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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(04): 268-278
DOI: 10.1590/0004-282X20190025
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Virtual reality in the rehabilitation of patients with stroke: an integrative review

Realidade virtual na reabilitação de pacientes após acidente vascular cerebral: uma revisão integrativa
Alberto Luiz Aramaki 
1   Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG, Brasil;
2   NETRAS - Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde, Uberaba MG, Brasil.
,
Rosana Ferreira Sampaio 
3   Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Reabilitação, Belo Horizonte MG, Brasil;
,
Ana Caroline Silva Reis 
2   NETRAS - Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde, Uberaba MG, Brasil.
4   Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba MG, Brasil.
,
Alessandra Cavalcanti 
4   Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba MG, Brasil.
,
Fabiana Caetano Martins Silva e Dutra 
1   Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG, Brasil;
2   NETRAS - Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde, Uberaba MG, Brasil.
4   Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba MG, Brasil.
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ABSTRACT

Objective: To describe the intervention protocols to using commercial video games as virtual reality (VR) in rehabilitation of patients with stroke.

Methods: Integrative review using the descriptors “rehabilitation”, “virtual reality exposure therapy” and “videogames” in the LILACS and PUBMED databases. Articles published from 2011 to 2018 were selected.

Results: We found 1,396 articles, 1,383 were excluded and 13 were selected. Most of the articles were randomized clinical trials published in 2014 or later. The sample size varied from 5–47 adults, or adults and elders, with chronic stroke. The Nintendo Wii ® was the most used video game system. The intervention happened two or three times a week, each session lasting from 30 to 60 minutes, over 2–12 weeks. Balance, upper limb motor functions, quality of life and daily living activities were the most common evaluated outcomes. The Fugl-Meyer Assessment, Berg Balance Scale, Timed Up and Go test, Barthel Scale and SF-36 were the most common outcome measurement tools.

Conclusions: The studies indicated improvement in dynamic balance, upper limb motor function and quality of life after rehabilitation using VR. The VR was more effective than conventional treatments for the outcome of dynamic balance. Two studies did not find any changes in static balance and daily living activities. Physical aspects and quality of life were the outcomes most evaluated by the researchers; as were the population with chronic strokes and protocols of long duration and low intensity. Few studies targeted immediate VR effects, performance in daily living activities and social participation.

RESUMO

Objetivo: Descrever os protocolos de intervenção utilizando sistemas de vídeo game comerciais como realidade virtual (RV) na reabilitação de pacientes após AVE.

Método: Revisão integrativa usando os descritores “reabilitação”, “terapia de exposição a realidade virtual” e “videogames”, nas bases de dados LILACS e PUBMED, e artigos publicados entre 2011 e 2018.

Resultados: Foram encontrados 1.396, excluídos 1.383 e selecionados 13 artigos. A maioria era ensaio clínico aleatorizado publicados a partir de 2014. O tamanho da amostra variou de 5 a 47 participantes adultos ou adultos e idosos com AVE crçnico. O Nintendo Wii ® foi o videogame mais empregado. A intervenção constava de duas ou três sessões semanais, com duração de 30 ou 60 minutos por um período de duas a 12 semanas. Equilíbrio, função motora de membro superior, qualidade de vida e atividade de vida diária foram os principais desfechos. Empregou-se principalmente Escala Fugl-Meyer, Escala de Equilíbrio de Berg, teste Timed Up and Go, Índice de Barthel e SF-36 como medidas de desfecho.

Conclusões: Os estudos indicaram melhora do equilíbrio dinâmico, função motora de membro superior e qualidade de vida após reabilitação usando RV. A RV se mostrou mais eficaz que tratamentos convencionais para o desfecho equilíbrio dinâmico. Dois estudos não encontraram mudanças no equilíbrio estático e atividade de vida diária. Observou-se maior foco em desfechos relacionados a aspectos físicos e qualidade de vida, em população com AVE crçnico e protocolo com maior duração e menor intensidade. Poucos estudos voltados para efeitos imediatos da RV, desempenho em atividades de vida diária e participação social.

Keywords:

Rehabilitation - virtual reality exposure therapy - video games - stroke

Palavras-chave:

Reabilitação - terapia de exposição à realidade virtual - jogos de vídeo - acidente vascular cerebral


Publikationsverlauf

Eingereicht: 15. September 2018

Angenommen: 10. Dezember 2018

Artikel online veröffentlicht:
16. August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Monteiro Junior RS, Carvalho RJ, Silva EB, Bastos FG. Efeito da reabilitação virtual em diferentes tipos de tratamento. Rev Bras Cienc Saúde. 2011;9(29):56-63. https://doi.org/10.13037/rbcs.vol9n29.1331
  • 2 Sampaio RF, Mancini MC, Fonseca ST. Produção científica e atuação profissional: aspectos que limitam essa integração na Fisioterapia e na Terapia Ocupacional. Braz J Phys Ther. 2002;6(3):113-8.
  • 3 Assis GA, Corrêa AG, Martins MB, Pedrozo WG, Lopes RD. An augmented reality system for upper-limb post-stroke motor rehabilitation: a feasibility study. Disabil Rehabil Assist Technol. 2016 Aug;11(6):521-8. https://doi.org/10.3109/17483107.2014.979330
  • 4 Bondoc S, Booth J, Budde G, Caruso K, DeSousa M, Earl B, et al. Mirror therapy and task-oriented training for people with a paretic upper extremity. Am J Occup Ther. 2018 Mar/Apr;72(2):p1. https://doi.org/10.5014/ajot.2018.025064
  • 5 Saunders DH, Sanderson M, Hayes S, Kilrane M, Greig CA, Brazzelli M, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2016 Mar;3:CD003316. https://doi.org/10.1002/14651858.CD003316.pub6
  • 6 Vasileva D, Lubenova D, Mihova M, Dimitrova A, Grigorova-Petrova K. Influence of Kinesitherapy on Gait in Patients with Ischemic Stroke in the Chronic Period. Open Access Maced J Med Sci. 2015 Dec;3(4):619-23. https://doi.org/10.3889/oamjms.2015.107
  • 7 Levin MF, Snir O, Liebermann DG, Weingarden H, Weiss PL. Virtual reality versus conventional treatment of reaching ability in chronic stroke: clinical feasibility study. Neurol Ther. 2012 Aug;1(1):3. https://doi.org/10.1007/s40120-012-0003-9
  • 8 Kwon JS, Park MJ, Yoon IJ, Park SH. Effects of virtual reality on upper extremity function and activities of daily living performance in acute stroke: a double-blind randomized clinical trial. NeuroRehabilitation. 2012;31(4):379-85. https://doi.org/10.3233/NRE-2012-00807
  • 9 Schuster-Amft C, Henneke A, Hartog-Keisker B, Holper L, Siekierka E, Chevrier E, et al. Intensive virtual reality-based training for upper limb motor function in chronic stroke: a feasibility study using a single case experimental design and fMRI. Disabil Rehabil Assist Technol. 2015;10(5):385-92. https://doi.org/10.3109/17483107.2014.908963
  • 10 Allain P, Foloppe DA, Besnard J, Yamaguchi T, Etcharry-Bouyx F, Le Gall D, et al. Detecting everyday action deficits in Alzheimer's disease using a nonimmersive virtual reality kitchen. J Int Neuropsychol Soc. 2014 May;20(5):468-77. https://doi.org/10.1017/S1355617714000344
  • 11 Kizony R, Mallory K, Sinoff G, Klinger E, Josman N. Using a virtual supermarket as a tool for training executive functions in people with mild cognitive impairment. J Stroke Cerebrovasc Dis. 2012;23(5):10-2.
  • 12 da Costa RM, de Carvalho LA. The acceptance of virtual reality devices for cognitive rehabilitation: a report of positive results with schizophrenia. Comput Methods Programs Biomed. 2004 Mar;73(3):173-82. https://doi.org/10.1016/S0169-2607(03)00066-X
  • 13 Lee KH. Effects of a virtual reality-based exercise program on functional recovery in stroke patients: part 1. J Phys Ther Sci. 2015 Jun;27(6):1637-40. https://doi.org/10.1589/jpts.27.1637
  • 14 Saposnik G, Levin M, Thomas S, Deutsch JE, Crotty M; Outcome Research Canada (SORCan) Working Group. Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians. Stroke. 2011 May;42(5):1380-6. https://doi.org/10.1161/STROKEAHA.110.605451
  • 15 Basílio ML, de Faria-Fortini I, Polese JC, Scianni AA, Faria CD, Teixeira-Salmela LF. Handgrip strength deficits best explain limitations in performing bimanual activities after stroke. J Phys Ther Sci. 2016 Apr;28(4):1161-5. https://doi.org/10.1589/jpts.28.1161
  • 16 Laver K, George S, Thomas S, Deutsch JE, Crotty M. Cochrane review: virtual reality for stroke rehabilitation. Eur J Phys Rehabil Med. 2012 Sep;48(3):523-30.
  • 17 Souza MT, Silva MD, Carvalho R. Revisão integrativa: o que é e como fazer. Einstein (Sao Paulo). 2010;8(1):102-6. https://doi.org/10.1590/s1679-45082010rw1134
  • 18 Dores AR, Barbosa F, Marques A, Carvalho IP, De Sousa L, Castro-Caldas A. [Virtual reality and rehabilitation: why or why not? A systematic literature review]. Acta Med Port. 2012 Nov-Dec;25(6):414-21. Portuguese.
  • 19 Caiana TL, Nogueira DL, Lima AC. A realidade virtual e seu uso como recurso terapêutico ocupacional: revisão integrativa. Cad Ter Ocup UFSCar. 2016;24(3):575-89. https://doi.org/10.4322/0104-4931.ctoAR0619
  • 20 Portney LG, Watkins M. Foundations of clinical research: applications to practice. 3rd ed. Upper Saddle River: Prentice Hall; 2009.
  • 21 Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014 Jan;383(9913):245-54. https://doi.org/10.1016/S0140-6736(13)61953-4
  • 22 Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, et al. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010 Oct;41(10):2402-48. https://doi.org/10.1161/STR.0b013e3181e7512b
  • 23 Gamba RT, Cruz DM. Efeitos da terapia por contensão induzida em longo prazo em pacientes pós AVC. Rev Neurocienc. 2011;19(4):735-40.
  • 24 Belliveau D, Belliveau I, Camire-Raymond A, Kessler D, Egan M. Use of occupational performance coaching for stroke survivors (OPC-Stroke) in late rehabilitation: a descriptive case study. Open J Occup Ther. 2016;4(2):7. https://doi.org/10.15453/2168-6408.1219
  • 25 Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-169. https://doi.org/10.1161/STR.20190025201900250098
  • 26 Tripette J, Murakami H, Ryan KR, Ohta Y, Miyachi M. The contribution of Nintendo Wii Fit series in the field of health: a systematic review and meta-analysis. PeerJ. 2017 Sep;5:e3600. https://doi.org/10.7717/peerj.3600
  • 27 Mendes FA, Arduini L, Botelho A, Cruz MB, Paz CCS, Pompeu SMAA et al. Pacientes com a Doença de Parkinson são capazes de melhorar seu desempenho em tarefas virtuais do Xbox Kinect®: “uma série de casos. Motricidade. 2015;11(3):68-80. https://doi.org/10.6063/motricidade.3805
  • 28 Organização Mundial de Saúde – OMS. CIF: Classificação internacional de funcionalidade, incapacidade e saúde. São Paulo: Editora da Universidade de São Paulo; 2003.
  • 29 Alt Murphy M, Resteghini C, Feys P, Lamers I. An overview of systematic reviews on upper extremity outcome measures after stroke. BMC Neurol. 2015 Mar;15(1):29. https://doi.org/10.1186/s12883-015-0292-6
  • 30 Santisteban L, Térémetz M, Bleton JP, Baron JC, Maier MA, Lindberg PG. Upper limb outcome measures used in stroke rehabilitation studies: a systematic literature review. PLoS One. 2016 May;11(5):e0154792. https://doi.org/10.1371/journal.pone.0154792
  • 31 Maki T, Quagliato EM, Cacho EW, Paz LP, Nascimento NH, Inoue MM, et al. Estudo de confiabilidade da aplicação da escala de Fugl-Meyer no Brasil. Braz J Phys Ther. 2006;10(2):177-83. https://doi.org/10.1590/S1413-35552006000200007
  • 32 Tyson SF, Connell LA. How to measure balance in clinical practice: a systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions. Clin Rehabil. 2009 Sep;23(9):824-40. https://doi.org/10.1177/0269215509335018
  • 33 Woellner SS, Araujo AG, Cabral FM, Uessler PN, Soares AV. Testes de equilíbrio em pacientes hemiparéticos por AVC. Neurociencias. 2015;11(1):32-40.
  • 34 Hafsteinsdóttir TB, Rensink M, Schuurmans M. Clinimetric properties of the Timed Up and Go Test for patients with stroke: a systematic review. Top Stroke Rehabil. 2014 May-Jun;21(3):197-210. https://doi.org/10.1310/tsr2103-197
  • 35 Correia A, Pimenta C, Alves M, Virella D. Concordância entre instrumentos de avaliação do equilíbrio após acidente vascular cerebral. Saúde Tecnol. 2017;(17):33-8.
  • 36 Taylor-Rowan M, Wilson A, Dawson J, Quinn TJ. Functional assessment for acute stroke trials: properties, analysis, and application. Front Neurol. 2018 Mar;9:191. https://doi.org/10.3389/fneur.2018.00191
  • 37 de Haan RJ. Measuring quality of life after stroke using the SF-36. Stroke. 2002 May;33(5):1176-7. https://doi.org/10.1161/01.STR.0000015223.98452.97
  • 38 Anderson C, Laubscher S, Burns R. Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients. Stroke. 1996 Oct;27(10):1812-6. https://doi.org/10.1161/01.STR.27.10.1812
  • 39 Iruthayarajah J, McIntyre A, Cotoi A, Macaluso S, Teasell R. The use of virtual reality for balance among individuals with chronic stroke: a systematic review and meta-analysis. Top Stroke Rehabil. 2017 Jan;24(1):68-79. https://doi.org/10.1080/10749357.2016.1192361
  • 40 Yates M, Kelemen A, Sik Lanyi C. Virtual reality gaming in the rehabilitation of the upper extremities post-stroke. Brain Inj. 2016;30(7):855-63. https://doi.org/10.3109/02699052.2016.1144146
  • 41 Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2017 Sep;(9):CD008349. https://doi.org/10.1002/14651858.CD008349.pub2.
  • 42 Li Z, Han XG, Sheng J, Ma SJ. Virtual reality for improving balance in patients after stroke: a systematic review and meta-analysis. Clin Rehabil. 2016 May;30(5):432-40. https://doi.org/10.1177/0269215515593611
  • 43 Santos LRA, Carregosa AA, Masruha MR, Santos PA, Coêlho MLS, Ferraz DD, et al. The use of Nintendo Wii in the rehabilitation of poststroke patients: a systematic review. J Stroke Cerebrovasc Dis. 2015 Oct;24(10):2298-305. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.06.010