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Randomized Controlled Trial
. 2022 Apr 30;22(1):381.
doi: 10.1186/s12877-022-03035-1.

Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial

Muhammad Kashif  1   2 , Ashfaq Ahmad  3 , Muhammad Ali Mohseni Bandpei  3 , Syed Amir Gilani  3 , Asif Hanif  3 , Humaira Iram  4
Affiliations
Randomized Controlled Trial

Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial

Muhammad Kashif et al. BMC Geriatr. .

Abstract

Background: Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder, impairing balance and motor function. Virtual reality (VR) and motor imagery (MI) are emerging techniques for rehabilitating people with PD. VR and MI combination have not been studied in PD patients. This study was conducted to investigate the combined effects of VR and MI techniques on the balance, motor function, and activities of daily living (ADLs) of patients with PD.

Methods: This study was a single-centered, two-armed, parallel-designed randomized controlled trial. A total of 44 patients of either gender who had idiopathic PD were randomly allocated into two groups using lottery methods. Both groups received Physical therapy (PT) treatment, while the experimental group (N: 20) received VR and MI in addition to PT. Both groups received assigned treatment for three days a week on alternate days for 12 weeks. The Unified Parkinson's Disease Rating Scale (UPDRS) (parts II and III), Berg Balance Scale (BBS), and Activities-specific Balance Confidence (ABC) Scale were used as outcome measures for motor function, balance, and ADLs. The baseline, 6th, and 12th weeks of treatment were assessed, with a 16th week follow-up to measure retention. The data was analysed using SPSS 24.

Results: The experimental group showed significant improvement in motor function than the control group on the UPDRS part III, with 32.45±3.98 vs. 31.86±4.62 before and 15.05±7.16 vs. 25.52±7.36 at 12-weeks, and a p-value < 0.001. At 12 weeks, the experimental group's BBS scores improved from 38.95±3.23 to 51.36±2.83, with p-value < 0.001. At 12 weeks, the experimental group's balance confidence improved considerably, from 59.26±5.87to 81.01±6.14, with a p-value of < 0.001. The experimental group's ADL scores improved as well, going from 22.00±4.64 to 13.07±4.005 after 12 weeks, with a p-value of < 0.001.

Conclusion: VR with MI techniques in addition to routine PT significantly improved motor function, balance, and ADLs in PD patients compared to PT alone.

Trial registration: IRCT20200221046567N1 . Date of registration: 01/04/2020.

Keywords: Motor imagery; Parkinson’s disease; Physical therapy, Rehabilitation; Virtual reliability.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
CONSORT study flow diagram
Fig. 2
Fig. 2
Different types of games used in VR training
See this image and copyright information in PMC

References

    1. Fereshtehnejad S-M, Yao C, Pelletier A, Montplaisir JY, Gagnon J-F, Postuma RB. Evolution of prodromal Parkinson’s disease and dementia with Lewy bodies: a prospective study. Brain. 2019;142(7):2051–2067. doi: 10.1093/brain/awz111. - DOI - PubMed
    1. Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease and other movement disorders. Bradley's Neurology in Clinical Practice E-Book 2021:310.
    1. Nuic D, Vinti M, Karachi C, Foulon P, Van Hamme A, Welter M-L. The feasibility and positive effects of a customised videogame rehabilitation programme for freezing of gait and falls in Parkinson’s disease patients: a pilot study. J Neuroeng Rehabil. 2018;15(1):31. doi: 10.1186/s12984-018-0375-x. - DOI - PMC - PubMed
    1. Schootemeijer S, van der Kolk NM, Ellis T, Mirelman A, Nieuwboer A, Nieuwhof F, et al. Barriers and motivators to engage in exercise for persons with Parkinson’s disease. J Parkinsons Dis. 2020;10(4):1293–1299. doi: 10.3233/JPD-202247. - DOI - PMC - PubMed
    1. Mak MK, Wong-Yu IS, Shen X, Chung CL. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nat Rev Neurol. 2017;13(11):689–703. doi: 10.1038/nrneurol.2017.128. - DOI - PubMed

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