Virtual reality applied to the lower limb motor function in post-stroke individuals
DOI:
https://doi.org/10.5935/0104-7795.20160026Keywords:
Stroke, Postural Balance, Lower Extremity, Rehabilitation, Virtual Reality Exposure TherapyAbstract
Strokes can generate significant motor, tonic and sensitive changes. Virtual reality (RV), focused on rehabilitation, can bring several benefits such as improvements on physical fitness, motor skills and balance. Objective: To assess the effects of the RV intervention to the static and dynamic balance, weight load on the affected limb, tone and muscle recruitment, functional independence and sensorimotor function in post-stroke individuals. Methods: Quasi-experimental and prospective clinical study with 6 subjects with diagnosis of stroke. Before and after the intervention with Nintendo Wii Fit Plus, the subjects were assessed by the Berg Balance Scale, Timed “Up and Go” and Dynamic Floor Index; Gait Test (GT); Modified Ashworth Scale (MAS); Electromyography; Barthel Index and Fugl-Meyer Scale (FMS). The Statistical analysis used Kolmogorov-Smirnov test, t test and Wilcoxon. Results: The 1st and 15th session evaluations have shown that GT (p = 0.03, d = 1.96, P = 96%), MAS for hip extensor muscles (p = 0.04; d = 3.77; P = 99%), knee extensors (p = 0.04; d = 3.23; P = 99%), plantar flexors (p = 0.01; d = 3.18; P = 99%), FMS in coordination/velocity dimensions (p = 0.02; d = 6.74; P = 100%) and sensitivity (p = 0.01) presented significant results, large effect size and power above 90%. Significant values were not found to the other evaluations. Conclusion: The RV rehabilitation program was effective and improved the weight-load in affected limb, muscle tone and sensorimotor function of the subjects
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Barcala L, Colella F, Araujo MC, Salgado ASI, Oliveira CS. Análise do equilíbrio em pacientes hemiparéticos após o treino com o programa Wii Fit. Fisioter Mov. 2011;24(2):337-43. DOI: http://dx.doi.org/10.1590/S0103-51502011000200015
Campos TF, Pinheiro CDG, Diógenes FP, Barroso MTM, Dantas AATSG. Cronotipo e implicações para sua utilização na fisioterapia em pacientes com acidente vascular encefálico. Fisioter Pesq. 2011;18(3):258-63. DOI: http://dx.doi.org/10.1590/S1809-29502011000300010
Pavão SL, Sousa NVC, Oliveira CM, Castro PCG, Santos MCM. O ambiente virtual como interface na reabilitação pós-AVE. Fisioter Mov. 2013;26(2):455-62. DOI: http://dx.doi.org/10.1590/S0103-51502013000200022
Santana I, Duro D, Lemos R, Costa V, Pereira M, Simões MR, et al. Mini-Mental State Examination: screening and diagnosis of cognitive decline, using new normative data. Acta Med Port. 2016;29(4):240-8. DOI: http://dx.doi.org/10.20344/amp.6889
Faria CDCM, Saliba VA, Teixeira-Salmela LF, Nadeau S. Comparação entre indivíduos hemiparéticos com e sem histórico de quedas com base nos componentes da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Fisioter Pesq. 2010;17(3):242-7. DOI: http://dx.doi.org/10.1590/S1809-29502010000300010
Bonnyaud C, Pradon D, Bensmail D, Roche N. Dynamic Stability and Risk of Tripping during the Timed Up and Go Test in Hemiparetic and Healthy Subjects. PLoS One. 2015;10(10):e0140317. DOI: http://dx.doi.org/10.1371/journal.pone.0140317
Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007;88(11):1410-5. PMID: 17964880 DOI: http://dx.doi.org/10.1016/j.apmr.2007.08.109
Luvizutto GJ, Gameiro MO. Efeito da espasticidade sobre os padrões lineares de marcha em hemiparético. Fisioter Mov. 2011;24(4):705-12. DOI: http://dx.doi.org/10.1590/S0103-51502011000400015
Rangel ESS, Belasco AGS, Diccini S. Qualidade de vida de pacientes com acidente vascular cerebral em reabilitação. Acta Paul Enferm. 2013;26(2):205-12. DOI: http://dx.doi.org/10.1590/S0103-21002013000200016
Michaelsen SM, Rocha AS, Knabben RJ, Rodrigues LP, Fernandes CG. Translation, adaptation and inter-rater reliability of the administration manual for the Fugl-Meyer assessment. Rev Bras Fisioter. 2011;15(1):80-8. DOI: http://dx.doi.org/10.1590/S1413-35552011000100013
Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erbaum; 1988.
Goble DJ, Cone BL, Fling BW. Using the Wii Fit as a tool for balance assessment and neurorehabilitation: the first half decade of "Wii-search". J Neuroeng Rehabil. 2014;11:12. DOI: http://dx.doi.org/10.1186/1743-0003-11-12
Barcala L, Grecco LA, Colella F, Lucareli PR, Salgado AS, Oliveira CS. Visual biofeedback balance training using wii fit after stroke: a randomized controlled trial. J Phys Ther Sci. 2013;25(8):1027-32. DOI: http://dx.doi.org/10.1589/jpts.25.1027
Singh DKA, Nordin NAM, Aziz NAA, Lim BK, Soh LC. Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. BMC Neurol. 2013;13(199):1-7. DOI: http://dx.doi.org/10.1186/1471-2377-13-199
Saposnik G1, Teasell R, Mamdani M, Hall J, McIlroy W, Cheung D, et al. Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke. 2010;41(7):1477-84. DOI: http://dx.doi.org/10.1161/STROKEAHA.110.584979
Nitz JC, Kuys S, Isles R, Fu S. Is the Wii Fit a new-generation tool for improving balance, health and well-being? A pilot study. Climacteric. 2010;13(5):487-91. DOI: http://dx.doi.org/10.3109/13697130903395193
Pereira LC, Botelho AC, Martins EF. Correlação entre simetria corporal na descarga de peso e alcance funcional em hemiparéticos crônicos. Rev Bras Fisioter. 2010;14(3):259-66. DOI: http://dx.doi.org/10.1590/S1413-35552010000300009
Duncan F, Lewis SJ, Greig CA, Dennis MS, Sharpe M, MacLullich AM, et al. Exploratory longitudinal cohort study of associations of fatigue after stroke. Stroke. 2015;46(4):1052-8. DOI: http://dx.doi.org/10.1161/STROKEAHA.114.008079
Ding Q, Stevenson IH, Wang N, Li W, Sun Y, Kording KP, et al. Motion games improve balance control in stroke survivors Displays. 2013;32(2):125-131.
Silva AT, Dias MP, Calixto R Jr, Carone AL, Martinez BB, Silva AM, et al. Acute effects of whole-body vibration on the motor function of patients with stroke: a randomized clinical trial. Am J Phys Med Rehabil. 2014;93(4):310-9. DOI: http://dx.doi.org/10.1097/PHM.0000000000000042
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