Objective: To compare the effects of balance training in Virtual Reality (VR) supported  by manual and verbal guidance (MVG) versus an identical training in absence of  MVG  during the training on balance and gait performance in people with Parkinson’s disease (PPD)

Background: According to current evidences, the training based on VR may be efficient to improve balance and gait performance in PPD.  However, there is no study that had investigated the role of physiotherapist (PT) during this kind of training. It is a fundamental issue to establish the guidelines for the therapeutic use for this kind of intervention in PD. 

Methods: Parallel, prospective, single-blind, randomized clinical trial was conducted with 24 PPD in stages 2 and 3 according to Hoehn and Yahr Classification, treated with levodopa; following adequate inclusion criteria, took part in the study. PPD were randomly allocated into an experimental group (EG) that performed the balance training based on games from Nintendo Wii Fit^TM (NWF) supported by MVG provided by a PT and a control group (CG) that performed an identical training with no MVG  during the training. The training consists of 14 individual intervention sessions (2 per week). Both groups received instructions about the purpose, rules and best strategies to reach success in the games before the start of each session of training and verbal motivator stimulus during the training. The primary outcomes were Dynamic Gait Index (DGI) for gait and Mini Balance Evaluation Systems Test (MBT) for balance. All outcomes were applied at baseline (BT), 1-week (FU7d) and 2-month follow-up (FU60d) by a blinded examiner.

Results: All PPD were able to improve their games performance. The results according to 2(EGXCG)X3(BTXFU7dXFU60d) RM-ANOVA showed a significant interaction between the factors for DGI (p<.001,ES=.90); and  MBT (p<.01,ES=.88). Tukey pos-hoc test (TT) for these measures showed a significant increase in the score for EG only, that remained at end of the study. 

Conclusions: The MVG provided during the balance training in VR was fundamental to improve the balance, gait performance in PPD. Thus, the therapeutic effects of balance training in VR for PPD depend on the manual and verbal orientations provided by PT in order to guarantee that therapeutic goals were reached.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/manual-and-verbal-guidance-during-the-balance-training-based-in-virtual-reality-is-essential-for-therapeutic-results-in-people-with-parkinsons-disease-a-randomized-clinical-trial/