Realidade virtual não-imersiva no desempenho funcional,sintomas de depressão e qualidade de vida na Doença de Parkinson: um estudo piloto

Abstract

Background: Motor symptoms of Parkinson's disease (PD) can lead to movement disorders of upper limb (UL), affecting the performance of activities of daily life (ADL) and patient independence. The literature is still scarce in relation to the therapeutic approach of the UL in patients with PD. Objective: This study aimed to investigate the effects of non-immersive virtual reality training on the UL, as well as on the quality of life of patients with PD. Methods: We evaluated prospectively 16 volunteers of both genders, age 64 ± 5 years, diagnosis time of 5.4 ± 3.8 years, Hoehn & Yahr of 2.5 [2.0; 3.0]. Patients were recruited between January 2015 and January 2017 at the Neurology outpatient clinic of the Fluminense Federal University-UFF, Niteroi - RJ, Brazil. Participants performed 22 individualized training sessions, with non-immersive virtual reality, playing eight games of the Nintendo Wii®. They were supervised by a physiotherapist in all sessions, held twice a week, lasting 60 minutes each. Main outcome measures: quality of life was assessed using the Specific Quality of Life Assessment Scale in PD - PDQ - 39 and the clinical results were determined based on the Unified Parkinson's Disease Scale - UPDRS (Total, Sections II and III). The motor results were evaluated using the Test d'Evaluation des Membres Superieurs de Personnes Agees (TEMPA) and Nine Hole Peg Test (9HPT). Results: There were significant differences were observed for the variables PDQ39 total (p = 0.019), PDQ39 in the mobility domains (p = 0.002), ADLs (p = 0.043), cognition = 0.017), communication (p <0.001) and body discomfort (p = 0.011). Significant differences were observed for the total UPDRS (p = 0.002), as well as for UPDRS II and III (both p <0.001) for the pre, postintervention and follow-up analysis, statistically significant differences were observed for total TEMPA (p = 0.003), task 4 (p = 0.005), task 5 (p = 0.002), task 6 (p <0.001), task 7 (right: p = 0.009, left: p <0.001), task 8 (right: p = 0.002; left: p <0.001) for pre, postintervention and follow up analysis. No significant differences were observed for 9HPT. Conclusion: Patients with PD in the 2-3 stages of Hoehn and Yahr presented functional improvement of the UL submitted to non-immersive virtual reality training, even one month after the end of the protocol