The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily LifeFunding This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) under grant number 001.
Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability.
Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation.
Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality.
Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95% CI −0.85; −0.17) first and (p = 0.002, 95% CI −0.88; −0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95% CI −0.85; −0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95% CI −12.5; −0.3) and ski slalom games (p = 0.005, 95% CI −34.8; −6.6).
Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.
Received: 13 May 2019
Accepted: 26 December 2019
24 April 2020 (online)
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- 1 Andrade LAF, Barbosa ER, Cardoso F, Teive HAG. Parkinson's disease: Current treatment strategies. São Paulo: Lemos Editorial; 1999
- 2 Mhatre PV, Vilares I, Stibb SM. et al. Wii Fit balance board playing improves balance and gait in Parkinson disease. PM R 2013; 5 (09) 769-777
- 3 Silva PFC, Pereira RPR, Silva SM, Corrêa JCF, Corrêa FI. Correlation between clinical profile, quality of life and disability of the patients of Associação Brasil Parkinson. ConsScientiare Saúde 2011; 10 (04) 650-656
- 4 Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 2008; 79 (04) 368-376
- 5 Lee HK, Altmann LJ, McFarland N, Hass CJ. The relationship between balance confidence and control in individuals with Parkinson's disease. Parkinsonism Relat Disord 2016; 26: 24-28
- 6 Zeigelboim BS, Jurkiewicz AL, Fukuda Y, Mangabeira-Albernaz PL. Vestibular alterations in degenerative diseases of the central nervous system. Pro Fono 2001; 13: 263-270
- 7 Smiley-Oyen AL, Cheng HY, Latt LD, Redfern MS. Adaptation of vibration-induced postural sway in individuals with Parkinson's disease. Gait Posture 2002; 16 (02) 188-197
- 8 Herdman SJ. Vestibular rehabilitation. Curr Opin Neurol 2013; 26 (01) 96-101
- 9 Cohen H. Vestibular rehabilitation improves daily life function. Am J Occup Ther 1994; 48 (10) 919-925
- 10 Aratani MC, Ricci NA, Caovilla HH, Ganança FF. Brazilian version of the Vestibular Disorders Activities of Daily Living Scale (VADL). Rev Bras Otorrinolaringol (Engl Ed) 2013; 79 (02) 203-211
- 11 Marques AP, Mendes YC, Taddei U, Pereira CA, Assumpção A. Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence (ABC) scale. Braz J Phys Ther 2013; 17 (02) 170-178
- 12 Kim S, Horak FB, Carlson-Kuhta P, Park S. Postural feedback scaling deficits in Parkinson's disease. J Neurophysiol 2009; 102 (05) 2910-2920
- 13 Schrag A, Jahanshahi M, Quinn N. How does Parkinson's disease affect quality of life? A comparison with quality of life in the general population. Mov Disord 2000; 15 (06) 1112-1118
- 14 Adkin AL, Frank JS, Jog MS. Fear of falling and postural control in Parkinson's disease. Mov Disord 2003; 18 (05) 496-502
- 15 Ellis T, Cavanaugh JT, Earhart GM, Ford MP, Foreman KB, Dibble LE. Which measures of physical function and motor impairment best predict quality of life in Parkinson's disease?. Parkinsonism Relat Disord 2011; 17 (09) 693-697
- 16 Bryant MS, Rintala DH, Hou JG, Protas EJ. Influence of fear of falling on gait and balance in Parkinson's disease. Disabil Rehabil 2014; 36 (09) 744-748
- 17 Herman T, Giladi N, Gruendlinger L, Hausdorff JM. Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson's disease: a pilot study. Arch Phys Med Rehabil 2007; 88 (09) 1154-1158
- 18 Müjdeci B, Aksoy S, Atas A. Evaluation of balance in fallers and non-fallers elderly. Rev Bras Otorrinolaringol (Engl Ed) 2012; 78 (05) 104-109
- 19 Wolfson L, Judge J, Whipple R, King M. Strength is a major factor in balance, gait, and the occurrence of falls. J Gerontol A Biol Sci Med Sci 1995; 50 (Spec No): 64-67
- 20 Gushikem P, Caovilla HH, Ganança MM. Avaliação otoneurológica em idosos com tontura. Acta Awho. 2002; 21 (01) 1-25
- 21 Mota PHM, Franco ES, Monteiro Pinto ES, Arieta AM. Estudo do equilíbrio no idoso por meio da electronistagmografia. Acta Awho. 2002; 21 (03) 1-12
- 22 Martins Bassetto J, Zeigelboim BS, Jurkiewicz AL, Klagenberg KF. Achados otoneurológicos em pacientes com doença de Parkinson. Rev Bras Otorrinolaringol 2008; 74: 350-355
- 23 Jankovic J, Kapadia AS. Functional decline in Parkinson disease. Arch Neurol 2001; 58 (10) 1611-1615
- 24 Shulman LM, Gruber-Baldini AL, Anderson KE. et al. The evolution of disability in Parkinson disease. Mov Disord 2000; 15: 1112-1118
- 25 Volpe D, Giantin MG, Manuela P. et al. Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson's disease: a randomized controlled pilot study. Clin Rehabil 2017; 31 (08) 1107-1115
- 26 Atterbury EM, Welman KE. Balance training in individuals with Parkinson's disease: Therapist-supervised vs. home-based exercise programme. Gait Posture 2017; 55: 138-144
- 27 Curtze C, Nutt JG, Carlson-Kuhta P, Mancini M, Horak FB. Objective gait and balance impairments relate to balance confidence and perceived mobility in people with Parkinson disease. Phys Ther 2016; 96 (11) 1734-1743
- 28 Canning CG, Sherrington C, Lord SR. et al. Exercise for falls prevention in Parkinson disease: a randomized controlled trial. Neurology 2015; 84 (03) 304-312
- 29 Zettergren K, Franca J, Antunes M, Lavallee C. The effects of Nintendo Wii Fit training on gait speed, balance, functional mobility and depression in one person with Parkinson's disease. ATI 2011; 5 (02) 38-44
- 30 Marchant D, Sylvester JL, Earhart GM. Effects of a short duration, high dose contact improvisation dance workshop on Parkinson disease: a pilot study. Complement Ther Med 2010; 18 (05) 184-190
- 31 Petzinger GM, Walsh JP, Akopian G. et al. Effects of treadmill exercise on dopaminergic transmission in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse model of basal ganglia injury. J Neurosci 2007; 27 (20) 5291-5300
- 32 Lin MR, Wolf SL, Hwang HF, Gong SY, Chen CY. A randomized, controlled trial of fall prevention programs and quality of life in older fallers. J Am Geriatr Soc 2007; 55 (04) 499-506
- 33 Acarer A, Karapolat H, Celebisoy N, Ozgen G, Colakoglu Z. Is customized vestibular rehabilitation effective in patients with Parkinson's?. NeuroRehabilitation 2015; 37 (02) 255-262