Abstract
Objective: To evaluate the efficacy of Nintendo Wii training in quality of life in Parkinson’s disease (PD) patients when compared to traditional physical therapy (PT). Methods: A randomized, single-blinded trial with 2 parallel arms was performed in a referral center for movement disorders in North-eastern, Brazil. Forty-four PD outpatients that fulfilled the eligibility criteria with mild to moderate motor impairment were randomized. Both groups executed a warm up session for 10 minutes that consisted of trunk flexion, extension and rotation, associated with upper and lower limbs stretching. The PT group followed a program that consisted of trunk and limb mobilisation, balance, muscle strengthening, rhythmic movement, postural alignment, double-task execution, bimanual tasks, and gait training. The Nintendo Wii group executed a sequence of tasks according to a previously established protocol, with similar training exercises. Duration of exercises was 40 minutes per session, 3 days per week for 4 weeks. The primary endpoint was the total score obtained in the Parkinson’s disease quality of life questionnaire (PDQ-39) translated from English to Brazilian Portuguese by Oxford outcomes. Secondary endpoints were the scores achieved by each group in the following domains of PDQ-39 scale: mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort. Assessments were performed before and after intervention in both groups with subjects in the “on” period. Results: Subjects in the Nintendo Wii group showed greater improvement in the PDQ-39 total score when compared to PT group (p = 0.01). Also, significant differences were observed in ADL, stigma, social support and communication when comparing subjects before and after intervention in the Nintendo Wii group (p < 0.05). Conclusions: The results achieved in this trial suggest that rehabilitation using Nintendo Wii may have beneficial effects in quality of life of PD subjects, when compared to traditional PT. Further larger randomised controlled-trials are necessary to reassure these results.
Highlights
Parkinson’s disease (PD) is classically characterised by rigidity, tremor, bradykinesia, and postural instability [1]
A total of 71 subjects were recruited and 44 that fulfilled the eligibility criteria were randomized to traditional physical therapy (PT) or Nintendo Wii, with the same number of patients in each arm (Figure 1)
All patients submitted to Nintendo Wii training showed an improvement of more than 10% in their total quality of life scores (P < 0.05)
Summary
Parkinson’s disease (PD) is classically characterised by rigidity, tremor, bradykinesia, and postural instability [1]. The relevance of traditional physical therapy (PT) has been recognized to alleviate PD symptoms and improve quality of life, there are no clear guidelines or practical uniform recommendations that support this treatment. Despite several case reports showing motor improvements in PD patients after exercising with VG, no clear evidence has been presented so far to show whether these exercises are beneficial to improve quality of life in PD patients. The objective of this trial was to evaluate the effects of Nintendo Wii training in quality of life of PD patients, when compared to traditional PT
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