Effectiveness of virtual reality games for falls, postural oscillations, pain and quality of life of individual HAM/TSP:
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Effectiveness of virtual reality games for falls, postural oscillations, pain and quality of life of individual HAM/TSP: a randomized, controlled, clinical trial Naiane Araújo Patrício 1 & Diogo Guedes Vidal 2 & Elen Beatriz Pinto 3 & Katia Nunes Sá 3 & Abrahão Fontes Baptista 4 Received: 17 July 2019 / Revised: 17 March 2020 / Accepted: 6 July 2020 # Journal of NeuroVirology, Inc. 2020
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. Keywords HAM/TSP . Virtual reality . Postural balance . Pain . Quality of life
Introduction * Naiane Araújo Patrício [email protected]; [email protected] Diogo Guedes Vidal [email protected] Elen Beatriz Pinto [email protected] Katia Nunes Sá [email protected] Abrahão Fontes Baptista [email protected] 1
Doutoranda em Medicina e Saúde pela Universidade Federal da Bahia, Salvador, BA, Brazil
2
Unidade de Pesquisa em Ecologia e Meio Ambiente e Saúde (Portugal), Colaboradora de Pesquisa da Faculdade de Medicina e Saúde Pública da Bahia, Universidade do Porto, Porto, Portugal
3
Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
4
Universidade Federal do ABC, Sao Bernardo, Sao Paulo, Brazil
The Human T cell lymphotropic virus type 1 (HTLV-1) is a sexually transmitted retrovirus, considered to be a trigger agent for chronic high-intensity pain and neurological disorders that interfere with daily living activities (ADLs) and quality of life of infected individuals
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