Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review / Intervención terapéutica con realidad virtual en pacientes con enfermedad de Parkinson para entrenamiento motor del miembro superior: revisión sistemática

To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.(AU)

Analizar la evidencia científica relativa a los cambios en las extremidades superiores en pacientes con enfermedad de Parkinson que utilizan realidad virtual como parte de su tratamiento de rehabilitación neurológica. La búsqueda se realizó en las bases de datos siguientes: MEDLINE, Cochrane Library, PEDROs y SCOPUS. Se aplicaron los siguientes criterios de inclusión a un total de 106 artículos: ensayos clínicos aleatorizados con edad de 5 años, muestra que incluyera pacientes con EP (independientemente de su estado de compromiso), y que hubieran realizado RV para el tratamiento de los miembros superiores. Se utilizó un total de n=7 artículos, en los que se midieron las variables correspondientes al control motor de los miembros superiores, tales como: destreza motora fina, destreza motora bruta, fuerza, temblor, funcionalidad y velocidad. La realidad virtual como herramienta de neurorehabilitación en los pacientes con enfermedad de Parkinson muestra efectos positivos en todas las medidas relacionadas con el control motor de las extremidades superiores.(AU)

Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review.

To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.

[Validity of the Wisconsin Gait Scale to predict the risk of falls in stroke patients]. / Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus.

INTRODUCTION: Approximately, half of the stroke patients suffered a fall during the first year after the injury, affecting its functionality. Gait evaluation scales could evaluate to predict the risk of falls. OBJECTIVE: To study the ability of the Wisconsin Gait Scale (WGS) to predict the risk of falls in stroke subjects. PATIENTS AND METHODS: Retrospective observational study that included stroke patients between May 2010 and October 2016. Data from the WGS and the Berg Balance Scale (BBS) were collected after hospitalization (acute phase), at 3 months (subacute phase) and at 6 and 12 months (chronic phases). BBS was used as the outcome variable to determine the ability of the WGS to predict the risk of falls. The calculation of the predictive validity was carried out using the ROC (Receiver Operating Characteristics) curves and the analysis of the area under the curve (AUC, area under the curve). RESULTS: Data were collected from 61 patients who met the inclusion criteria (after admission: 61; 3 months: 61; 6 months: 58; 12 months: 42). In all measurements, the AUC was greater than 0.9, so the WGS distinguishes stroke patients with moderate risk of falling from those with low risk. CONCLUSIONS: The WGS scale is a valid instrument to predict the risk of falls in patients with a criterion in relation to the cut-off points established in the BBS.

TITLE: Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus.Introducción. Aproximadamente, la mitad de las personas que han sufrido un ictus sufre una caída durante el primer año tras la lesión, lo que afecta a su funcionalidad. Las escalas de evaluación de la marcha podrían utilizarse para predecir el riesgo de caídas. Objetivo. Estudiar la capacidad de la Wisconsin Gait Scale (WGS) para predecir el riesgo de caídas en pacientes con ictus. Pacientes y métodos. Estudio observacional retrospectivo que incluyó a pacientes con ictus entre mayo de 2010 y octubre de 2016. Se recopilaron datos de la WGS y de la Berg Balance Scale (BBS) tras la hospitalización (fase aguda), a los tres meses (fase subaguda) y a los seis y 12 meses (fases crónicas). Se empleó la BBS como variable de resultado para determinar la capacidad de la WGS para predecir el riesgo de caídas. El cálculo de la validez predictiva se llevó a cabo mediante las curvas receiver operating characteristics y el análisis del área bajo la curva (AUC). Resultados. Se recopilaron datos de 61 pacientes que cumplieron los criterios de inclusión (tras la admisión: 61; a los tres meses: 61; a los seis meses: 58; a los 12 meses: 42). En todas las mediciones, el AUC fue mayor de 0,9, por lo que la WGS distingue a los pacientes con ictus con riesgo moderado de sufrir caídas de los de riesgo bajo. Conclusiones. La WGS es un instrumento válido para predecir el riesgo de caídas en pacientes con un ictus en relación con los puntos de corte establecidos en la BBS.

Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus / Validity of the Wisconsin Gait Scale to predict the risk of falls in stroke patients

Introducción: Aproximadamente, la mitad de las personas que han sufrido un ictus sufre una caída durante el primer año tras la lesión, lo que afecta a su funcionalidad. Las escalas de evaluación de la marcha podrían utilizarse para predecir el riesgo de caídas. Objetivo: Estudiar la capacidad de la Wisconsin Gait Scale (WGS) para predecir el riesgo de caídas en pacientes con ictus. Pacientes y métodos: Estudio observacional retrospectivo que incluyó a pacientes con ictus entre mayo de 2010 y octubre de 2016. Se recopilaron datos de la WGS y de la Berg Balance Scale (BBS) tras la hospitalización (fase aguda), a los tres meses (fase subaguda) y a los seis y 12 meses (fases crónicas). Se empleó la BBS como variable de resultado para determinar la capacidad de la WGS para predecir el riesgo de caídas. El cálculo de la validez predictiva se llevó a cabo mediante las curvas receiver operating characteristics y el análisis del área bajo la curva (AUC). Resultados: Se recopilaron datos de 61 pacientes que cumplieron los criterios de inclusión (tras la admisión: 61; a los tres meses: 61; a los seis meses: 58; a los 12 meses: 42). En todas las mediciones, el AUC fue mayor de 0,9, por lo que la WGS distingue a los pacientes con ictus con riesgo moderado de sufrir caídas de los de riesgo bajo. Conclusiones: La WGS es un instrumento válido para predecir el riesgo de caídas en pacientes con un ictus en relación con los puntos de corte establecidos en la BBS.(AU)

Introduction: Approximately, half of the stroke patients suffered a fall during the first year after the injury, affecting its functionality. Gait evaluation scales could evaluate to predict the risk of falls. Objective: To study the ability of the Wisconsin Gait Scale (WGS) to predict the risk of falls in stroke subjects. Patients and methods. Retrospective observational study that included stroke patients between May 2010 and October 2016. Data from the WGS and the Berg Balance Scale (BBS) were collected after hospitalization (acute phase), at 3 months (subacute phase) and at 6 and 12 months (chronic phases). BBS was used as the outcome variable to determine the ability of the WGS to predict the risk of falls. The calculation of the predictive validity was carried out using the ROC (Receiver Operating Characteristics) curves and the analysis of the area under the curve (AUC, area under the curve). Results: Data were collected from 61 patients who met the inclusion criteria (after admission: 61; 3 months: 61; 6 months: 58; 12 months: 42). In all measurements, the AUC was greater than 0.9, so the WGS distinguishes stroke patients with moderate risk of falling from those with low risk. Conclusions: The WGS scale is a valid instrument to predict the risk of falls in patients with a criterion in relation to the cut-off points established in the BBS.(AU)

Construct validity of the Wisconsin Gait Scale in acute, subacute and chronic stroke.

OBJECTIVE: To assess the construct validity of the Wisconsin Gait Scale (WGS) in subjects after stroke. METHODS: A retrospective observational study was conducted at inpatient rehabilitation hospital. Data from 61 stroke patients was compiled. The Functional Ambulatory Categories (FAC), the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke Patients (PASS), the Barthel Index (BI) and the Functional Independence Measure (FIM) were selected to analyze the WGS construct validity at four specific time points after stroke (acute, subacute and chronic stages). Spearman correlation coefficients investigated the relationship between WGS and clinical measures. RESULTS: The construct validity of the WGS in patients with stroke at acute stage was moderate with the FAC (r=-.773), the BBS (r=-.676), the PASS (r=-.646) and the FIM (r=-.592). At subacute stage, the construct validity of the WGS was excellent with the FAC (r=-878), the BBS (r=-.882), the PASS (r=-.847) and the BI (r=-.813). The correlation was moderate with the FIM (r=-.693). At six and twelve months, the construct validity of WGS with the FAC, the BBS, the PASS, the BI and the FIM was excellent (r ≥ .8). CONCLUSION: The WGS has moderate construct validity with walking, balance and functionality scales in patients with acute stroke. The correlation with the FAC, the BBS, the PASS and the BI at subacute and chronic stages was excellent.