Functional Improvement in Patients With Parkinson's Disease After Training in Real or Virtual Environment
Functional Improvement in Patients With Parkinson's Disease After Training in Real or Virtual Environment
The objective of this work was to compare the effects of two balance training programs, one
 Nintendo Wii Fit-based and the other traditionally-based without the use of a gaming system,
 on the balance, functionality and cognition of patients with Parkinson´s disease. It was a
 prospective, single blinded, randomized clinical trial performed at Brazil Parkinson
 Association and Center of Research of the courses of Speech Therapy, Physical Therapy and
 Occupational Therapy of São Paulo University. 32 patients with Parkinson´s disease on stages
 1 and 2,5 of Hoehn e Yahr participated of this work. Patients were randomized in control and
 experimental group, 16 each one.

 The study was finished at december 2011.
The objective of this work was to compare the effects of two balance training programs, one
 Nintendo Wii Fit-based and the other traditionally-based without the use of a gaming system,
 on the balance, functionality and cognition of patients with Parkinson´s disease. It was a
 prospective, single blinded, randomized clinical trial performed at Brazil Parkinson
 Association and Center of Research of the courses of Speech Therapy, Physical Therapy and
 Occupational Therapy of São Paulo University. 32 patients with Parkinson´s disease on stages
 1 and 2,5 of Hoehn e Yahr participated of this work. Patients were randomized in control and
 experimental group, 16 each one. Both groups performed 14 training sessions, twice a week,
 for seven weeks. Each session was composed of a 30 minute-global-exercise series including
 stretching, muscle strengthen and axial mobility exercises. After this, both groups performed
 more 30 minutes of balance training: the control group performed balance exercises without
 external cues, visual or auditory feedbacks or cognitive stimulations; the experimental group
 performed the balance training with 10 Wii Fit games which stimulated motor and cognitive
 functions. The main outcome measures were: (1) Unified Parkinson´s Disease Rating Scale
 (UPDRS); (2) Berg Balance Scale (BBS); (3) Unipedal Stance Test (UST) and (4) Montreal
 Cognitive Assessment (MoCA). The statistical analysis was done by repeated measures ANOVA in
 order to assess the possible differences among the analyzed variables. Both groups showed
 improvement in the section II of UPDRS, BBS, UST and MoCA. Patients with Parkinson´s disease
 showed balance and cognitive improvement with positive repercussion on daily living
 activities after 14 sessions of balance training without additional advantages to the virtual
 training.
Inclusion Criteria:

 -  Patients with Parkinson´s disease

 -  both gender

 -  on stages 1 and 2,5 of Hoehn e Yahr

 Exclusion Criteria:

 -  depression

 -  cognitive impairment

 -  deficits of visual acuity

 -  Score on Berg Balance Scale under 46