by Dr. Trupti Shirole on  September 7, 2015 at 4:26 PM Health In Focus
Advantages of Virtual Games to Improve Quality of Life in Parkinsonís Disease
Video games are usually considered as a waste of time. However, a study has found that Nintendo Wii can actually benefit patients with Parkinson's disease.

Parkinson's disease is a non-reversible and progressive disorder of the nervous system that affects an individual's movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand, and then progressing further to cause muscle stiffness, slowing of movement, and impaired posture and balance. The main concerns in Parkinson's disease patients are postural control, fear of falls and balance disorders. Therefore, patients have alterations in their daily life activities, increasing healthcare costs and causing a high risk of mortality. Several factors such as functional limitations and dependency on others, low self-esteem, social restriction and reduction of leisure time can negatively influence the quality of life in Parkinson's disease patients.

At present, there is no cure for Parkinson's disease, and treatment is focused on symptom management via dopamine replacement therapy. While medication has been found to work remarkably well in improving some of the symptoms of Parkinson's disease such as slowing of movement, rigidity, and tremor, it has been found to be only partially effective in the treatment of symptoms like balance and posture.

Previous research has suggested that physical therapies are generally effective in alleviating symptoms of Parkinson's disease. Improvements have been demonstrated in strength, physical functioning, quality of life, balance, and gait speed with physical therapies.

In the area of new technologies, systems based on virtual reality are promising tools for rehabilitation of Parkinson's disease patients. They increase the performance of the rehabilitation process against traditional rehabilitation, which can be sometimes boring, tedious and repetitive. The main objective in rehabilitation by virtual reality is to increase the functional ability and raise the participation of a patient in daily life. Among the more recent resources available for virtual reality are virtual games such as Nintendo Wii.

These interactive games can help in the recovery of motor skills, working on one's coordination skills, strength and reasoning. Virtual games also require users to perform cognitive tasks related to attention and executive functions that are affected in Parkinson's disease patients.

Nintendo Wii is a less expensive and portable home video game with several exercises that allow training on strength, balance and aerobics. The players are stimulated to defeat their adversaries in specific trainings such as boxing or tennis, and they can track their progress over time, enhancing adhesion and concentration in their physical activity.

Researchers conducted a trial to evaluate the effects of Nintendo Wii training in improving quality of life of Parkinson's disease patients, when compared to traditional physical therapy.

For the study, the researchers followed 44 patients, aged between 45 and 80 years, who were diagnosed of Parkinson's disease with mild-to-moderate motor impairment, by a certified neurologist. Half the study subjects were assigned to the Nintendo Wii group while the other half underwent traditional physical therapy. Subjects in both the study groups underwent a warm up session for 10-minutes. This was followed by a 40-minute physical therapy program that consisted of physical therapy or Nintendo Wii virtual game.

The traditional physical therapy group performed exercises that involved mobilization of trunk and limbs. The exercises focused on improving the patient's balance, muscle strength, rhythmic movement, posture alignment and double-task execution. This group also received cardio-respiratory and gait training. Patients in the Nintendo Wii group executed a sequence of tasks according to a previously established protocol. Both the groups underwent the exercise sessions for three days per week for four weeks.

At the beginning of the study, the 39-item Parkinson's disease quality of life scale (PDQ-39) scores suggested an impaired the quality of life among all the Parkinson's disease patients enrolled for the study. After the intervention, all patients assigned to physical therapy strategies based on Nintendo Wii training program showed an improvement of more than 10% in their total quality of life scores especially with regards to social support, communication, ability to deal with stigma and perform daily living activities.

Researchers also noted an improvement in the cognitive functions among the study subjects. They reported a high degree of participant interactivity and satisfaction during Nintendo Wii games execution.

On the other hand, no significant difference in the quality of life was observed in the group assigned to traditional physical therapy.

The main limitation of this study was the impossibility to blind patients to the program being assigned to them. If the patient is not aware of which group he/she is assigned to, there is less likeliness of a bias in the results. However, this was not possible in this study.

A review of previously published literature suggests that the type of exercise is relatively unimportant for individuals with Parkinson's disease, and the key to the effectiveness of physical activity intervention is likely to be found within the ability of a program to create and sustain user interest. After completion of the four-week study period, all patients (except for four) in the traditional physical therapy group migrated to Nintendo Wii group. This indicates the preference of the patients for rehabilitation with Nintendo Wii as compared to traditional physical therapy.

The research team concluded that rehabilitation using Nintendo Wii is superior to traditional physical therapy to improve the quality of life in Parkinson's disease patients. Further larger randomized controlled trials are necessary to reassure the results of this study.

Reference :

Source: Medindia

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