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Santana Muñoz D, Lorca Navarro M, Araya Orellana E, Moscoso Aguayo P, Martínez Huenchullán S. [Effect of training with immersive virtual reality on the risk of falling in the elderly: a systematic review]. Rehabilitacion (Madr) 2024; 58:100857. [PMID: 38788265 DOI: 10.1016/j.rh.2024.100857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024]
Abstract
Aging entails changes in the human body, generating a decrease in physical capabilities, including the risk of falls. New therapies are currently emerging for the risk of falls and immersive virtual reality is one of them, giving the user a realistic feeling of a virtual environment. This systematic review aims to investigate the effects of immersive virtual reality on the risk of falling in older people. Randomized controlled clinical trials were included, with at least one intervention group that used immersive virtual reality, age >60 years and without multiple serious pathologies. Articles published until November 2023 were included, in accordance with the PRISMA guideline and including the PICO strategy, in the electronic databases PubMed, Scielo, Scopus, Semantic Scholar and Science Direct. From a total of 413 articles, 7 studies were selected, which met the pre-established inclusion and exclusion criteria. Of the studies reviewed, the majority found significant improvements in tests that measure risk of falls, only one study did not find improvements in this variable but did find improvements for walking speed and functional reach test. Despite the limited literature, it seems that these interventions can have a positive effect, becoming a good tool to reduce the risk of falling in older people.
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Affiliation(s)
- D Santana Muñoz
- Escuela de Kinesiología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - M Lorca Navarro
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.
| | - E Araya Orellana
- Escuela de Terapia Ocupacional, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Valdivia, Chile
| | - P Moscoso Aguayo
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - S Martínez Huenchullán
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
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Oliveira LKR, Marques AP, Andrade KFA, Assis JCSD, Brito AL, Souza GS, Callegari B. Virtual Reality in Improving Anticipatory Postural Adjustments to Step Initiation in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial. Games Health J 2024; 13:100-108. [PMID: 38436585 DOI: 10.1089/g4h.2023.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Background: Virtual reality (VR) has been suggested as a new therapeutic approach in various sectors of rehabilitation, including the treatment of patients with knee osteoarthritis (OA), and one of its treatment goals is to improve the gait pattern and walking ability of patients. Objective: This study aimed to evaluate if VR, along with conventional physiotherapy treatment (CT), has superior effects to kinesiotherapy alone on pain, physical capacity, balance, and the parameters of anticipatory postural adjustments (APAs) in patients with knee OA. Design: This study is a single-blind randomized controlled trial. Setting: Secondary care at Hospital SARAH Network of Rehabilitation Hospitals, Brazil. Participants: Forty participants (31 women and 9 men) with knee OA in at least one knee and able to ambulate independently. Intervention: A rehabilitation program (8 consecutive weeks, 50-minute session, twice a week). Patients were randomized into the intervention groups CT or VR. Main Outcome Measures: Primary-latency of APA, amplitude of APA, and time to reach the maximum acceleration amplitude. Secondary-balance control by Mini-Balance Evaluation Systems Test, pain, and physical capacity by Western Ontario and McMaster Universities Arthritis Index. Results: The results of the study showed that conventional treatment significantly improved pain intensity, physical capacity, and balance in individuals with knee OA; however, only the group that used VR showed improvement in the APA parameters. Conclusion: This study demonstrated that VR associated with conventional treatment improved APAs in patients with knee OA.
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Affiliation(s)
- Luana Karine Resende Oliveira
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- SARAH Network of Rehabilitation Hospitals, Brasília, Distrito Federal, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Amélia Pasqual Marques
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jéssica Cristina Santos de Assis
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Aymee Lobato Brito
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Givago Silva Souza
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
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Gilani M, Torkaman G, Bahrami F, Bayat N. Virtual Reality Exergaming Capability to Change Muscle Strategy During the Limits of Stability Test and Reduce Fear of Falling in Primary Osteoporotic Women. Games Health J 2023. [PMID: 36940295 DOI: 10.1089/g4h.2022.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Objective: Muscle strength and balance impairment change the control strategy and increase the probability of falling. This study aimed to investigate the effect of 6-week strength-balance training through virtual reality exergaming (VRE) on muscle strategy during the limits of stability (LOS) test, fear of falling, and quality of life (QOL) in osteoporotic women. Materials and Methods: Twenty volunteer postmenopausal women with osteoporosis were randomly allocated to the VRE (n = 10) and traditional training (TRT as control, n = 10) groups. The VRE and TRT strength-balance training was performed for 6 weeks and three sessions per week. Before and after exercise, the muscle activity (onset time, peak root means square [PRMS]) and hip/ankle activity ratio were assessed by the wireless electromyography system. The muscle activities of the dominant leg were recorded during LOS functional test. The fall efficacy scale and QOL were assessed. Paired t-test was used to compare results within groups, and an independent t-test was used to compare the percentage changes in parameters between the two groups. Results: The VRE improved the onset time and PRMS. The VRE significantly reduced the hip/ankle activity ratio in the LOS test's forward, backward, and right directions (P < 0.05). No significant change was seen in all directions of the LOS functional test in the TRT group (P > 0.05). VRE reduced the fall efficacy scale (P = 0.042). Both VRT and TRT improved the total QOL score (P = 0.010). Conclusion: VRE was more effective in decreasing the onset time and hip/ankle ratio of muscle activation. The VRE is recommended to induce a better ability to reduce the fear of falling and control balance during functional activity in osteoporotic women. Clinical Trial Registration number: IRCT20101017004952N9.
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Affiliation(s)
- Mohammad Gilani
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Giti Torkaman
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fariba Bahrami
- Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Noushin Bayat
- Department of Rheumatology, Exercise Physiology Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Kong L, Wang W, Zhu X, Zhang W, Li Q, Wang X, Wang L. Effect of frailty on kinematic characteristics of walking in community-dwelling elders. Z Gerontol Geriatr 2022; 55:689-695. [PMID: 34757468 DOI: 10.1007/s00391-021-01997-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Frailty has a high prevalence in elders and impairs motor ability. This study aimed to investigate the influence caused by frailty in kinematic characteristics of walking and walking strategy adjustment from static standing to stable walking. METHODS In this study, 80 community-dwelling elders performed tests. The Kihon checklist (KCL) was used to assess frailty. The timed up and go test (TUGT) and the 30-s chair stand test (30-s CST) were used to assess balance and muscle strength. The Xsens MVN BIOMECH Awinda was used to collect walking kinematic data. RESULTS This study included 25 robust, 30 prefrail, and 25 frail elders. The TUGT completed time (P < 0.001) and the 30-s CST completed number (P = 0.002) had statistical differences among groups. The maximum peak of knee internal rotation showed an interaction between the frailty and the walking phase (P = 0.015). The peak angle of hip adduction, hip and knee flexion, and knee and ankle internal rotation were significantly lower in frail elders than others (P < 0.05). CONCLUSION Frailty affects the kinematic characteristics of walking, resulting in the hip, knee, and ankle flexion, hip adduction, knee and ankle internal rotation reduced. Besides, frailty has a specific negative effect on the walking strategy adjustment from static standing to stable walking.
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Affiliation(s)
- Lingyu Kong
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Wei Wang
- School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Xinrui Zhu
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Wen Zhang
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Qianqian Li
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Xiaowen Wang
- Department of Rehabilitation Medicine, Affiliated Hospital, Weifang Medical University, Weifang, China
| | - Liduan Wang
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China.
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