RESUMO
Introduction: Stroke is the leading cause of functional disability worldwide. With the increase of the global population, motor rehabilitation of stroke survivors is of ever-increasing importance. In the last decade, virtual reality (VR) technologies for rehabilitation have been extensively studied, to be used instead of or together with conventional treatments such as physiotherapy or occupational therapy. The aim of this work was to evaluate the GestureCollection VR-based rehabilitation tool in terms of the brain changes and clinical outcomes of the patients. Methods: Two groups of chronic patients underwent a rehabilitation treatment with (experimental) or without (control) complementation with GestureCollection. Functional magnetic resonance imaging exams and clinical assessments were performed before and after the treatment. A functional connectivity graph-based analysis was used to assess differences between the connections and in the network parameters strength and clustering coefficient. Results: Patients in both groups showed improvement in clinical scales, but there were more increases in functional connectivity in the experimental group than in the control group. Discussion: The experimental group presented changes in the connections between the frontoparietal and the somatomotor networks, associative cerebellum and basal ganglia, which are regions associated with reward-based motor learning. On the other hand, the control group also had results in the somatomotor network, in its ipsilateral connections with the thalamus and with the motor cerebellum, which are regions more related to a purely mechanical activity. Thus, the use of the GestureCollection system was successfully shown to promote neuroplasticity in several motor-related areas.
RESUMO
Objetivo: Comparar nos idosos a evolução do equilíbrio, cognição e marcha durante a prática de exercício físico com a realidade virtual. Métodos: 31 participantes de ambos os sexos, foram divididos nos grupos: 1. Realidade Virtual (RV); 2. Exercício Físico (EF) e 3. Realidade Virtual e Exercício Físico (RVEF), realizaram procedimentos com um quebra-cabeça virtual (grupos RV) e/ou exercício físico de caminhada (grupos EF), durante 5 meses. Resultados: Na atenção todos os grupos aumentaram o escore médio após o período de intervenção. Na memória as diferenças estatisticamente significativas ocorreram nos grupos RV e RVEF. No equilíbrio todos os grupos aumentaram o escore após o período de intervenção. Na marcha o grupo RVEF obteve melhor resultado. Conclusões: As intervenções por RV e EF mostraram-se eficazes para a melhora do equilíbrio, marcha, atenção e memória. Portanto, conclui-se que a intervenção por RV associada ao EF melhora o desempenho físico funcional em idosos.
Objective: To compare in the elderly, the evolution of balance, cognition and walking during physical exercise with virtual reality. Methods: 31 participants of both sexes divided into groups: 1. Virtual Reality (VR); 2. Physical Exercise (PE) and 3. Virtual Reality and Physical Exercise (VRPE), performed procedures with a virtual puzzle (VR groups) or walking physical exercise (PE groups), during five months. Results: In the attention test, all groups increased the mean score after the intervention period; In the memory test, statistically significant differences occurred in the VR and VRPE groups; In the balance test, all groups increased the score after the intervention period, and in the gait test, the VRPE group obtained better results. Conclusions: The interventions by VR and PE were effective in improving balance, gait, attention and memory. Therefore, we conclude that VR intervention associated with PE improves functional physical performance in the elderly.
Objetivo: Comparar la evolución del equilibrio, la cognición y la marcha durante el ejercicio físico con la realidad virtual del ancianos. Métodos: 31 participantes de ambos sexos fueron divididos en grupos: 1. Realidad Virtual (RV) con un rompecabezas virtual; 2. Ejercicio Físico (EF) caminando; y 3. Realidad Virtual y Ejercicio Físico (RVEF). La intervención ha durado cinco meses. Resultados: En la atención todos aumentaron la puntuación media después del período de intervención. En la memoria, las diferencias estadísticamente significativas ocurrieron en los grupos RV y RVEF. En equilibrio, todos aumentaron la puntuación después del período de intervención. En la marcha el grupo RVEF obtuvo mejores resultados. Conclusiones: Las intervenciones de RV y EF fueron efectivas para mejorar el equilibrio, la marcha, la atención y la memoria. Se concluye que la intervención de la RV asociada a la EF mejora el rendimiento físico y funcional en los ancianos.
