Daniel Dominguez Ferraz

The Use of Nintendo Wii in the Rehabilitation of Poststroke Patients: A Systematic Review

BACKGROUND To evaluate the effectiveness of the video game console Nintendo Wii (NW) in motor function, balance, and functional independence in the treatment of poststroke patients and to identify which games are commonly used in therapy. METHODS Randomized controlled trials were researched in MEDLINE, Cochrane Library, PEDro, CAPES Periodic, BIREME, and LILACS databases, covering publications up to March 31, 2014. The assessment of methodological quality was performed using the PEDro Scale as reference. RESULTS The 5 studies included for analysis showed that NW can provide an improvement of motor function of the individual, but the data are unclear when it comes to the balance and functional independence. CONCLUSIONS It was concluded that there is little evidence to ensure the effectiveness and support the inclusion of the treatment with NW in patients with sequelae caused by a stroke; however, some of the studies analyzed suggest that NW can provide improvement in motor function.

The Effects of Functional Training, Bicycle Exercise, and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial

OBJECTIVES To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD). DESIGN A pilot randomized, controlled, single-blinded trial. SETTING A state reference health care center for elderly, a public reference outpatient clinic for the elderly. PARTICIPANTS Elderly individuals (≥60 years of age; N=62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank. INTERVENTION The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n=22); group 2 (G2) performed bicycle exercise (n=20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n=20). MAIN OUTCOME MEASURES The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale. RESULTS All groups showed significant improvements in 6MWT (G1 P=.008; G2 P=.001; G3 P=.005), SRT (G1 P<.001; G2 P=.001; G3 P=.003), and WHODAS 2.0 (G1 P=.018; G2 P=.019; G3 P=.041). Only G3 improved gait speed in 10MWT (P=.11). G1 (P=.014) and G3 (P=.004) improved quality of life. No difference was found between groups. CONCLUSIONS Eight weeks of exergaming can improve the walking capacity of elderly patients with PD. Exergame training had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants.