Virtual Reality Therapy in the Treatment of Ham/TSP Individuals: Radomized Clinical Trial

Abstract

Introdution: The myelopathy associated with HTLV-1 or tropical spastic paraparesis (HAM/TSP) is a chronic, progressive demyelination disease that predominantly affects the spinal cord. The balance and locomotion in affected individuals are compromised and require therapeutic alternatives for rehabilitation. Objective: To determine the effect on aspects of balance, pain and quality of life for the use of virtual reality as an additional therapeutic option in the treatment of patients with HAM / TSP. Methodology: Randomized double blind clinical trial was conducted with nine individuals with the diagnosis confirmed by WHO criteria, divided into a group that performed a protocol of therapeutic exercises and another added that the exercise protocol, four games to virtual reality. All participants underwent an evaluation of the balance by Berg scale, of pain by visual analogical scale (VAS) and quality of life by SF-36 before and after 10 sessions. Results: The group that performed exercises with virtual therapy showed improvements in balance (p=0.033), functional capacity (p=0.010) and emotional aspects (p=0.004) in the intragroup analysis and the emotional aspects on intergroup analysis (p=0.027). Conclusion: Virtual reality did not reduce pain intensity but demonstrated a positive impact on the emotional aspects of quality of life.

Exergaming for Quality of Life in Persons Living with Chronic Diseases: A Systematic Review and Meta‐analysis

“…Thirty‐four studies (n = 1594 participants) published between 2010 and 2019 fulfilled all the inclusion criteria and were included: 30 randomized controlled trials 38‐67 and four controlled, cross‐over trials 68‐71 . Table 1 summarizes the main characteristics of the included studies.…”

“…Samples in the included studies ranged widely between 12 40 and 224 participants, 36 with a mean (±SD) of 54.4 ± 48.8. Twenty‐one studies targeted persons affected by neurological disorders, such as stroke, 38,40,45,51,52,61,62,64 Parkinson's disease, 46,47,53,58,60,65 Alzheimer's disease, 55,56 cognitive decline and mild cognitive impairment, 50,57 multiple sclerosis, 69 Huntington's disease, 68 or tropical spastic hemiparesis 42 . Five studies targeted persons with rheumatologic diseases, such as osteoarthritis, 44,67 fibromyalgia, 39 ankylosing spondylitis, 48 and rheumatoid arthritis 71 .…”

“…The length of interventions ranged between 2 61,62 and 24 weeks, 66 with a mean (±SD) of 8.05 ± 4.3 weeks. Exergame‐based interventions in 24 of the included studies were performed with the Nintendo Wii console, through the games available with the Wii platform (Wii Sports, Wii Fit, Wii Minisports) 38,40‐43,45,47,49,50,53‐64,69‐71 . In nine studies, the exergame‐based intervention was carried out using the Microsoft Kinect console (Xbox, Kinect Adventures, Kinect Sports, Light Race), 39,44,46,48,51,52,65‐67 and one study used the Dance Dance Revolution game platform 68 …”

“…Conventional disease‐related rehabilitation treatments included conventional exercise‐based rehabilitation training 38,40,42,44,46,51,55,56,58,60,63,65,71 and some specific rehabilitation programs 43,47,50,52‐54,57,59,60,62,64,68 . Interventions were carried out in clinical or rehabilitation care centers in all except 10 studies, in which exergame‐based programs were performed at home, mostly unsupervised 38,41,49,55,59,66,69,70 .…”

“…HRQoL was the primary outcome in 17 studies 39, 40, 42, 44, 48‐ 50, 52, 57, 58, 63, 64, 66, 67, 69‐71 and a secondary outcome in another 17 studies 38,41,43,45‐47,51,53‐56,59‐62,65,68 . HRQoL was assessed through widely used general questionnaires, such as EuroQoL‐5 Dimensions, 5‐item World Health Organization Well‐being Index, World Health Organization‐QoL Brief, and Short Form Health Survey at 36, 12, or 8 items, 38‐40,42,44,49,52,57,59,63,67,68,70,71 or through disease‐specific questionnaires measuring the disease‐specific burden on HRQoL 41,43,45‐48,50,51,53‐56,58,60‐62,64‐66,69 . (See Table 1 for the HRQoL assessment tools.…”