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虚拟现实游戏对 HAM/TSP 个体跌倒、姿势摆动、疼痛和生活质量的有效性:一项随机、对照、临床试验。

Effectiveness of virtual reality games for falls, postural oscillations, pain and quality of life of individual HAM/TSP: a randomized, controlled, clinical trial.

机构信息

Doutoranda em Medicina e Saúde pela Universidade Federal da Bahia, Salvador, BA, Brazil.

Unidade de Investigação em Energia, Ambiente e Saúde (FP-ENAS), Universidade Fernando Pessoa, Porto (Portugal), Colaborador de pesquisa da Escola Bahiana de Medicina e Saúde Pública, Bahia, Brasil.

出版信息

J Neurovirol. 2020 Oct;26(5):676-686. doi: 10.1007/s13365-020-00880-x. Epub 2020 Jul 31.

Abstract

People with HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP) have sensorimotor losses and postural instability, resulting in frequent falls. These findings stimulate the use of exercise protocols associated with postural control. This study investigated the effectiveness of a balance training exercise protocol through a virtual game. This is a randomized crossover clinical trial performed in subjects with imbalance disorders (HAM/TSP). To evaluate postural oscillations by baropodometry (total area, anterior, posterior and lateral projection), the Footwork® system was used and by cinemetry (angle of the body, hip and ankle alignment in the lateral view), the CVMob system. In addition, the Brief Pain Inventory and the WHOQoL Bref were used to measure pain intensity and quality of life. Comparison tests of the averages (intra and inter groups) and correlations were applied considering an alpha of 5% and power of 80%. The study was approved by the Ethics Committee of the Catholic University of Salvador and registered in the Clinical Trials database (NCT02877030). The final sample consisted of 26, predominantly female subjects. An increase in the postural oscillations of the control subjects (p < 0.05), a reduction in the occurrence of falls (p = 0.039) and an improvement in the quality of life of the control-test group (p < 0.05) were observed. Virtual game training did not improve the static balance, promoting an increase in postural oscillations. Immediately after the application of the protocol, there was a reduction in fall occurrence and improvement in the quality of life.

摘要

患有人类嗜 T 淋巴细胞病毒 1 相关性脊髓病或热带痉挛性截瘫(HAM/TSP)的人会出现感觉运动丧失和姿势不稳,导致频繁跌倒。这些发现促使人们使用与姿势控制相关的运动方案。本研究通过虚拟游戏来调查平衡训练运动方案的效果。这是一项针对平衡障碍受试者(HAM/TSP)进行的随机交叉临床试验。为了通过触地压力计(总区域、前、后和侧投影)评估姿势摆动,使用了 Footwork®系统,并通过运动学(侧视图下的身体、髋关节和踝关节角度)评估 CVMob 系统。此外,还使用了简明疼痛量表和 WHOQoL Bref 来衡量疼痛强度和生活质量。考虑到 5%的置信度和 80%的功效,应用了平均值(组内和组间)的比较测试和相关性。该研究得到了萨尔瓦多天主教大学伦理委员会的批准,并在临床试验数据库(NCT02877030)中注册。最终样本包括 26 名受试者,主要为女性。对照组的姿势摆动增加(p<0.05),跌倒发生率降低(p=0.039),对照组-测试组的生活质量改善(p<0.05)。虚拟游戏训练并没有改善静态平衡,反而增加了姿势摆动。在方案实施后立即,跌倒发生的减少和生活质量的改善。

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