Abstract
To describe the intervention protocols to using commercial video games as virtual reality (VR) in rehabilitation of patients with stroke. Integrative review using the descriptors "rehabilitation", "virtual reality exposure therapy" and "videogames" in the LILACS and PUBMED databases. Articles published from 2011 to 2018 were selected. We found 1,396 articles, 1,383 were excluded and 13 were selected. Most of the articles were randomized clinical trials published in 2014 or later. The sample size varied from 5-47 adults, or adults and elders, with chronic stroke. The Nintendo Wii® was the most used video game system. The intervention happened two or three times a week, each session lasting from 30 to 60 minutes, over 2-12 weeks. Balance, upper limb motor functions, quality of life and daily living activities were the most common evaluated outcomes. The Fugl-Meyer Assessment, Berg Balance Scale, Timed Up and Go test, Barthel Scale and SF-36 were the most common outcome measurement tools. The studies indicated improvement in dynamic balance, upper limb motor function and quality of life after rehabilitation using VR. The VR was more effective than conventional treatments for the outcome of dynamic balance. Two studies did not find any changes in static balance and daily living activities. Physical aspects and quality of life were the outcomes most evaluated by the researchers; as were the population with chronic strokes and protocols of long duration and low intensity. Few studies targeted immediate VR effects, performance in daily living activities and social participation.
Highlights
Considering the above, this study aimed to review and analyze information from the literature on the main intervention protocols delineated by rehabilitation professionals, using virtual reality (VR) in commercial video game systems for the treatment of patients who had suffered strokes, while identifying the most common outcomes found by these professionals
After the filters were used, the abstract and content of the articles were carefully analyzed by two independent researchers who excluded studies with the following traits: interventions that were not focused on rehabilitation; development of intervention protocols in computer games; studies whose participants had primary health conditions different from those of stroke patients; studies whose games were classified as Exergames; articles with qualitative methodologies; and studies that used the video game in the residence of the participants and not in a clinical environment, which is known as telerehabilitation
Aramaki AL et al Virtual reality in the rehabilitation of stroke after their title and abstract were read, 10 were removed after the entire text had been analyzed and eight because they had been published in other languages
Summary
This was an integrative literature review, consisting of the analysis of relevant research that gave support for decision-making and the improvement of clinical practice, offering instruments for evidence-based practices[17]. The research took place in April 2018, and the criteria for the inclusion of the studies were: articles that used commercial video game system VR in the rehabilitation of patients who had strokes; were published in 2011 or later; and had their entire content made available. After the filters were used, the abstract and content of the articles were carefully analyzed by two independent researchers who excluded studies with the following traits: interventions that were not focused on rehabilitation; development of intervention protocols in computer games; studies whose participants had primary health conditions different from those of stroke patients; studies whose games were classified as Exergames; articles with qualitative methodologies; and studies that used the video game in the residence of the participants and not in a clinical environment, which is known as telerehabilitation
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