional and basal ganglia networks, but with an increase between the cerebellar and basal ganglia networks. In contrast, the control group showed no significant changes, and rs-FC significantly decreased in the mesolimbic and visuospatial cerebellar and basal ganglia networks. Post-training, the rsFC was greater in the active relative to the control group between the basal ganglia, motor cortical and cerebellar areas, and bilaterally between the insula and the inferior temporal lobe. Conversely, rs FC was lower in the active relative to the control group between the pedunculopontine nucleus and cerebellar areas, between the temporal inferior lobes and the right thalamus, between the left putamen and dorsolateral prefrontal cortex, and within the default mode network. Conclusions. Full-body movement training using a customized exergame induced brain rs-FC changes within the sensorimotor, attentional and cerebellar networks in people with PD. Further research is needed to comprehensively understand the neurophysiological effects of such training approaches. Trial registration: ClinicalTrials.gov NCT03560089

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“…In PD, the therapeutic use of VRG is applicable, efficient, and safe [14]. Evidence indicates positive short-term effects of exercises with VRG, which are similar to the results of conventional physiotherapy treatment [13,15]. Considering this potential to stimulate motor control and mental aspects such as cognition and humor [16], VRG training can benefit the functioning of people with PD (PwPD).…”

Section: Introductionmentioning

confidence: 99%

Effects of kinesthetic cues supported by physiotherapist during a motor training intervention with virtual reality-based games on functioning in people with Parkinson’s disease: A prospective, single-blinded, parallel-group, randomized clinical trial

Igarasi Barbosa,

Falconi,

D’Alencar

et al. 2023

Preprint

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Background: Effects of kinesthetic cues (KC) offered through physiotherapists (PT) during the training with virtual reality-based games (VRG) in people with Parkinson's Disease (PwPD) have not been investigated yet. Therefore, this study aimed to compare the effects of motor intervention using VRG coupled or not with KC provided by a PT during the training on the functioning of PwPD. Methods: Thirty-eight PwPD in 1-3 Hoehn and Yahr (HY) stage were randomized into two groups: (1) VRG with KC Group (KCG), where KC was provided by manual assistance of a PT, and (2) VRG with NO KC group (NKCG), where no PT manual assistance was provided during the training. Both groups received 8 individual sessions with 50 minutes, twice a week, for 4 weeks: 10 minutes for warm-up and 40 minutes to play 4 games from XBOX 360 with Kinect system. Outcomes were evaluated three times: (1) before training (BT), (2) 1 week after training (AT), and 8 weeks after that as follow-up (FU). To reach a comprehensive evaluation of functioning, several outcomes were adopted and categorized according to International Classification of Functioning Disability and Health (ICF): Geriatric Depression Scale (GDS); Montreal Cognitive Assessment (MOCA); Unified Parkinson Disease Rating Scale (UPDRS) - section 3 (UPDRS-III); and Rapid Turns Test (RTT) used to assess motor and non-motor alteration into Function domain; Balance Evaluation Systems Test (BESTest); Falls Efficacy Scale International (FES-I); Thirty-Second Walk Test (30sWT); Six-Minute Walk Test (6mWT); 5 Times Sit to Stand Test; and UPDRS section II (UPDRS-II) used to assess motor performance into Activity domain, and finally, the Parkinson Disease Questionnaire (PDQ-39) to assess quality of life into Participation domain. Results: ANOVA for repeated measures showed a significant effect for evaluation-time factor only (p-value<.001), (no effect for group or evaluation-time X group interaction) for all measures of three ICF domains, excluding GDS and 6mWT. The Tukey post-hoc test confirmed significant improvements in AT that remained at FU. Conclusions: A motor intervention using VRG can improve the functioning in terms of Function, Activity, and Participation of PwPD, regardless of the KC provided by PT during the training.

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Comparison of the Effects of an Exergame-Based Program with Conventional Physiotherapy Protocol Based on Core Areas of the European Guideline on Postural Control, Functional Mobility, and Quality of Life in Patients with Parkinson's Disease: Randomized Clinical Trial

Cited by 8 publications

References 68 publications

Learning of a postural control task in a virtual environment with Parkinson´s disease individuals

Learning of a postural control task in a virtual environment with Parkinson´s disease individuals

Brain modulation after exergaming training in advanced forms of Parkinson’s disease: a randomized controlled study

Effects of kinesthetic cues supported by physiotherapist during a motor training intervention with virtual reality-based games on functioning in people with Parkinson’s disease: A prospective, single-blinded, parallel-group, randomized clinical trial

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