Parkinson Hastalarında Sanal Gerçeklik Temelli Oyunların Üst Ekstremite ve Gövde Fonksiyonları ve Kognitif Durum Üzerine Etkisinin İncelenmesi

Abstract

In recent years, game-based exercises have been included more in the rehabilitation programs of Parkinson’s disease (PD) patients and positive effects have been observed. This study aims to investigate the effects of innovative games particularly designed for neurological patients on upper extremity performance, trunk mobility and cognition in patients with PD. Participants were randomly allocated into two groups. Both groups recevied 1 hour physiotherapy session for 3 days a week and 8 weeks in total (24 sessions). The first 40 minutes of the 1-hour exercise session of both groups included conventional exercises tailored to the needs of the patients. In the last 20 minutes of the exercise sessions, the experimental group patients performed game-based exercises with the USE-IT system while control group patients performed conventional exercises especially aiming upper extremity and trunk mobility. Evaluations were applied twice, before and after treatment. Primary outcome assessments were 9-Hole Peg Test (9-HPT) and Minnesota Manual Dexterity Test (MMDT) for upper extremity performance, Trunk Impairment Scale (TIS) for trunk mobility, Montreal Cognitive Assessment (MoCA) for cognitive status. Secondary outcome assessments were Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) for disease severity, Timed-Up and Go Test (TUG) for functional mobility, Functional Reach Test (FRT) for dynamic balance and Parkinson Disease Questionnaire (PDQ-39) for quality of life. Our study was completed with a total of 20 participants: 10 participants in the experimental group and 10 participants in the control group. Our findings showed that both groups improved significantly in 9-HPT dominant side, MMDT, TIS, MDS-UPDRS, TUG, FRT and PDQ-39 (p<0.05). MoCA scores of experimental group improved significantly (p<0.05) while control group’s did not (p>0.05). It was found that EP group had better imrovements in 9-HPT dominant side, MMDT turning test and MoCA than CP group when the differences in the changes within the groups were compared (p<0.05). It was thought that game-based exercises developed for the needs of patients could be a useful rehabilitation tool to improve upper extremity performance, trunk mobility, cognitive status, balance and quality of life and could be more effective rehabilitation method than conventional exercises, especially in improving upper extremity and cognitive functions.