Bacha JMR1, Cunha MCC1, Silva KG1, Freitas TB2, Doná F3, Ganança FF3, Pompeu JE1
1University of Sao Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Faculty of Medicine, Sao Paulo, Brazil, 2University of Sao Paulo, Motor Behavior Laboratory, School of Physical Education and Sport, Sao Paulo, Brazil, 3Federal University of São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery, Sao Paulo, Brazil
Background: Parkinson´s disease (PD) is degenerative, chronic, and progressive, with postural instability being one of the most limiting symptoms and the most refractory to dopaminergic replacement treatment. Virtual reality is a new intervention possibility that is attractive to patients, and offers diverse stimuli that favor motor-sensorial integration. Although little explored, virtual reality could have beneficial effects on the postural control of individuals with PD.
Purpose: To analyze the effects of training through Kinect Adventures! Games on the area of the limits of stability and postural oscillation in conditions of static and non static visual environment in people with Parkinson's disease.
Methods: This is a pilot study, ten individuals diagnosed with idiopathic PD, in stages I to III of the Hoehn & Yahr scale and aged between 48 and 73 years were selected. In total, 14 training sessions of one hour each were performed, twice a week.Individuals were evaluated pre and post-intervention and 30 days after the final intervention session using a force platform, which measured the Limits of Stability (LOS), and the oscillation area of the center of pressure (COP) and oscillation velocity of the center of pressure (VOS) both in ten different sensory conditions. Demographic and clinical data from the patients were collected and normality and homogeneity tests were carried out through the Kolmogorov-Smirnov and Levene's tests, respectively. For the parametric variables, the comparisons in the three conditions (before and after the intervention and 30 days after the intervention) were performed using ANOVA and, for the non-parametric variables, Kruskal Wallis tests were carried out. An alpha of 0.05 was adopted as statistical significance and the confidence interval was 95%.
Results: The LOS presented a statistically significant increase immediately after the training sessions, while no significant changes were observed in COP and VOS immediately after the intervention or 30 days after the end of training.
Conclusion(s): Training with Kinect Adventures! Games improves the postural control of people with PD, by increasing the LOS.
Implications: The increase in LOS allows better displacement of weight during the performance of tasks, with better guaranteed stability, reducing the risk of falling. The training with Kinect Adventures! Games may have decreased muscle and axial rigidity and bradykinesia, as well as possibly increasing articular mobility, factors which could also be related to improvement in LOS.
Keywords: Virtual reality, physiotherapy, Parkinson's disease
Funding acknowledgements: Fundação de Amparo à Pesquisa do Estado de São Paulo. Number 2015/19622-7 and 2014/22348-1.
Purpose: To analyze the effects of training through Kinect Adventures! Games on the area of the limits of stability and postural oscillation in conditions of static and non static visual environment in people with Parkinson's disease.
Methods: This is a pilot study, ten individuals diagnosed with idiopathic PD, in stages I to III of the Hoehn & Yahr scale and aged between 48 and 73 years were selected. In total, 14 training sessions of one hour each were performed, twice a week.Individuals were evaluated pre and post-intervention and 30 days after the final intervention session using a force platform, which measured the Limits of Stability (LOS), and the oscillation area of the center of pressure (COP) and oscillation velocity of the center of pressure (VOS) both in ten different sensory conditions. Demographic and clinical data from the patients were collected and normality and homogeneity tests were carried out through the Kolmogorov-Smirnov and Levene's tests, respectively. For the parametric variables, the comparisons in the three conditions (before and after the intervention and 30 days after the intervention) were performed using ANOVA and, for the non-parametric variables, Kruskal Wallis tests were carried out. An alpha of 0.05 was adopted as statistical significance and the confidence interval was 95%.
Results: The LOS presented a statistically significant increase immediately after the training sessions, while no significant changes were observed in COP and VOS immediately after the intervention or 30 days after the end of training.
Conclusion(s): Training with Kinect Adventures! Games improves the postural control of people with PD, by increasing the LOS.
Implications: The increase in LOS allows better displacement of weight during the performance of tasks, with better guaranteed stability, reducing the risk of falling. The training with Kinect Adventures! Games may have decreased muscle and axial rigidity and bradykinesia, as well as possibly increasing articular mobility, factors which could also be related to improvement in LOS.
Keywords: Virtual reality, physiotherapy, Parkinson's disease
Funding acknowledgements: Fundação de Amparo à Pesquisa do Estado de São Paulo. Number 2015/19622-7 and 2014/22348-1.
Topic: Neurology: Parkinson's disease; Robotics & technology
Ethics approval required: Yes
Institution: Universidade Federal de Sao Paulo
Ethics committee: Ethical Committee of the Universidade Federal de Sao Paulo
Ethics number: 08885912.1.0000.550
All authors, affiliations and abstracts have been published as submitted.
