Figura 1. Imagen experimental de un paciente deambulando sobre el sistema Motigravity. a) Vista posterior; b) Vista anterior.
Figura 2. Imágenes representativas del entorno virtual. El entorno consistió en un paisaje marciano con rocas y edificios (a) o dunas(b).
Figura 3. Diagrama de flujo.
Tabla. Puntuaciones de medianas y rango intercuartílicos para las variables de estudio en las evaluaciones pre y post. |
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Pre (n = 12) |
Post (n = 12) |
p |
TE |
|
6MWT (m) |
326 (181-379) |
374 (201-394) |
0,005 a |
0,3 |
Tinetti: total (0-28) |
24 (20,8-25,8) |
26 (23,5-27,8) |
0,044 a |
0,6 |
Tinetti: sección de marcha (0-12) |
11 (9,3-12) |
12 (11-12) |
0,123 |
0,6 |
Tinetti: sección de equilibrio (0-16) |
13,5 (11,3-14) |
14,0 (12,3-15,8) |
0,066 |
0,5 |
10MWT (m/s) |
1,38 (0,85-1,64) |
1,39 (0,90-1,65) |
0,047 a |
0,2 |
Función física (SF-36, 0-100) |
48 (21-68) |
60 (41-83) |
0,027 a |
0,4 |
Función social (SF-36, 0-100) |
63 (50-72) |
69 (41-85) |
0,263 |
0,4 |
Rol físico (SF-36, 0-100) |
41 (9-74) |
63 (31-75) |
0,049 a |
0,6 |
Dolor corporal (SF-36, 0-100) |
46 (24-65) |
63 (27-82) |
0,018 a |
0,5 |
Salud mental (SF-36, 0-100) |
48 (41-56) |
52 (45-64) |
0,212 |
0,4 |
Rol emocional (SF-36, 0-100) |
67 (35-98) |
67 (50-100) |
0,246 |
0,4 |
Vitalidad (SF-36, 0-100) |
38 (19-45) |
43 (35-50) |
0,065 |
0,6 |
Salud general (SF-36, 0-100) |
38 (30-56) |
45 (35-54) |
0,234 |
0,3 |
6MWT: prueba de marcha de seis minutos; 10MWT: prueba de distancia de 10 metros; SF-36: encuesta de salud, formulario corto de 36-ítems; TE: tamaño del efecto. a Diferencias significativas entre pre y post después de la prueba de rango con signo de Wilcoxon (p < 0,05). |
Figura 4. Cambios individuales en los participantes que completaron la intervención (n = 9). a) Prueba de marcha de seis minutos; b) Escala de Tinetti: total; c) Escala de Tinetti: sección de marcha; d) Escala de Tinetti: sección de equilibrio; e) Prueba de distancia de 10 metros.
Immersive virtual reality and antigravity treadmill training for gait rehabilitation in Parkinson’s disease: a pilot and feasibility study Introduction. Treadmill training is considered an effective intervention to improve gait ability in patients with Parkinson’s disease (PD). In parallel, virtual reality shows promising intervention with several applications in the inpatient medical setting. Aim. To evaluate the feasibility and preliminary efficacy of mechanical gait assistance combined with immersive virtual reality in patients with PD. Patients and methods. This pilot and feasibility study followed a pre-post study design. The intervention consisted of 12 sessions of 30 minutes, distributed regularly over four consecutive weeks. Participants walked on a treadmill with a body-weight support system set at approximately 20% of body weight and equipped with a virtual reality helmet controlled by a two-handed joystick. Feasibility and intervention outcomes were collected at baseline and after four weeks of intervention. Results. Twelve participants of 60 patients were finally enrolled. Nine of them (75%) completed the treatment intervention with an adherence rate of 97%. Two participants left the study, one of them due to sickness associated with virtual reality and another because of a lack of motivation. There were significant differences associated with small-medium effect sizes when comparing the pre and post values for walk distance, walk speed, balance, and quality of life. Conclusions. The present study provided preliminary evidence supporting the feasibility of the combination of antigravity treadmill and immersive virtual reality system for the rehabilitation of patients with PD. Key words. Gait. Parkinson’s disease. Physical therapy. Quality of life. Treadmill training. Virtual reality. |