Uso de um jogo de tabuleiro na reabilitação dos membros superiores de idosos institucionalizados em Portugal: um estudo piloto quase-experimental / Board game for the upper limbs rehabilitation in institutionalised elderly from Portugal: a quasiexperimental pilot study

INTRODUÇÃO: A utilização do jogo como estratégia de reabilitação tem revelado um especial impacto nas variáveis cognitivas no idoso, não sendo consensual o seu impacto em indicadores físicos. OBJETIVO: Medir o efeito do treino com um jogo de tabuleiro na melhoria da coordenação dos membros superiores e na força de preensão palmar em idosos institucionalizados. Foi também caracterizada a percepção dos idosos sobre o jogo como estratégia de reabilitação. MATERIAIS E MÉTODOS: Foi conduzido um estudo quase-experimental, longitudinal, incluindo 10 idosos institucionalizados sem alterações significativas na cognição (6CIT 0-7) e na mobilidade dos membros superiores. Este grupo foi inicialmente avaliado (T0) quanto à Força de preensão manual (FPM) e quanto à coordenação dos membros superiores (Bateria de testes EUROFIT), repetindo a avaliação após 2 semanas de terapias convencionais (T1), tendo sido novamente reavaliados 2 semanas após frequentarem as terapias convencionais mais 2 horas adicionais de um programa com um jogo de tabuleiro (T2). Foi ainda coletada a perceção dos idosos sobre a experiência com o jogo. Foi comparada a evolução entre T0-T1 e T1-T2 usando o teste de Wilcoxon. RESULTADOS: Apenas entre T1 e T2 ocorreram mudanças significativas na EUROFIT (p=0.005) e na FPM para ambos os membros (p=0.005; p= 0.007). Os idosos destacaram uma maior relevância do jogo no trabalho em equipe, no estímulo de raciocínio e de agilidade dos membros superiores. CONCLUSÃO: O jogo de tabuleiro é uma potencial ferramenta para completar a terapia convencional, sendo a experiência considerada muito positiva pelos idosos participantes (ClinicalTrials.gov IDIPL10062019).

INTRODUCTION: Using games as a rehabilitation strategy has significantly impacted cognitive variables in the elderly; however, its impact on physical indicators is not consensual. OBJECTIVE: To measure the effect of a training program with a board game on upper limb coordination and handgrip strength of institutionalized elderly. The elderly's perception of playing a board game as a rehabilitation strategy was also characterised. MATERIALS AND METHODS: A longitudinal quasi-experimental study was carried out, including 10 institutionalized elderly people without significant changes in cognition (6CIT 0-7) and upper limb mobility. This group was initially evaluated (T0) for handgrip strength (HGS) and coordination of the upper limbs (EUROFIT test battery), repeating the assessment after 2 weeks of conventional therapies (T1), and also again 2 weeks after attending conventional therapies plus an additional 2 hours of a board game program (T2). The perception of the elderly about their experience with the game was also collected. The evolution between T0-T1 and T1-T2 was compared using the Wilcoxon test. RESULTS: Only between T1 and T2 were significant changes in EUROFIT (p=0.005) and HGS for both members (p=0.005; p= 0.007). A greater relevance of game-based program for teamwork, stimulating reasoning, and agility of the upper limbs was perceived. CONCLUSION: The board game is a potential tool to complement conventional therapy, and the experience is well perceived by the elderly participants (ClinicalTrials.gov IDIPL10062019).

Effects of a Recreation Therapy Program on Mental Health and Heart Rate Variability in Burn Rehabilitation Patients

PURPOSE: This study was done to evaluate the effects of a recreation therapy program on burn rehabilitation patients to determine if the program is an effective nursing intervention which can affect mental health problems and heart rate variability. METHODS: Subjects were 54 hospitalized burn rehabilitation patients (25 in the control group, 29 in the experimental group). The experimental group participated 6 times in a recreation therapy program led by a qualified instructor. Brief symptoms inventory-18 (somatization, anxiety, depression) questionnaire, and heart rate variability were checked before and after the recreation therapy program. RESULTS: The mental health scale showed significant differences in somatization (p<.001), anxiety (p<.001) and depression (p<.001). There was no significant difference in heart rate variability (autonomic activity, autonomic balance, stress resistance, stress parameter and fatigue, mean heart rate, electro-cardiac stability). CONCLUSION: The findings from this study suggest that a recreation therapy program is an effective nursing intervention to decrease the level of mental health problems of burn rehabilitation patients. However, a subsequent study is needed to develop an intervention program that will induce the effect of physiological parameters like heart rate variability (HRV).