Article

OBJECTIVES: To analyze the feasibility and efficacy of a novel system (Gamepad
[GAMing Experience in PArkinson's Disease]) for biofeedback rehabilitation of
balance and gait in Parkinson disease (PD). DESIGN: Randomized controlled trial.
SETTING: Clinical rehabilitation gym. PARTICIPANTS: Subjects with PD (N=42) were
randomized into experimental and physiotherapy without biofeedback groups.
INTERVENTIONS: Both groups underwent 20 sessions of training for balance and gait. The experimental group performed tailored functional tasks using Gamepad.
The system, based on wearable inertial sensors, provided users with real-time
visual and acoustic feedback about their movement during the exercises. The
physiotherapy group underwent individually structured physiotherapy without
feedback. MAIN OUTCOME MEASURES: Assessments were performed by a blinded examiner
preintervention, postintervention, and at 1-month follow-up. Primary outcomes
were the Berg Balance Scale (BBS) and 10-m walk test (10MWT). Secondary outcomes
included instrumental stabilometric indexes and the Tele-healthcare Satisfaction
Questionnaire. RESULTS: Gamepad was well accepted by participants. Statistically
significant between-group differences in BBS scores suggested better balance
performances of the experimental group compared with the physiotherapy without
biofeedback group both posttraining (experimental group-physiotherapy without
biofeedback group: mean, 2.3+/-3.4 points; P=.047) and at follow-up (experimental
group-physiotherapy without biofeedback group: mean, 2.7+/-3.3 points; P=.018).
Posttraining stabilometric indexes showed that mediolateral body sway during
upright stance was significantly reduced in the experimental group compared with
the physiotherapy without biofeedback group (experimental group-physiotherapy
without biofeedback group: -1.6+/-1.5mm; P=.003). No significant between-group
differences were found in the other outcomes. CONCLUSIONS: Gamepad-based training
was feasible and superior to physiotherapy without feedback in improving BBS
performance and retaining it for 1 month. After training, 10MWT data were
comparable between groups. Further development of the system is warranted to
allow the autonomous use of Gamepad outside clinical settings, to enhance gait
improvements, and to increase transfer of training effects to real-life contexts.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS