The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life

Abstract

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.

The therapeutic effects of physical treatment for patients with hereditary spastic paraplegia: a narrative review

“…The application of virtual reality (VR) can be employed as a therapeutic approach for the treatment of these individuals, as it serves to reinforce the connections between the vestibular and visual systems, while also improving both static and dynamic postural stability. Virtual reality (VR) has the potential to aid patients in restoring self-confidence, promoting increased autonomy in doing daily tasks, mitigating anxiety, and improving social relations through the improvement of balance ( 31 ). The existing literature suggests that this therapeutic approach offers various advantages, such as enhancing locomotion patterns, balance and posture, upper and lower limb functions, as well as fostering patient motivation for engaging in exercise ( 32 ).…”

Exergaming in the treatment of gait, balance, and quality of life in Parkinson's disease: Overview of systematic reviews

“…Such changes can reduce the quality of life of people with PD because they limit self‐confidence and functionality, making it difficult to carry out daily activities. As a result, patients become less capable, especially when performing activities that require mobility which can increase their risk of falling and can, subsequently, lead to serious complications (Boonstra et al., 2008; Duncan & Earhart, 2011; Zeigelboim et al., 2021).…”

Balance rehabilitation with a virtual reality protocol for patients with hereditary spastic paraplegia: Protocol for a clinical trial

“…Virtual reality can be used therapeutically to treat these patients by promoting stability and improving vestibular-visual interactions as well as enhancing static and dynamic postural stability; by improving balance, virtual reality may help reestablish self-confidence, provide greater independence in the development of daily activities, reduce anxiety and improve social interactions [ 10 ]. According to the literature, the benefits of this therapeutic modality include the correction of balance and posture, improved locomotion patterns, improved upper and lower limb functioning and greater motivation on the part of the patient to perform exercises [ 11 ].…”