Serebral Palsi’de İnteraktif Video Oyunlarının Denge ve Performans Üzerine Akut Etkisi

Abstract

Amaç: Serebral Palsi (SP)’li bireylerde video oyunları terapisi (VOT) ile nörogelişimsel terapinin (NGT) performans, denge üzerindeki akut etkilerini karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya 6-18 yaşları arasında 20 SP’li birey dahil edildi. Fonksiyonel düzeyleri; Kaba Motor Fonksiyon Sınıflama Sistemi (KMFSS), spastisiteleri Modifiye Ashword Skalası (MAS), kaba motor fonksiyonları Kaba Motor Fonksiyon Ölçeği-88 (KMFÖ-88) D&E modüllerine göre, fiziksel performansları 10m yürüme, 5 basamak merdiven inme ve çıkma sürelerine (5BMİS-5MBÇS) göre; fonksiyonel denge performansları süreli kalk ve yürü testi (SKYT), sağ-sol tek ayak üzerinde durma süreleri (TAÜDS) ile değerlendirildi. Birer seans NGT ve Nintendo Wii oyun konsolunda, 4 standart oyundan oluşan VOT uygulandı. 45 dakika süren 2 müdahelede önce ve sonrasında değerlendirmeler yapıldı. Sonuçlar: Performans parametrelerinde, terapi seanslarında anlamlı gelişme elde edilemedi. Denge performanslarında; VOT’da SKYT ve sol TAÜDS’de anlamlı gelişme olduğu belirlenirken (Z=-2,576, p=0,01), NGT’de elde edilmedi (Z=-1,531, p=0,126). VOT’da Spastik Diplejik (SDİ) ve Hemiplejik (SHİ) bireyler karşılaştırıldığında, 5BMÇ’da SDİ lehine anlamlı gelişme elde edildi (p=0,01). VOT’da KMFSS alt grupları; (KMFSS I-II) karşılaştırıldığında, 5BMÇS (p=0,01) ve SKYT’de (p=0,035) KMFSS II’de anlamlı gelişme elde edildi. Tartışma: SP’li bireylerde denge, performans açısından standart tedaviye oyun terapisinin eklenmesinin daha fazla fayda sağlayacağı, SP’de hastanın klinik tablosuna uygun oyun seçiminin önemli olduğu sonuçlarına varılmıştır.

Keywords

• Serebral palsi,Video oyunları,Sanal sistemler

Acute Impact on Balance and Performance of Interactive Video Games in Cerebral Palsy

Abstract

Purpose: Purpose: Comparing acute effects of video game therapy (VOT) and neurodevelopmental therapy (NGT) in cerebral palsy (SP) in relation to performance, balance. Material and Methods: Between ages of 6-18, 20 SP individuals were included in the study. Functional levels; Gross Motor Function Classification System (GMFCS), physical performance; 10m walking, 5 stairs climbing up (5SCU), down (5SCD), spasticity; Modified Ashworth Scale, gross motor function; Gross Motor Function Measurement-88; functional balance performances were assessed by timed up & go test (TUG) and right-left single-leg raise (SLR). NGT and VOT (4 standard games, Nintendo Wii game console) were applied for 45 minutes. Evaluations were done before-after interventions.  Results: Performance parameters; there is no significant improvement in both therapy sessions. Equilibrium performances; in VOT; there is significant improvement about TUG, left SLR (Z=-2,576, p=0.01), but not in NGT (Z=-1,531, p=0,126). Compared with Spastic Diplegic (SDI) and Hemiplegic (SHI) subjects in VOT, significant improvement obtained in 5SCU in favor of SDI (p=0,01). Comparing GMFCS subgroups (GMFCS I-II) in VOT; significant improvement observed in GMFCS II about 5SCU (p=0,01) and TUG (p=0,035). Discussion: In SP, the inclusion of game therapy in standard treatment will be beneficial in terms of balance and performance and it is important to select games appropriate to the clinical chart of the patient.

Keywords

• Cerebral palsy,Video games,Virtual systems

References

1. Acar, G., Altun, G. P., Yurdalan, S., & Polat, M. G. (2016). Efficacy of neurodevelopmental treatment combined with the Nintendo Wii in patients with cerebral palsy. J Phys Ther Sci, 28(3), 774–780.
2. Alotaibi, M., Long, T., Kennedy, E., & Bavishi, S. (2014). The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a literature review. Disabil Rehabil, 36(8), 617–627.
3. Al Saif, A. A., & Alsenany, S. (2015). Effects of interactive games on motor performance in children with spastic cerebral palsy. J Phys Ther Sci, 27(6), 2001–2003. Atasavun, U. S., & Baltacı, G. (2016). Effects of Nintendo Wii TM training on occupational performance, balance, and daily living activities in children with spastic hemiplegic cerebral palsy: A single-blind and randomized trial. Games Health J, 5(5), 311–317.
4. Ballaz, L., Robert, M., & Parent, A. (2014). Research in developmental disabilities impaired visually guided weight-shifting ability in children with cerebral palsy. Res Dev Disabil, 35, 1970–1977.
5. Bennell, K., Dobson, F., & Hinman, R. (2011). Measures of physical performance assessments: Self-Paced Walk Test (SPWT), Stair Climb Test (SCT), Six-Minute Walk Test (6MWT), Chair Stand Test (CST), Timed Up & Go (TUG), Sock Test, Lift and Carry Test (LCT), and Car Task. Arthritis Care Res, 63(11), 350–670.
6. Crosbie, J. H., Lennon, S., Basford, J. R., & McDonough, S. M. (2007). Virtual reality in stroke rehabilitation: Still more virtual than real. Disabil Rehabil, 29(14), 1139–1146.
7. Gatica-rojas, V., Cartes-velásquez, R., Méndez-rebolledo, G., Olave-godoy, F., & Villalobos-rebolledo, D. (2016). Change in functional balance after an exercise program with Nintendo Wii in Latino patients with cerebral palsy: a case series. J Phys Ther Sci, 28(8), 2414–2417.
8. Gatica-Rojas, V., Méndez-Rebolledo, G., Guzman-Muñoz, E., Soto-Poblete, A., Cartes-Velásquez, R., Elgueta-Cancino, E., & Cofré-Lizama, L. E. (2017). Does Nintendo Wii Balance Board improve standing balance? A randomized controlled trial in children with cerebral palsy. Eur J Phys Rehabil Med, 53(4), 535–544. ,

9. Gordon, C., Roopchand-Martin, S., & Gregg, A. (2012). Potential of the Nintendo WiiTM as a rehabilitation tool for children with cerebral palsy in a developing country: a pilot study. Physiotherapy, 98(3), 238–242.
10. Harris, K., & Reid, D. (2005). The influence of virtual reality play on children’s motivation. Can J Occup Ther, 72(1), 21–29.
11. Jelsma, J., Pronk, M., Ferguson, G., & Jelsma-Smit, D. (2013). The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Dev Neurorehabil, 16(1), 27–37.
12. Liao, H. F., Mao, P. J., & Hwang, A. W. (2001). Test-retest reliability of balance tests in children with cerebral palsy. Dev Med Child Neurol, 43(3), 180–186.
13. Mutlu, A., Livanelioglu, A., & Gunel, M. K. (2008). Reliability of Ashworth and Modified Ashworth Scales in Children with Spastic Cerebral Palsy. BMC Musculoskelet Disord, 9(1), 44.
14. Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol, 50(10), 744–750.
15. Pavão, S. L., Ledebt, A., Savelsbergh, G. J. P., & Rocha, N. A. C. F. (2017). Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS. Hum Mov Sci, 54, 137–143.
16. Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., Dan, B., & Jacobbson, B. (2007). A report: The definition and classification of cerebral palsy. Dev Med Child Neurol, 109, 8–14. Sajan, J. E., John, J. A., Grace, P., Sabu, S. S., & Tharion, G. (2017). Wii-based interactive video games as a supplement to conventional therapy for rehabilitation of children with cerebral palsy: A pilot, randomized controlled trial. Dev Neurorehabil, 20(6), 361–367.
17. Saxena, S., Rao, B. K., & Kumaran, S. (2014). Analysis of Postural Stability in Children With Cerebral Palsy and Children With Typical Development: An Observational Study. Pediatr Phys Ther, 26, 325–330.
18. Snider, L., Majnemer, A., & Darsaklis, V. (2010). Virtual reality as a therapeutic modality for children with cerbral palsy. Dev Neurorehabil, 13, 120–128.
19. Stackhouse, C., Shewokis, P. A., Pierce, S. R,, Smith, B., Mccarthy, J., & Tucker, C. (2007). Gait initiation in children with cerebral palsy. Gait & Posture, 26, 301–308.
20. Tarakci, D., Ozdincler, A. R,, Tarakci, E., Tutuncuoglu, F., & Ozmen, M. (2013). Wii-based Balance Therapy to Improve Balance Function of Children with Cerebral Palsy: A Pilot Study. J Phys Ther Sci, 25(9), 1123–1127.
21. Tarakci, D., Ersoz, H. B., Tarakci, E., & Razak, O. A. (2016). Effects of Nintendo Wii-Fit® video games on balance in children with mild cerebral palsy. Pediatr Int, 58(10), 1042–1050.
22. Winkels, D. G. M., Kottink, A. I. R., Temmink, R. A. J., Nijlant, J. M. M., & Buurke, J. H. (2013). Wii TM-habilitation of upper extremity function in children with Cerebral Palsy. An explorative study. Dev Neurorehabil, 16, 44–51. Woollacott, M., Physiology, H., & Msme, R. P. (2005). Effect of balance training on muscle activity used in recovery of stability in children with cerebral palsy: a pilot study. Dev Med Child Neurol, 47(7), 455-461.