Medical Resort Treatment Extended with Modern Feedback Exercises Using Virtual Reality Improve Postural Control in Breast Cancer Survivors. Preliminary Study

Abstract

Introduction: Women with breast cancer have an increasing chance of survival for many years. Multimodal, extremely effective but also aggressive treatment, often leads to disorders of neuromuscular excitability and physical fitness of the patients. Therefore, when planning the physiotherapy process of women treated for breast cancer, one should look for the most effective methods of improvement with broad neurostimulatory and neuromodulatory effects. In recent years, more and more attention has been paid to the possibilities of using virtual reality exercises in therapy. Aim: The study was to understand the impact of medical resort treatment extended with modern feedback exercises using virtual reality to improve postural control in breast cancer survivors. M aterial and Methods: A clinical, pilot, non-controlled study was conducted at the Solanki Medical Resort in Inowroclaw. 46 women aged 36 to 63 completed the study (mean 51.67 ± 6.62 years). The patients participated in spa therapy for 3 weeks. For basic medical treatment, to improve postural control, physical exercises using feedback based on virtual reality were introduced. Postural control tests performed on the stabilometric platform were used to assess the progress of therapy. Results: In the assessment of dynamic postural control, the length of the center of foot pressure (COP) movement path before the treatment was on average 278.28 cm (± 147.13) and after treatment shortened to 209.60 cm (± 86.49) which was statistically significant (p = 0.0083). In the assessment of static postural control, no statistically significant differences were found between the length of the COP pathway before treatment compared to the condition before treatment (p> 0.05). Conclusions: Medical treatment enriched with physical exercises using feedback based on virtual reality did not affect static postural control but contributed to the improvement of dynamic postural control. The results of the study should be confirmed in high-quality therapeutic experiments, including control groups.

Virtual Reality as a Promising Tool Supporting Oncological Treatment in Breast Cancer

“…Interventions with the use of VR in the studies analysed can be divided into those that affected the physical functions of patients [29,31,32,35], the mental sphere [30,33,34,[36][37][38][39], and the pain level [14,32,34].…”

“…The methodological quality of all included studies was presented in Table 1. Seven studies were considered as 'strong' [29][30][31][33][34][35]39], and four were considered 'weak' [32,[36][37][38]. The highest-rated section was data collection, and the worst sections were blinding and selection bias.…”

“…In total, 137 records were identified from searches in all databases, and 9 additional records were identified after the reference list search; a total of 11 entries [29][30][31][32][33][34][35][36][37][38][39] were included in the study. The PRISMA flowchart of the search process is presented in Figure 1.…”

“…In four studies [29][30][31]34], participants were assigned to a control group (CG) and an intervention group (IG). Three studies did not include CG [32,33,35], and the remaining four [36][37][38][39] used a cross-study type design where the same patients constituted CG and IG. All women were diagnosed with BC.…”

“…Three of the studies also included patients with BC and other types of cancers such as gynaecological cancer [33], colon, or lung cancer [38,39]. In four studies [29,31,32,35], VR-based therapy was used as an adjunctive treatment after surgical removal of breast tumours, and in six [30,33,[36][37][38][39] during chemotherapy.…”