scholarly journals EFEITO DA TERAPIA COM REALIDADE VIRTUAL NO EQUILÍBRIO DINÂMICO DE INDIVÍDUOS PÓS-ACIDENTE VASCULAR ENCEFÁLICO

2019 ◽  
Vol 11 (3) ◽  
pp. 99-105
Author(s):  
Alice Haniuda Moliterno ◽  
Isabela Bortolim Frasson ◽  
Silas de Oliveira Damasceno ◽  
Caroline Nunes Gonzaga ◽  
Isabella Cristina Leoci ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Dynamic Balance ◽  
Balance Training ◽  
Moderate Correlation ◽  
Nintendo Wii ◽  
Significant Difference ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Therapy Sessions

The aim of this study was to analyze the effect of virtual reality-based (VR) therapy on balance training of patients after stroke. 10 hemiparetic participants received twelve individual physical therapy sessions using the VR therapeutic, through Nintendo Wii® Fit Plus and Wii Sports Resort™. The analysis revealed that the Dynamic Gait Index (DGI) instrument, responsible for evaluating the dynamic balance, obtained significant difference (p=0.0085) between the basal (17.30±3.59) and final (20.30±2.94) evaluation. The Penguin Slide game had no significance between the scores (p=0.918), but there was a moderate correlation between the DGI instrument (r=0.662; p=0.037). This study obtained favorable results related to dynamic balance and also suggests that VR therapy as in general influenced the improvement of dynamic balance in individuals with hemiparesis after stroke.

The Effects of Virtual Reality on Upper Extremity in Patients with Obstetric Brachial Plexus Injury

2021 ◽  
Author(s):  
Havva Ezgi Karas ◽  
Emine Atıcı ◽  
Gamze Aydın ◽  
Mert Demirsöz
Keyword(s):  
Virtual Reality ◽  
Brachial Plexus ◽  
Upper Extremity ◽  
Brachial Plexus Injury ◽  
Control Group ◽  
Nintendo Wii ◽  
Significant Difference ◽  
Obstetric Brachial Plexus ◽  
Conventional Physiotherapy ◽  
Obstetric Brachial Plexus Injury

AbstractThe present study aimed to examine the effects of playing Nintendo Wii games on upper extremity functions compared with conventional physiotherapy, in children with obstetric brachial plexus injury (OBPI). Twenty-two patients with brachial plexus injuries were enrolled. The patients were divided into two groups by simple randomization. The control group (conventional physiotherapy group [CTG]: n = 11) received conventional physiotherapy for 6 weeks (40 minutes per day, for 4 days per week). The study group, called Nintendo Wii group (NWG; n = 11), received conventional physiotherapy as well as tennis, baseball, and boxing games with Nintendo Wii on days when there was no physical therapy. The upper extremity range of motion (ROM) was evaluated using a digital goniometer, motor function was assessed using the Active Movement Scale (AMS), and shoulder functions were assessed with the Mallet Scoring System (MSS). Virtual reality treatment had a positive effect on shoulder flexion, forearm pronation, wrist flexion, ROM, and functionality (p < 0.05). There was a significant improvement in shoulder abduction and shoulder external rotation in the CTG (p < 0.05). There was no significant difference in the MSS values of either groups (p > 0.05). As per the AMS, in the NWG, the shoulder internal rotation increased significantly (p < 0.05). Nintendo Wii treatment used in addition to conventional physiotherapy may be effective in increasing upper extremity functions in children with OBPI. Clinical Trials Number NCT04605601.

scholarly journals Examining the effects of active video games and balance training on static balance in 6 years old children6 yaş grubu çocuklarda aktif video oyunları ve denge antrenmanlarının statik dengeye etkisinin incelenmesi

2018 ◽  
Vol 15 (4) ◽  
pp. 2376
Author(s):  
Abdurrahman Demir ◽  
Manolya Akın
Keyword(s):  
Video Games ◽  
Video Game ◽  
Balance Training ◽  
Control Group ◽  
Static Balance ◽  
Nintendo Wii ◽  
Active Video Games ◽  
Significant Difference ◽  
Active Video Game ◽  
Active Video

The purpose of this study was to examine the effects of active video games Nintendo Wii and Wobel Board balance exercises on static balance development in children aged 6 years.          54 children, participated in the research voluntarily on informed consents from according to Helsinki criteria by taking permission from Mersin University Ethics Committe. The study was carried out with 3 groups with similar physical characteristics (mean age = 6,21, mean weight= 21,3, mean height = 116,8). The balance training were applied to a group with a 'wobble board' and another group with a 'nintendo wii game console' from active video games. The pre and post test static balance measurements of all groups were measured using the 'Balance Error Scoring System' and the differences between the groups were examined. For parametric results, 3x2 repetitive measurements were performed with anova analysis, and for non-parametric results kruskall wallis test was applied.         There was no significant difference between the groups participating in active video game and wobble board balance training in the measurements made after the study (p>,05). The difference between the experimental group and the foot and tandem position were found statistically significant. (p <,01). There was no significant difference between the two groups in paired feet values (p>, 05).         Both the wobbel board and the active video game training have been found to improve the static balance in children. It has been seen that there is no meaningful development in the control group. This result shows us that active video games are as effective as balance training in 6 years old children. In this context, active video games can be proposed as an alternative method to improve balance.Extended English summary is in the end of Full Text PDF (TURKISH) file. Özet Bu çalışmanın amacı, 6 yaş çocuklarda aktif video oyunları nintendo wii ve wobble board denge antrenmanlarının statik denge gelişimleri üzerine etkisini incelemektir.        Araştırmaya, 54 çocuk, Mersin Üniversitesi etik kurulundan izin alınarak Helsinki kriterlerine uygun olarak katılmıştır. Çalışma benzer fiziksel özellikte (yaş ort.=6,21, kilo ort.=21,3, boy ort.=116,8) 3 grupla  yürütülmüştür. Denge antrenmanları haftada üç gün 8 hafta ‘wobble board’ denge tahtası ve aktif video oyunları ‘nintendo wii oyun konsolu’ ile uygulanmıştır. Kontrol grubuna ise herhangi bir uygulama yaptırılmamıştır. Tüm grupların statik denge ölçümleri ‘Denge Hata Skoru Sistemi’ kullanılarak ölçülmüştür.Parametrik sonuçlar için, çalışmada 3x2 tekrarlı ölçümler anova analizi yapılmış, non-parametrik sonuçlar için ise kruskall wallis testi uygulanmıştır.       Araştırma sonrasında aktif video oyunu ve wobble board denge antrenmanına katılan gruplar arasında istatistiksel olarak manidar fark bulunmamıştır (p>,05). Deney gruplarının, zeminde ve köpükte tek ayak ve tandem duruşlarda bulunan fark kontrol grubuna göre istatistiksel olarak anlamlı (p<,01) iken, çift ayak değerlerinde, üç grup arasında da anlamlı bir fark bulunmamıştır (p>,05).       Hem wobble board hem de aktif video oyunları nintendo wii denge antrenmanlarının çocuklarda statik dengeyi geliştirdiği bulunmuştur. Kontrol gurubunda ise anlamlı bir gelişimin olmadığı görülmüştür. Bu sonuç bize aktif video oyunlarının 6 yaş grubu çocuklarda denge antrenmanları kadar etkili olduğunu göstermektedir. Bu bağlamda aktif video oyunları dengeyi geliştirmek için alternatif bir yöntem olarak önerilebilir.

scholarly journals Are physical therapy pain levels affected by surgical approach in total hip arthroplasty? A randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Dan-Viorel Nistor ◽  
Nicolae Ciprian Bota ◽  
Sergiu Caterev ◽  
Adrian Todor
Keyword(s):  
Physical Therapy ◽  
Controlled Trial ◽  
Direct Anterior Approach ◽  
Lateral Approach ◽  
Total Hip ◽  
Significant Difference ◽  
Postoperative Physical Therapy ◽  
Muscle Sparing ◽  
The Difference ◽  
Therapy Sessions

The main objective of this study was to evaluate the difference in pain levels during postoperative physical therapy pathways in patients who underwent a cement less total hip replacement either through a muscle sparing direct anterior approach (DAA), or the classic trans-gluteal lateral approach (LA). One hundred and twelve (112) patients were randomized into two equal groups. Baseline values of myoglobin levels were acquired prior to surgery and repeated at 6 hours postoperatively as a biomarker for muscle damage. Pain levels during the first passive and consecutive 3 active physical therapy sessions were noted using a visual analogue-numeric scale (VAS). Pain levels were also acquired at 6 weeks, 3 months, 6 months and 1 year, following a 20-meter (65.6 feet) walking test. Postoperative myoglobin (ng/mL) levels were significantly higher (p< 0.05) in the LA group (335.05±83.54) then the DAA group (237.71±57.54). Pain levels were significantly lower (p<0.001) in the DAA group for both passive (2.5±1.45 vs. 4.28±2.19) and active physical therapy sessions and there was a positive correlation between postoperative myoglobin levels and pain levels until 6 postoperative weeks. There was no significant difference in demographics between the two groups except for gender distribution. The direct anterior approach’s main advantage of being a minimally invasive muscle sparing technique is showing a better rehabilitation experience with lower pain levels during passive and active physical therapy when compared to the classic trans-gluteal lateral approach.

scholarly journals Intrarater and Interrater Reliability of Dynamic Gait Index in Post Stroke Patients With Eye Movement Disorders

2021 ◽  
Author(s):  
Sana Batool ◽  
Hamayun Zafar ◽  
Syed Amir Gilani ◽  
Ashfaq Ahmad ◽  
Asif Hanif
Keyword(s):  
Acute Stroke ◽  
Eye Movement ◽  
Movement Disorders ◽  
Dynamic Balance ◽  
Stroke Patients ◽  
Rater Reliability ◽  
Eye Movement Disorders ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Abstract Background: The Dynamic Gait Index is a useful scale that has been evaluated for its reliability in patients with vestibular disorder, elderly people and, in chronic stroke population but its reliability has not been evaluated yet in sub-acute stroke patients with eye movement disorders. So the purpose of this study was to evaluate the intra-rater and inter-rater reliability of the Dynamic gait index to measure the dynamic balance, gait and risk of fall in sub-acute stroke population with eye movement disorders.Methods: A total of 30 (18 male, 12 females) stroke patients in the sub-acute phase suffering from eye movement disorders were recruited for this reliability study. Two experienced Physical therapists assessed the intra-rater and inter-rater reliability of the Dynamic gait index in two testing sessions three days apart. In the later session, two raters assessed the patients’ performance simultaneously on the Dynamic gait index. Data analysis was done at 95% confidence interval using the intra-class correlation coefficient (ICC2, 1). A significance level was set at P-value <0.05.Results: Mean tests scores by rater 1 in the first and second assessment were 17.4±2.04 and 18.0±2.05. Mean tests score by rater 2 in the second assessment were 18.6±2.06. Intra-rater (ICC=0.86, CI=0.73-0.93) and inter-rater (ICC=0.91, CI=0.83-0.96) reliability of total DGI scores was found good to excellent while intra-rater (ICC=0.73-0.91) and inter-rater (ICC=0.73-0.93) reliability of individual items of DGI scores were ranged from moderate to good. Item 8 (steps) showed lowest reliability (ICC=0.73). The significant difference was seen in total and individual scores (P<0.001) of DGI scale in both intra-rater and inter-rater reliability.Conclusions: The Dynamic gait index is found clinically a reliable tool to objectively measure dynamic balance, gait and risk of fall in sub-acute stroke individuals with eye movement disorders. The intra-rater and inter-rater reliability of the total DGI scores was found good to excellent; whereas intra-rater and inter-rater reliability for individual items of DGI were varied from moderate to good.

scholarly journals Temporal virtual reality-guided, dual-task, body trunk-balance training in a sitting position improved persistent postural-perceptual dizziness: proof of concept

2021 ◽  
Author(s):  
Tomoya Yamaguchi ◽  
Toru Miwa ◽  
Kaoru Tamura ◽  
Fumiko Inoue ◽  
Naomi Umezawa ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Dual Task ◽  
Dynamic Balance ◽  
Training Session ◽  
Balance Training ◽  
Depression Scale ◽  
Definitive Treatment ◽  
Balance Disorders ◽  
Institutional Ethics ◽  
Trunk Balance

Abstract BackgroundPersistent postural-perceptual dizziness (PPPD) is a newly defined disorder of functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to measure the effectiveness of virtual reality (VR)-guided, dual-task, body trunk balance training using the mediVR KAGURA system for the treatment of PPPD.MethodsData from patients with PPPD collected from January 1, 2021 to February 28, 2021 were reviewed. Additionally, healthy people were included as controls. VR-guided training was performed using 100 tasks for 10 min. Equilibrium tests were performed at baseline and immediately after VR-guided training to examine the effectiveness of static and dynamic balance ability. Additionally, assessments of clinical questionnaire-based surveys of balance disorders were performed at baseline and 1 week after VR-guided training to examine the effects on the symptoms related to balance disorders. The primary outcome was the usefulness of static and dynamic body balance and NPQ scores.ResultsVR-guided training using mediVR KAGURA improved objective symptoms, including static and dynamic postural stability (relating to somatosensory and visual weighting, respectively) even when the training was conducted once for 10 min. Additionally, VR-guided training improved the Hospital Anxiety and Depression Scale score and the Niigata PPPD Questionnaire score, 1 week after a 10-min training session. ConclusionVR-guided training was found to be a viable method in managing the balancing ability, anxiety, and symptoms of patients with PPPD. VR-guided training offers safety and reduction of human resources; however, its clinical efficiency warrants further evaluation in prospective studies.Trial registrationInstitutional Ethics Committee of Kitano Hospital, approval number: 1911003. Registered 18 December 2019, https://kitano.bvits.com/rinri/publish_document.aspx?ID=426

scholarly journals Effects of application of texture insoles on the balance of subjects with Multiple Sclerosis

2017 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Wildja De Lima Gomes ◽  
Thais Botossi Scalha ◽  
Lucas Brino Mota ◽  
Viviane Almeida Kuroda ◽  
Juliana Cintra Garrafa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Measuring Instruments ◽  
Balance Scale ◽  
Functional Gait ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Objective: The aim of this study was to evaluate the effects on static and dynamic balance after the use of textured insoles. Method: Fifteen subjects with multiple sclerosis were evaluated before using the insoles, after using them for 1 month, and after 2 months without using, them using the following measuring instruments: the Berg Balance Scale, Dynamic Gait Index, and 10-meter Walk Test, a means of functional gait assessment. Results: Improvement was observed in the Berg Balance Scale and Dynamic Gait Index scores, walking time, number of steps and step length after using the insoles for 1 month. The improvement in Berg Balance Scale score remained after two months without the insoles and there were no changes in gait speed. Conclusion: The use of textured insoles was effective as an intervention to improve static and dynamic balance in patients with multiple sclerosis.

scholarly journals Comparison of mini-bestest and dynamic gait index for prediction of fall susceptibility in old individuals

2017 ◽  
Vol 5 (7) ◽  
pp. 3018
Author(s):  
. Miqdad ◽  
Sushil Kumar Pawar
Keyword(s):  
Physical Therapy ◽  
Early Identification ◽  
Fall Risk ◽  
Elderly Population ◽  
Elderly Subjects ◽  
Vestibular Apparatus ◽  
Normal Individuals ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Larger Sample

Background: Emphasis on early identification, prevention, and intervention of fall risk in elderly people is becoming increasingly important in the fields of physical therapy and rehabilitation.Methods: Various scales are currently used for assessment of balance and fall risk. We have selected, MiniBESTest and DGI for our present study. We compared scores of Mini-BESTest and DGI in 30 elderly subjects with mean age of 62.23±4.38yrs. These subjects included 17 completely normal individuals, whereas 13 subjects were having early clinical features of fall-related disorders. Example: Parkinsonism, vertigo and paresis.Results: The data indicated that Mini-BESTest is more superior than DGI to indicate the fall risk in normal elderly population. Similarly, in cases of paresis and Parkinsonism, results are indicating that Mini-BESTest is better suited than the DGI. But in cases of vertigo, the results indicate that DGI is more superior than Mini-BESTest.Conclusions: An interesting finding is that the DGI scale seems to be more superior in subjects having vertigo (Refer Table-4), which is to be verified by further studies in a larger sample. The point which justifies the above conclusion is that the DGI scale includes many items which test the vestibular apparatus.

scholarly journals Comparing the Convergent and Concurrent Validity of the Dynamic Gait Index with the Berg Balance Scale in People with Multiple Sclerosis

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 27 ◽  
Author(s):  
Tapan Mehta ◽  
Hui-Ju Young ◽  
Byron Lai ◽  
Fuchenchu Wang ◽  
Yumi Kim ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Extremity ◽  
Physical Functioning ◽  
Concurrent Validity ◽  
Convergent Validity ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Sf 36 ◽  
Dynamic Gait Index ◽  
Dynamic Gait

Background: Recent clinical guidelines for adults with neurological disabilities suggest the need to assess measures of static and dynamic balance using the Berg Balance Scale (BBS) and Dynamic Gait Index (DGI) as core outcome measures. Given that the BBS measures both static and dynamic balance, it was unclear as to whether either of these instruments was superior in terms of its convergent and concurrent validity, and whether there was value in complementing the BBS with the DGI. Objective: The objective was to evaluate the concurrent and convergent validity of the BBS and DGI by comparing the performance of these two functional balance tests in people with multiple sclerosis (MS). Methods: Baseline cross-sectional data on 75 people with MS were collected for use in this study from 14 physical therapy clinics participating in a large pragmatic cluster-randomized trial. Convergent validity estimates between the DGI and BBS were examined by comparing the partial Spearman correlations of each test to objective lower extremity functional measures (Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), Timed 25-Foot Walk (T25FW) test) and the self-reported outcomes of physical functioning and general health using the 36-Item Short Form Health Survey (SF-36). Concurrent validity was assessed by applying logistic regression with gait disability as the binary outcome (Patient Determined Disease Steps (PDDS) as the criterion measure). The predictive ability of two models, a reduced/parsimonious model including the BBS only and a second model including both the BBS and DGI, were compared using the adjusted coefficient of determinations. Results: Both the DGI and BBS were strongly correlated with lower extremity measures overall as well as across the two PDSS strata with correlations. In PDDS ≤ 2, the difference in the convergence of BBS with TUG and DGI with TUG was −0.123 (95% CI: −0.280, −0.012). While this finding was statistically significant at a type 1 error rate of 0.05, it was not significant (Hommel’s adjusted p-value = 0.465) after accounting for multiple testing corrections to control for the family-wise error rate. The BBS–SF-36 physical functioning correlation was at least moderate and significant overall and across both PDDS strata. However, the DGI–physical functioning score did not have a statistically significant correlation within PDDS ≤ 2. None of the differences in convergent and concurrent validity between the BBS and DGI were significant. The additional variation in 6MWT explained by the DGI when added to a model with the BBS was 7.78% (95% CI: 0.6%, 15%). Conclusions: These exploratory analyses on data collected in pragmatic real-world settings suggest that neither of these measures of balance is profoundly superior to the other in terms of its concurrent and convergent validity. The DGI may not have any utility for people with PDDS ≤ 2, especially if the focus is on mobility, but may be useful if the goal is to provide insight on lower extremity endurance. Further research leveraging longitudinal data from pragmatic trials and quasi-experimental designs may provide more information about the clinical usefulness of the DGI in terms of its predictive validity when compared to the BBS.

scholarly journals Case of cerebellar ataxia successfully treated by virtual reality-guided rehabilitation

2021 ◽  
Vol 14 (5) ◽  
pp. e242287
Author(s):  
Kazuhiro Takimoto ◽  
Kyohei Omon ◽  
Yuichiro Murakawa ◽  
Hideo Ishikawa
Keyword(s):  
Virtual Reality ◽  
Physical Therapy ◽  
Test Score ◽  
Daily Life ◽  
Balance Training ◽  
Balance Function ◽  
Brainstem Infarction ◽  
Evaluation Systems ◽  
Functional Balance ◽  
Trunk Sway

A male patient in his 40s was transferred to our hospital for rehabilitation of ataxia after right cerebellar and brainstem infarction. After 3 weeks of conventional physical therapy, his activities of daily life successfully improved with an increase in the functional impedance measure from 101 to 124. However, he still fell short of gaining a higher level of balance function, which was necessary for his job as a standup forklift driver. We introduced virtual reality-guided balance training. The training was performed for approximately 40 min on weekdays for 2 weeks. As a result, the Scale for the Assessment and Rating of Ataxia score decreased from 5 to 1, Functional Balance Scale score improved from 48 to 56, and Mini-Balance Evaluation Systems Test score increased from 20 to 28. The trunk sway disappeared clinically. He regained confidence and returned to work after an additional 2 weeks of physical therapy.

scholarly journals A VARIANT OF EXPERT ASSESSMENT OF BALANCE AND GAIT FUNCTIONS IN PATIENTS AFTER STROKE

2017 ◽  
Vol 20 (4) ◽  
pp. 176-180
Author(s):  
S. V Prokopenko ◽  
Mariya V. Abros’kina ◽  
V. S Ondar ◽  
S. A Kaygorodtseva
Keyword(s):  
Dynamic Balance ◽  
Dynamic Assessment ◽  
Objective Evaluation ◽  
Berg Balance Scale ◽  
Expert Assessment ◽  
Kinematic Parameters ◽  
Neurological Patients ◽  
Risk Of Falls ◽  
Dynamic Gait Index ◽  
Dynamic Gait

The article presents the results of approbation of the complex of objective evaluation of equilibrium and walking functions, including such functional scales as Berg Balance Scale, Dynamic Gait Index, hardware methods of computer stabilometry and laser analyzer of kinematic parameters of walking in groups of patients with poststroke vestibulo-atactic syndrome and hemiparesis syndrome. The proposed complex allows objectively and informatively to assess the state of static and dynamic balance, the risk of falls during walking, changes in the walking pattern in neurological patients. The complex is recommended for the dynamic assessment of patients’ condition during neurorehabilitation.

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