Silva ECGe1, Silva TMe2, Prado TAdS3, Junior NC4, Bacha JMR5, Pompeu JE5
1University of Sao Paulo, Neurosciences and Behavior, Institute of Psychology, São Paulo, Brazil, 2Neurological and Aquatic Rehabilitation Clinic - RNA, São Paulo, Brazil, 3Aquatic Neurological Rehabilitation Clinic - RNA, São Paulo, Brazil, 4Universidade Ibirapuera – UNIB, São Paulo, Brazil, 5University of Sao Paulo, Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, São Paulo, Brazil
Background: Post-Polio Syndrome (PPS) refers to new neuromuscular symptoms occurring at least 15 years after stability in patients with prior acute paralytic polio. Symptoms include the development of muscle weakness associated with a new process of hypotrophy that can affect the limbs, medulla oblongata and respiratory muscles. In addition, other symptoms can occur as excessive fatigue, decreased endurance, joint and muscle pain, cold intolerance, and sleep disorders. Weakness and upper limb muscle hypotrophy can compromise the functionality and independence for daily living activities of the patients. However, there is a scarcity of studies on the rehabilitation of the upper limbs of these patients and the few existing studies showed modest effects on functional recovery. Therefore, new treatment strategies should be investigated, including motor training through videogames.
Purpose: To analyze the applicability, safety, and effects of video games on upper limb function (UL) of individuals with PPS.
Methods: 32 patients diagnosed with PPS were recruited from the Giorgio Nicoli Motor Neuron Institute. We selected subjects of both genders, aged 40-75 years. The individuals performed 14 training sessions, lasting 50 minutes each, twice a week. Patients were randomly divided into Experimental Group (EG) and Control Group (CG), 16 patients in each group. The CG patients underwent conventional motor physical therapy exercises. The EG patients performed intervention with four Nintendo Wii Sports games: Tennis, Bowling, Golf, and Boxing. The individuals played each game for 10 minutes. The groups were evaluated before and after the 14 intervention sessions and 30 days after the end of the intervention. The primary outcome was the motor function assessed through the MFM-32 Motor Function Scale. The secondary outcomes were
(1) the functional independence assessed through the Functional Independence Measure (FIM);
(2) balance assessed through the Functional Reach Test;
(3) fatigue assessed through the Muscle Fatigue Severity Scale;
(4) pain, assessed through the Visual Analog Pain Scale (VAS) score for the upper limbs and,
(5) dexterity assessed through the Box and Block test.
Statistical analysis was done using ANOVA Type III for repeated measures and Bayesian ANOVA.
Results: There were no differences between the groups after the interventions or at the follow-up in any outcomes. Both groups presented improvement in motor function, dexterity, and functionality after the interventions (Tukey Post hoc tests, P 0.05). In addition, both groups presented decrease in muscle fatigue and pain, demonstrating that both, the Nintendo Wii Sports games and conventional physical therapy exercises are safe for post-polio patients.
Conclusion(s): Conventional physical therapy and the Nintendo Wii Sports games were safe, applicable and provided positive effects on the motor function, dexterity, and functionality of post-polio patients, without superiority between the interventions.
Implications: The reabilitation with the interactive video game is an alternative and an additional resource in the treatment of this population with security and applicability.
Keywords: Neuromuscular Diseases, Post-Polio Syndrome, Virtual Reality
Funding acknowledgements: Self-financing, we would like to thank the Giorgio Nicoli Institute.
Purpose: To analyze the applicability, safety, and effects of video games on upper limb function (UL) of individuals with PPS.
Methods: 32 patients diagnosed with PPS were recruited from the Giorgio Nicoli Motor Neuron Institute. We selected subjects of both genders, aged 40-75 years. The individuals performed 14 training sessions, lasting 50 minutes each, twice a week. Patients were randomly divided into Experimental Group (EG) and Control Group (CG), 16 patients in each group. The CG patients underwent conventional motor physical therapy exercises. The EG patients performed intervention with four Nintendo Wii Sports games: Tennis, Bowling, Golf, and Boxing. The individuals played each game for 10 minutes. The groups were evaluated before and after the 14 intervention sessions and 30 days after the end of the intervention. The primary outcome was the motor function assessed through the MFM-32 Motor Function Scale. The secondary outcomes were
(1) the functional independence assessed through the Functional Independence Measure (FIM);
(2) balance assessed through the Functional Reach Test;
(3) fatigue assessed through the Muscle Fatigue Severity Scale;
(4) pain, assessed through the Visual Analog Pain Scale (VAS) score for the upper limbs and,
(5) dexterity assessed through the Box and Block test.
Statistical analysis was done using ANOVA Type III for repeated measures and Bayesian ANOVA.
Results: There were no differences between the groups after the interventions or at the follow-up in any outcomes. Both groups presented improvement in motor function, dexterity, and functionality after the interventions (Tukey Post hoc tests, P 0.05). In addition, both groups presented decrease in muscle fatigue and pain, demonstrating that both, the Nintendo Wii Sports games and conventional physical therapy exercises are safe for post-polio patients.
Conclusion(s): Conventional physical therapy and the Nintendo Wii Sports games were safe, applicable and provided positive effects on the motor function, dexterity, and functionality of post-polio patients, without superiority between the interventions.
Implications: The reabilitation with the interactive video game is an alternative and an additional resource in the treatment of this population with security and applicability.
Keywords: Neuromuscular Diseases, Post-Polio Syndrome, Virtual Reality
Funding acknowledgements: Self-financing, we would like to thank the Giorgio Nicoli Institute.
Topic: Neurology
Ethics approval required: Yes
Institution: Universidade de São Paulo
Ethics committee: Institute of Psychology (CEP/IP/USP)
Ethics number: 1506941
All authors, affiliations and abstracts have been published as submitted.
