Saturday, May 18, 2019

Virtual reality in the rehabilitation of patients with stroke: an integrative review

We don't need reviews we need protocols. WHEN THE HELL will we get them? After everyone in the existing stroke medical world is dead? All these posts that have been out there for years with nothing done to help survivors.

 

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 Aramaki1  2 
http://orcid.org/0000-0002-1740-6686
Rosana Ferreira Sampaio3 
http://orcid.org/0000-0002-4775-9650
Ana Caroline Silva Reis2  4 
http://orcid.org/0000-0001-6943-2600
Alessandra Cavalcanti4 
http://orcid.org/0000-0002-2306-2031
Fabiana Caetano Martins Silva e Dutra1  2  4 
http://orcid.org/0000-0003-3295-1583
1Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG, Brasil;
2NETRAS - Núcleo de Estudos e Pesquisas em Trabalho, Participação Social e Saúde, Uberaba MG, Brasil.
3Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Reabilitação, Belo Horizonte MG, Brasil;
4Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba MG, Brasil.

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.

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