Immediate Effect of Augmented Reality, Virtual Reality, and Neurofunctional Physiotherapy on Postural Control and Executive Function of Individuals with Parkinson's Disease
Hayslenne Andressa Gonçalves de Oliveira Araújo, Rogério José de Souza, Taís Caroline Oliveira da Silva, Tawany Sanches do Nascimento, Marcelle Brandão Terra, Suhaila Mahmoud Smaili
Abstract
Objective: To assess the immediate effect of augmented reality (AR), virtual reality (VR), and neurofunctional physiotherapy (NPT) on postural control (PC) and executive function (EF) of individuals with Parkinson's disease (PD). Materials and Methods: Forty subjects from mild-to-moderate PD stages, with no cognitive impairment were submitted to one session of NPT, one session of AR, and one session of VR for 50 minutes each (7 days interval between them). PC was evaluated before and after each therapy, using force platform in bipedal positions: tandem with eyes opened (EO), eyes closed (EC), and with double-task and one-legged stance. We recorded the center of pressure area, and anteroposterior (AP) and mediolateral (ML) displacement amplitude and velocity. EF was assessed by Trail Making Test (TMT). Results: PC improved (pre- vs. postintervention) after the three modalities: AP velocity decreased after AR (tandem EC 2.3 [1.7 to 2.9] vs. 2.1 [1.5 to 2.9], one-legged 3.0 [1.9 to 4.0] vs. 2.9 [1.9 to 3.6]), NPT (tandem EC 2.2 [1.7 to 3.1] vs. 2.1 [1.6 to 3.0]), and VR (tandem EO 1.9 [1.4 to 2.6] vs. 1.8 [1.4 to 2.4], tandem EC 2.3 [1.6 to 3.0] vs. 2.0 [1.5 to 2.8]); ML velocity decreased after AR in one-legged (P = 0.04); and permanence time in one-legged position increased in AR (Δ: 2.5 [−0.2 to 6.9]). There was also improvement in EF: TMT part A (TMTA)'s time decreased after AR (−9.3 [−15.7 to 1.9]), and TMT part B (TMTB)'s time decreased after the three modalities (ΔNPT: −7.7 [−29.4 to 0.0] vs. ΔAR: −4.6 [−34.6 to 0.6] vs. ΔVR: −4.9 [−28.2 to 0.9]). There were no differences between the modalities. Conclusion: The three treatment modalities improved PC and EF of subjects with PD. Moreover, AR and VR generated similar immediate effects to NPT on both outcomes in these patients. Trial registration: Brazilian Clinical Trial Registration: RBR-5r5dhf.