Comparative Analysis of the Impact of Virtual Reality Training and Conventional Physiotherapy on Balance and Gait in Older Adults with Parkinson's Disease
DOI:
https://doi.org/10.61919/jhrr.v3i2.179Keywords:
Parkinson's disease (PD), Virtual reality, (VR) training, Conventional physiotherapy (CPT), Balance and gait rehabilitation, older adultsAbstract
Background: Parkinson's disease (PD) is a neurodegenerative condition predominantly manifesting in motor impairments, notably in balance and gait. Recent advancements have highlighted Virtual Reality (VR) training as a potent alternative or adjunct to conventional physiotherapy (CPT) for the rehabilitation of these motor disturbances in PD patients.
Objective: This study aimed to evaluate and compare the efficacy of VR training and CPT in ameliorating balance and gait issues in older adults diagnosed with PD.
Methods: In this randomized controlled trial, 56 patients with PD were assigned either to VR training or to CPT. The VR training entailed immersive and interactive exercises specifically designed for balance and gait enhancement using VR technology. Conversely, CPT consisted of traditional exercises targeting similar motor skills. Standardized assessments for balance and gait were administered both prior to and following the intervention to all participants.
Results: The intervention demonstrated that VR training led to more pronounced improvements in balance and gait parameters as compared to CPT. Notably, the Timed Up and Go test (TUG) exhibited an improvement of 4.2 seconds in the VR group versus 3.6 seconds in the CPT group, a difference statistically significant (p<0.05). Similarly, the Berg Balance Scale (BBS) scores increased by 12.4 points in the VR group and 10.8 points in the CPT group, again showing a significant advantage for VR (p<0.05). The Mini-BESTest scores improved by 2.6 points in the VR group compared to 2.1 points in the CPT group, reinforcing the superiority of VR (p<0.05).
Conclusion: The study conclusively finds that VR training surpasses CPT in enhancing balance and gait in older adults with PD. Offering an immersive, engaging, and tailored therapeutic environment, VR training emerges as a potent modality for augmenting rehabilitation outcomes in this demographic.
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Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, et al. Tai chi and postural stability in patients with Parkinson's disease. The New England journal of medicine. 2012;366(6):511-9.
Conradsson D, Löfgren N, Nero H, Hagströmer M, Ståhle A, Lökk J, et al. The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial. Neurorehabilitation and neural repair. 2015;29(9):827-36.
Schlenstedt C, Paschen S, Kruse A, Raethjen J, Weisser B, Deuschl G. Resistance versus Balance Training to Improve Postural Control in Parkinson's Disease: A Randomized Rater Blinded Controlled Study. PloS one. 2015;10(10):e0140584.
Dockx K, Bekkers EM, Van den Bergh V, Ginis P, Rochester L, Hausdorff JM, et al. Virtual reality for rehabilitation in Parkinson's disease. The Cochrane database of systematic reviews. 2016;12(12):Cd010760.
Stożek J, Rudzińska M, Pustułka-Piwnik U, Szczudlik A. The effect of the rehabilitation program on balance, gait, physical performance and trunk rotation in Parkinson's disease. Aging clinical and experimental research. 2016;28(6):1169-77.
Gandolfi M, Geroin C, Dimitrova E, Boldrini P, Waldner A, Bonadiman S, et al. Virtual Reality Telerehabilitation for Postural Instability in Parkinson's Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial. BioMed research international. 2017;2017:7962826.
Santos L, Fernandez-Rio J, Winge K, Barragán-Pérez B, González-Gómez L, Rodríguez-Pérez V, et al. Effects of progressive resistance exercise in akinetic-rigid Parkinson's disease patients: a randomized controlled trial. European journal of physical and rehabilitation medicine. 2017;53(5):651-63.
Santos SM, da Silva RA, Terra MB, Almeida IA, de Melo LB, Ferraz HB. Balance versus resistance training on postural control in patients with Parkinson's disease: a randomized controlled trial. European journal of physical and rehabilitation medicine. 2017;53(2):173-83.
Debû B, De Oliveira Godeiro C, Lino JC, Moro E. Managing Gait, Balance, and Posture in Parkinson's Disease. Current neurology and neuroscience reports. 2018;18(5):23.
Gordt K, Gerhardy T, Najafi B, Schwenk M. Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Gerontology. 2018;64(1):74-89.
Montero-Odasso M, Speechley M. Falls in Cognitively Impaired Older Adults: Implications for Risk Assessment And Prevention. Journal of the American Geriatrics Society. 2018;66(2):367-75.
Silva-Batista C, Corcos DM, Kanegusuku H, Piemonte MEP, Gobbi LTB, de Lima-Pardini AC, et al. Balance and fear of falling in subjects with Parkinson's disease is improved after exercises with motor complexity. Gait & posture. 2018;61:90-7.
Stuart S, Vitorio R, Morris R, Martini DN, Fino PC, Mancini M. Cortical activity during walking and balance tasks in older adults and in people with Parkinson's disease: A structured review. Maturitas. 2018;113:53-72.
Van Puymbroeck M, Walter AA, Hawkins BL, Sharp JL, Woschkolup K, Urrea-Mendoza E, et al. Functional Improvements in Parkinson's Disease Following a Randomized Trial of Yoga. Evidence-based complementary and alternative medicine : eCAM. 2018;2018:8516351.
Cornejo Thumm P, Giladi N, Hausdorff JM, Mirelman A. Tele-Rehabilitation with Virtual Reality: A Case Report on the Simultaneous, Remote Training of Two Patients with Parkinson Disease. American journal of physical medicine & rehabilitation. 2021;100(5):435-8.
Pereira APS, Marinho V, Gupta D, Magalhães F, Ayres C, Teixeira S. Music Therapy and Dance as Gait Rehabilitation in Patients With Parkinson Disease: A Review of Evidence. Journal of geriatric psychiatry and neurology. 2019;32(1):49-56.
Silva AZD, Israel VL. Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease: A randomized clinical trial with a 3-month follow-up. Complementary therapies in medicine. 2019;42:119-24.
Pohl P, Wressle E, Lundin F, Enthoven P, Dizdar N. Group-based music intervention in Parkinson's disease - findings from a mixed-methods study. Clinical rehabilitation. 2020;34(4):533-44.
Costa TM, Simieli L, Bersotti FM, Mochizuki L, Barbieri FA, Coelho DB. Gait and posture are correlated domains in Parkinson's disease. Neuroscience letters. 2022;775:136537.
Maranesi E, Casoni E, Baldoni R, Barboni I, Rinaldi N, Tramontana B, et al. The Effect of Non-Immersive Virtual Reality Exergames versus Traditional Physiotherapy in Parkinson's Disease Older Patients: Preliminary Results from a Randomized-Controlled Trial. International journal of environmental research and public health. 2022;19(22).
Kim H, Kim E, Yun SJ, Kang MG, Shin HI, Oh BM, et al. Robot-assisted gait training with auditory and visual cues in Parkinson's disease: A randomized controlled trial. Ann Phys Rehabil Med. 2022;65(3):101620.
Zhang J, Luximon Y, Pang MYC, Wang H. Effectiveness of exergaming-based interventions for mobility and balance performance in older adults with Parkinson's disease: systematic review and meta-analysis of randomised controlled trials. Age and ageing. 2022;51(8).
Yun SJ, Hyun SE, Oh BM, Seo HG. Fully immersive virtual reality exergames with dual-task components for patients with Parkinson's disease: a feasibility study. Journal of neuroengineering and rehabilitation. 2023;20(1):92.
Tuena C, Borghesi F, Bruni F, Cavedoni S, Maestri S, Riva G, et al. Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review. Journal of medical Internet research. 2023;25:e44484.
Spanakis M, Xylouri I, Patelarou E, Patelarou A. A Literature Review of High-Tech Physiotherapy Interventions in the Elderly with Neurological Disorders. International journal of environmental research and public health. 2022;19(15).
Tran S, Brooke C, Kim YJ, Perry SD, Nankoo JF, Rinchon C, et al. Visual and vestibular integration in Parkinson's disease while walking. Parkinsonism & related disorders. 2023;116:105886.
Thangavelu K, Hayward JA, Pachana NA, Byrne GJ, Mitchell LK, Wallis GM, et al. Designing Virtual Reality Assisted Psychotherapy for Anxiety in Older Adults Living with Parkinson's Disease: Integrating Literature for Scoping. Clinical gerontologist. 2022;45(2):235-51.
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Copyright (c) 2023 Muhammad Usama, Usama Ahmad Khan, Aqeel Saeed, Bakhtawar Siddiqui, Syeda Bizzah Fatima, Hanan Azfar
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