Banca de DEFESA: NATHALIA PRISCILLA OLIVEIRA SILVA BESSA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : NATHALIA PRISCILLA OLIVEIRA SILVA BESSA
DATE: 20/12/2021
TIME: 08:00
LOCAL: VIDEOCONFERÊNCIA
TITLE:

COMPARATIVE STUDY BETWEEN A PROTOCOL WITH NON-IMERSIVE VIRTUAL REALITY AND KINESIOTHERAPY ON POSTURAL BALANCE IN INDIVIDUALS WITH STROKE

KEY WORDS:

Stroke, Postural Balance, Virtual Reality Exposure Therapy.

PAGES: 195
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Stroke is the leading cause of disability in adults, resulting in functional changes such as deficit of balance and difficulty in performing activities of daily living. The sequelae result from the plastic changes in the neural tissue of these individuals, as a result of decreased excitability and non-use of the affected limbs after the injury, culminating in the reduction of the cortical representation of these areas. In the field of rehabilitation, Virtual Reality (VR) has been a great ally in the recovery of these patients. Objective: To compare the effects of a non-immersive virtual reality protocol with a kinesiotherapy protocol on the postural balance of patientes with chronic stroke. Methodology: It is a comparative study with 7 individuals, of both sexes, with a clinical diagnosis of stroke, unilateral brain injury, at least 6 months of injury, aged between 20-75 years. The individuals were initially assessed using a sociodemographic characterization form and then clinical assessment was performed: cognition (Mini Mental State Examination - MMSE), spasticity (Modified Ashworth Scale), ability to walk (Functional Walking Category), neurological impairment (National Institute Health Stroke Scale – NIHSS), quality of life (AVE Specific Quality of Life Scale), functionality (Functional Independence Measure - FIM), motivation (Intrinsic Motivation Inventory), balance and gait: BERG Balance Scale (BBS); Functional Range Test (FRT); Timed Up and Go Test (TUG); 6m Walk Test (6mWT), and Center of pressure variables by Force Platform (FP). These patientes were divided into two groups according to the proposed intervention protocol. The Kinesiotherapy group (KG) (n=4) performed lower limb strengthening (10 minutes) and kinesiotherapy focusing on balance with sensorimotor demand similar to virtual reality exercises (30 minutes) and the Virtual Reality Group (VRG) (n=3) performed the same strengthening mentioned (10 minutes) in addition to a virtual reality protocol based on body balance (30 minutes). There were 2 sessions per week, for 8 weeks, totaling 16 sessions. After completion of all therapy, patients were reassessed to the same standards as in the initial assessment. For the studied outcomes, a paired t-test was performed for intragroup analysis and t-test for intergroup comparison of the differences between pre- and post-intervention (delta) values observed in each group. Results: Both groups improved in all analyzed outcomes. However, in the intragroup analysis, only BBS (p = 0.006), total displacement of the center of pressure in the one-legged stance test with eyes open on paretic limb (p = 0.017), mean velocity in the one-legged stance test with eyes open on paretic limb (p = 0.007) and unipedal eyes closed on the healthy limb (p = 0.047) were significant in the control group. In the experimental BBS (p = 0.026) and total displacement of the center of pressure in the one-legged support test with eyes open on healthy limb (p = 0.035) were significant. In the intergroup analysis, there was a statistically significant difference for BBS (p = 0.033), and 6MWT (p = 0.021) and unipodal support with eyes open on paretic limb (p = 0.044). Conclusion: When comparing the effects of a non-immersive virtual reality protocol with a kinesiotherapy protocol on the postural balance of individuals with chronic stroke, it was observed that both were beneficial and caused improvements in the analyzed outcomes, with significance in the balance assessed by the scale of Berg balance. However, due to limitations in terms of sample size and number of sessions, it is suggested that studies be carried out with a more robust population and a longer total duration of therapy.

BANKING MEMBERS:
Externa ao Programa - 1032531 - ALINE BRAGA GALVAO SILVEIRA FERNANDES
Presidente - 2374822 - FABRICIA AZEVEDO DA COSTA CAVALCANTI
Externa à Instituição - HELOISA MARIA JACOME DE SOUSA BRITTO - ISD
Externa à Instituição - LUCIANA PROTASIO DE MELO - UES - RN
Externa à Instituição - SILVANA LOANA DE OLIVEIRA SOUZA - UMU