Jogos como Recurso Terapêutico para a Funcionalidade dos Membros Superiores na Doença de Parkinson

Página do item simplificado
dc.contributor.advisorCechetti, Fernanda
dc.contributor.authorCorrêa, Philipe Souza
dc.date.accessioned2023-10-25T13:04:07Z
dc.date.available2023-10-25T13:04:07Z
dc.date.date-insert2023-10-25
dc.date.issued2023-09-23
dc.descriptionTese (Doutorado)-Programa de Pós-Graduação em Ciências da Reabilitação, Fundação Universidade Federal de Ciências da Saúde de Porto Alegre.pt_BR
dc.description.abstractA presente tese é constituída por três estudos. Artigo 1: Uma revisão sistemática foi conduzida com o objetivo de quantificar e analisar o efeito de protocolos de terapia baseada em Realidade Virtual (RV) na destreza manual em indivíduos com doença de Parkinson (DP). A busca foi realizada nas bases de dados PubMed, EMBASE e PEDro até dezembro de 2020 e oito artigos foram incluídos na análise. Embora a maioria tenha demonstrado melhora na destreza manual, os artigos apresentaram alto risco de viés e baixa qualidade metodológica. Os resultados sugeriram que a terapia baseada em RV possui potencial e viabilidade como protocolo de reabilitação para destreza manual, porém os estudos analisados não abordaram os impactos relacionados às atividades de vida diária (AVD’s) e à qualidade de vida (QV) na DP. Artigo 2: Teve como objetivo verificar os efeitos de uma intervenção nos membros superiores (MMSS) utilizando equipamento de RV não imersivo nas AVD’s e na QV de indivíduos com DP, por meio de uma série de casos. Seis participantes foram avaliados por meio do miniexame do estado mental, da escala unificada de avaliação para a DP (UPDRS), do questionário sobre a doença de Parkinson (PDQ-39) e do test d’évaluation des membres supérieurs de personnes âgées (TEMPA). As intervenções tiveram duração de 27 minutos, duas vezes por semana, durante cinco semanas, utilizando o Leap Motion Controller. Observou-se melhora na força e resistência muscular, nas AVD’s e na QV. Portanto, o protocolo baseado em RV aplicado nos MMSS foi eficaz para melhorar as variáveis analisadas, além de servir como piloto para o protocolo das atividades virtuais e referência para o cálculo amostral do estudo principal. Artigo 3: Este ensaio clínico randomizado teve como objetivo analisar e comparar os efeitos de jogos de RV não imersiva com jogos de tabuleiro na funcionalidade dos MMSS, AVD’s e QV na DP. Vinte participantes, Hoehn & Yahr 2-3, foram divididos em dois grupos: jogos de RV não imersiva (n = 10) e jogos de tabuleiro (n = 10). As sessões tiveram duração de 30 minutos, duas vezes por semana, durante 8 semanas e os participantes foram avaliados quanto às AVD’s (TEMPA e MDS-UPDRS-II), função motora geral (MDS-UPDRS-III), destreza manual através do Box and Block Test (BBT) e Nine Hole Peg Test (9HPT), além da qualidade de vida (PDQ- 39). Os resultados mostraram que ambos os tratamentos foram eficazes, não havendo diferença significativa entre os grupos em relação as variáveis. Houve melhora nas AVD’s, conforme evidenciado pela execução das tarefas do TEMPA e MDS-UPDRS-II. Além disso, a destreza manual apresentou resultados positivos no BBT e 9HPT, com os jogos de RV demonstrando melhora intragrupo e na comparação intergrupos. Ambos os grupos mostraram melhora na função motora e na qualidade de vida. Portanto, constatou-se que os jogos de RV não imersivos e os jogos de tabuleiro têm um grande potencial como protocolos de reabilitação para os MMSS, impactando diretamente nas AVD’s e na QV de indivíduos com DP. O caráter desafiador e motivador dessas abordagens pode oferecer uma nova perspectiva de tratamento, especialmente nos estágios iniciais a moderados da doença.
dc.description.abstract-enThe present thesis consists of three studies. Article 1: A systematic review was conducted with the aim of quantifying and analyzing the effect of Virtual Reality (VR)-based therapy protocols on manual dexterity in individuals with Parkinson's disease (PD). The search was carried out in the PubMed, EMBASE, and PEDro databases up to December 2020 and eight studies were included in the analysis. Although most have shown improvement in manual dexterity, the articles presented a high risk of bias and low methodological quality. The results suggested that VR-based therapy has potential and feasibility as a rehabilitation protocol for manual dexterity, but the analyzed studies did not address aspects related to activities of daily living (ADLs) and quality of life (QoL) in PD. Article 2: The objective was to verify the effects of an Upper Limb (UL) intervention using non-immersive VR equipment on ADLs and QoL in individuals with PD through a case series. Six participants were assessed using the Mini-Mental State Examination, Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39) and the Test d'évaluation des membres supérieurs de personnes âgées (TEMPA). The interventions lasted 27 minutes, twice a week, for five weeks, utilizing the Leap Motion Controller. Improvement was observed in muscle strength, endurance, ADLs and QoL. Therefore, the VR- based protocol applied to UL was effective in improving the analyzed variables, serving as a pilot for virtual activities protocol and a reference for sample size calculation in the main study. Article 3: This randomized clinical trial aimed to analyze and compare the effects of non-immersive VR games with board games on UL functionality, ADLs and QoL in PD. Twenty participants, Hoehn & Yahr 2-3, were divided into two groups: non-immersive VR games (n = 10) and board games (n = 10). Sessions lasted 30 minutes, twice a week, for 8 weeks and participants were evaluated for ADLs (TEMPA and MDS-UPDRS-II), overall motor function (MDS-UPDRS-III), manual dexterity through the Box and Block Test (BBT) and Nine Hole Peg Test (9HPT), as well as QoL (PDQ-39). The results showed that both treatments were effective, with no significant difference between groups in terms of variables. Improvement in ADLs was evident from TEMPA and MDS-UPDRS-II task performance. Additionally, manual dexterity showed positive results in BBT and 9HPT, with VR games demonstrating intra- group and inter-group improvement. Both groups exhibited improvement in motor function and QoL. Thus, it was found that non-immersive VR games and board games have great potential as rehabilitation protocols for UL, directly impacting ADLs and QoL in individuals with PD. The challenging and motivating nature of these approaches offers a new perspective for treatment, especially in early to moderate stages of the disease.The present thesis consists of three studies. Article 1: A systematic review was conducted with the aim of quantifying and analyzing the effect of Virtual Reality (VR)-based therapy protocols on manual dexterity in individuals with Parkinson's disease (PD). The search was carried out in the PubMed, EMBASE, and PEDro databases up to December 2020 and eight studies were included in the analysis. Although most have shown improvement in manual dexterity, the articles presented a high risk of bias and low methodological quality. The results suggested that VR-based therapy has potential and feasibility as a rehabilitation protocol for manual dexterity, but the analyzed studies did not address aspects related to activities of daily living (ADLs) and quality of life (QoL) in PD. Article 2: The objective was to verify the effects of an Upper Limb (UL) intervention using non-immersive VR equipment on ADLs and QoL in individuals with PD through a case series. Six participants were assessed using the Mini-Mental State Examination, Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39) and the Test d'évaluation des membres supérieurs de personnes âgées (TEMPA). The interventions lasted 27 minutes, twice a week, for five weeks, utilizing the Leap Motion Controller. Improvement was observed in muscle strength, endurance, ADLs and QoL. Therefore, the VR- based protocol applied to UL was effective in improving the analyzed variables, serving as a pilot for virtual activities protocol and a reference for sample size calculation in the main study. Article 3: This randomized clinical trial aimed to analyze and compare the effects of non-immersive VR games with board games on UL functionality, ADLs and QoL in PD. Twenty participants, Hoehn & Yahr 2-3, were divided into two groups: non-immersive VR games (n = 10) and board games (n = 10). Sessions lasted 30 minutes, twice a week, for 8 weeks and participants were evaluated for ADLs (TEMPA and MDS-UPDRS-II), overall motor function (MDS-UPDRS-III), manual dexterity through the Box and Block Test (BBT) and Nine Hole Peg Test (9HPT), as well as QoL (PDQ-39). The results showed that both treatments were effective, with no significant difference between groups in terms of variables. Improvement in ADLs was evident from TEMPA and MDS-UPDRS-II task performance. Additionally, manual dexterity showed positive results in BBT and 9HPT, with VR games demonstrating intra- group and inter-group improvement. Both groups exhibited improvement in motor function and QoL. Thus, it was found that non-immersive VR games and board games have great potential as rehabilitation protocols for UL, directly impacting ADLs and QoL in individuals with PD. The challenging and motivating nature of these approaches offers a new perspective for treatment, especially in early to moderate stages of the disease.
dc.identifier.urihttps://repositorio.ufcspa.edu.br/handle/123456789/2404
dc.language.isopt_BR
dc.relation.requiresTEXTO - Adobe Reader
dc.rightsAcesso Aberto Imediatopt_BR
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/br/
dc.subjectDoença de Parkinson
dc.subjectExtremidade superior
dc.subjectRealidade Pacienteirtual
dc.subjectJogos e Brinquedos
dc.subjectAtividades Cotidianas
dc.subjectQualidade de Vida
dc.subject[en] Parkinson Diseaseen
dc.subject[en] Upper Extremityen
dc.subject[en] Virtual Realityen
dc.subject[en] Play and Playthingsen
dc.subject[en] Activities of Daily Livingen
dc.subject[en] Quality of Lifeen
dc.titleJogos como Recurso Terapêutico para a Funcionalidade dos Membros Superiores na Doença de Parkinson
dc.typeTese
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Nenhuma Miniatura disponível
Nome:
[TESE] Corrêa, Philipe Souza (C).pdf
Tamanho:
3.57 MB
Formato:
Adobe Portable Document Format
Descrição:
Texto completo
Baixar
Coleções
PPGCR - Teses