Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

Abstract

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.

Avaliação Postural Em Pessoas Com Doença De Parkinson: Estado Da Arte

“…(13) A deficiência na extensão do tronco e na amplitude da coluna vertebral pode somar-se a alterações como artrose e cifoescoliose que não são decorrentes da DP, e estas modificações podem reduzir a complacência, bem como, diminuir as incursões da inspiração e da expiração. (12) Além do impacto na função respiratória, a redução da amplitude articular do tórax pode aliar-se a rigidez da musculatura do tronco, restringindo à circundação sob o eixo longitudinal; (1) esta restrição limitará a tarefa de alcance durante as AVDs.…”

“…(1,2) As disfunções da síntese dopaminérgica no SNC na doença de Parkinson são causadas por degenerações nos neurônios na parte compacta da substân-cia negra; determinando alterações na regulação dos circuitos neuromoduladores da motricidade realizado pelos núcleos da base. (2,3) Esta afecção é um dos transtornos degenerativos mais comuns, ultrapassada apenas pela doença de Alzheimer.…”

Realidade virtual na reabilitação física de pacientes com doença de Parkinson

“…In another study 28 , researchers verified the applicability of VR as a rehabilitation method of balance and improvement of quality of life in patients with PD. In this study, different to the research mentioned above, six participants were trained only using VR by Nintendo Wii Fit™ for 12 sessions, twice a week, 20 minutes each session.…”

Virtual reality in the rehabilitation of the balance in the elderly.

“…According to Aylett and Luck (11) , the virtual reality (VR) consists of a technology characterized by an interface which integrates varying degrees of immersion, interaction and user involvement when using multisensory devices, from a three-dimensional environment created in real time by a computer. In this modality, the user interacts with the images displayed and may move and manipulate virtual objects, experiencing environment and the simulated task (9,12,15) . It is estimated that the VR began to be used as a rehabilitation tool in the transition between the twentieth to the twenty-first centuries (16)(17)(18) .…”

“…It has being seen as an innovative and promising therapy in rehabilitation technology, since its benefits may transcend the purely physiological and clinical aspects of the rehabilitation (4,17) . As the main objective for rehabilitation with the use of VR may be mentioned an increase in the functional capacity and better inclusion of the individual in the participations of its tasks of daily life due to the improvement of the motor, cognitive and sensorial function (15) .…”