Virtual reality therapy for rehabilitation of balance in the elderly: a systematic review and META-analysis
Tóm tắt
Virtual reality therapy (VRT) has clinical indications in rehabilitation programs for the elderly; however, there is still no consensus on the recovery of body balance. The objective of this review was to summarize the effects of physical therapy interventions with VRT in the rehabilitation of balance in the elderly. The studies were identified via a systematic search in the databases PubMed, SciELO, LILACS and PEDro from 2010 onward. Clinical trials with interventions that involved VRT in the elderly were included in the study and were subjected to methodological quality analysis using the PEDro scale. A random effects meta-analysis of the studies that analyzed balance using the Berg Balance Scale and the Timed Up and Go (TUG) test was performed. Ten articles met the inclusion criteria, which presented variability in relation to the types of interventions used (70%) and the outcomes analyzed (60%). The mean duration of the interventions was 13.90 (± 5.08) weeks, with at least two weekly sessions (± 0.73). There were positive results in relation to improvements in both dynamic and static balance (70% of the studies), mobility (80%), flexibility (30%), gait (20%) and fall prevention (20%). A summary of the meta-analysis showed mean effects on the Berg scale (standardized mean difference [SMD]: -0.848; 95% CI: -1.161; − 0.535) and the TUG test (SMD: 0.894; 95% CI: 0.341; 1.447). Individually, virtual reality is promising in rehabilitation programs for the elderly. The overall measures were sufficient to show beneficial effects of the therapy on balance in the elderly.
Tài liệu tham khảo
Bruniera CAV, Rodacki ALF. Respostas estabilométricas de jovens e idosos para recuperar o equilíbrio após uma perturbação inesperada controlada. Rev Educ Fis UEM. 2014;25(3):345–51.
Meireles AE, Pereira LVS, Oliveira TG, Christofoletti G, Fonseca AL. Alterações neurológicas fisiológicas ao envelhecimento afetam o sistema mantenedor do equilíbrio. Rev Neurocienc. 2010;18(1):103–8.
Pícoli TS, Figueiredo LL, Patrizzi LJ. Sarcopenia e envelhecimento. Fisioter Mov. 2011;24(3):455–62.
Teixeira INAO, Guariento ME. Biologia do envelhecimento: teorias, mecanismos e perspectivas. Ciênc Saúde Coletiva 2010. 2016;15(6):2845–57.
Gontijo RW, Leão MRC. Eficácia de um programa de fisioterapia preventiva para idosos. Rev Méd Minas Gerais. 2013;23(2):173–80.
Keshner EA. Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool? J Neuroeng Rehabil 2004. 2016;3(1):8.
Holden MK. Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 2005;8(3):187–211.
Rendon AA, Lohman EB, Thorpe D, Johnson EG, Medina E, Bradley B. The effect of virtual reality gaming on dynamic balance in older adults. Age Ageing. 2012;41(4):549–52.
Mussato R, Brandalize D, Brandalize M. Nintendo Wii® e seu efeito no equilíbrio e capacidade funcional de idosos saudáveis. Rev Brasil Ciência Mov 2012. 2016;20(2):68–75.
Lee S, Shin S. Effectiveness of virtual reality using video gaming. Diabetes Technol Ther. 2013;15(6):489–96.
Shiwa SR, Costa LOP, Moser ADL, Aguiar IC, Oliveira LVF. PEDro: a base de dados de evidências em fisioterapia. Fisioter Mov. 2011;24(3):523–33.
Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions 4.2.6 [updated September 2006]. In: The Cochrane Library, Issue 4. Chichester: John Wiley & Sons, Ltda; 2006.
Brasil. Ministério da Saúde. Diretrizes metodológicas: elaboração de pareceres técnicos-científicos. 3rd ed. Brasília: Ministério da Saúde; 2011. 80p.: il.
Franco JR, Jacobs K, Inzerillo C, Kluzik J. The effect of the Nintendo Wii fit and exercise in improving balance and quality of life in community dwelling elderls. Technol Health Care. 2012;20(2):95–115.
Treml CJ, Kalil Filho FA, Ciccarino RFL, Wegner RS, Saita CYS, Corrêa AG. O uso da plataforma Balance Board como recurso fisioterápico em idosos. Revbrasgeriatrgerontol. 2012;16(4):759–68.
Szturm T, Betkler AL, Moussavi Z, Desai A, Goodeman V. Effects of an interactive computer game exercise regimen on balance impairment in frail community-dwelling older adults: a randomized controlled trial. Phys Ther. 2011;91(10):1449–62.
Bieryla KA, Dold NM. Feasibility of Wii fit training to improve clinical measures of balance in older adults. Clin Interv Aging. 2013;8:775–81.
Yen CY, Lin KH, Hu MH, Wu RM, Lu Tw LCH. Effects of virtual reality-augmented balance training on sensory organization and attentional demand for postural control in people with Parkinson disease: a randomized controlled trial. Phys Ther. 2011;91(6):862–74.
Toulotte C, Toursel C, Olivier N. Wii fit® training vs. adapted physical activities: which one is the most appropriate to improve the balance of independent senior subjects? A randomized controlled study. Clin Rehabil. 2012;26(9):827–35.
Lai CH, Peng CW, Chen YL, Huang CP, Hsiao YL, Chen SC. Effects of interactive video-game based system exercise on the balance of the elderly. Gait Posture. 2013;37(4):511–8.
Booth V, Masud T, Connell L, Bath-Hextall F. The effectiveness of virtual reality intervention in improving balance in adults with impaired balance compared with standard or no treatment: a systematic review and meta-analysis. Clin Rehabil. 2014;28(5):419–31.
Ricci NA, Gazzola JM, Coimbra IB. Sistemas sensoriais no equilíbrio corporal de idosos. Arq Bras Ciên Saúde. 2009;34(2):94–100.
Lobo AM. Efeito de um Treinamento em Ambiente Virtual Sobre o Desempenho da Marcha e Funções Cognitivas em Idosos Saudáveis. 2013. 112 f. São Paulo: Dissertação (Mestrado em Psicologia) - Universidade de São Paulo; 2013.
Silva, K. G. Efeito de um Treinamento com o Nintendo Wii® Sobre o Equilíbrio Postural e Funções Executivas de Idosos Saudáveis – Um Estudo Clinico Longitudinal, Controlado e Aleatorizado. 2013. 128 f. Dissertação (Mestrado em Psicologia) - Universidade de São Paulo, São Paulo, 2013.
Santana CMF, Lins OG, Sanguinetti DCM, Silva FP, Angelo TDA, Cariolano MGWS, Câmara SB, Silva JPA. Efeitos do tratamento com realidade virtual não imersiva na qualidade de vida de indivíduos com Parkinson. Revbrasgergerontol. 2015;18(1):49–58.
Loureiro APC, Ribas CG, Zotz TGG, Chen R, Ribas F. Viabilidade da terapia virtual na reabilitação de pacientes com doença de Parkinson: estudo-piloto. Fisioter. Mov. 2012;25(3):659–66.