İNME HASTALARINDA NİNTENDO Wİİ OYUNLARININ DENGE VE ÜST EKSTREMİTE FONKSİYONLARINA ETKİSİ

Year 2016, Volume: 27 Issue: 2, 61 - 71, 15.08.2016

Kübra Çekok Tülay Tarsuslu Şimşek

https://doi.org/10.21653/tfrd.272981

Cited By: 2

Abstract

Amaç: Bu çalışmanın amacı, inme hastalarında Nintendo Wii (N-Wii) oyunlarının denge, üst
ekstremite fonksiyonu ve süreli performans üzerine etkisini incelemektir.

Yöntemler: Çalışma, yaşları 18-85 yıl arasında değişen 42 inmeli hasta ile gerçekleştirildi.
Çalışmaya dahil edilen hastalar N-Wii grubu (n=20) ve Bobath Nörogelişimsel tedavi
(NDT-n=22) grubu olmak üzere 2 gruba ayrıldı. Hastaların üst ekstremite fonksiyon
değerlendirmesinde Fugl-Meyer Motor Fonksiyon Testi ve Kol, Omuz ve El Sorunları Anketi
(DASH), postural düzgünlük ve fonksiyonel denge değerlendirmesinde Postural değerlendirme
Ölçeği (PASS), Fonksiyonel Uzanma Testi (FUT), Süreli Kalk Yürü Testi (TUG) kullanıldı. İlk
değerlendirmeleri yapılan hastalara 10 hafta boyunca düzenlenen tedavi programları
uygulandı. N-Wii grubundaki hastalara, N-Wii oyunlarıyla 10 hafta, haftada 5 gün, 1 saatlik
oyun sistemleri ile eğitim verildi. Bobath NDT grubundaki hastalar içinde terapist eşliğinde
10 hafta, haftada 3 gün, 1 saat süren hastanın fonksiyonel ihtiyaçlarına göre düzenlenmiş
egzersiz programı uygulandı.

Sonuçlar: Çalışmanın sonunda, her iki gruptaki hastaların Fugl-Meyer, DASH, PASS, FUT,
TUG testlerinde anlamlı gelişmeler kaydedildi (p<0.05). DASH, PASS, FUT parametrelerinde
N-Wii grubunda Bobath NDT grubuna göre daha anlamlı bir iyileşme kaydedildi (p<0.05).
Fugl-Meyer, TUG değerlendirme parametrelerinde gruplar arasında anlamlı bir farklılık
bulunmadı ( p>0.05).

Tartışma: N-Wii uygulamalarının Bobath NDT yaklaşımlarına göre inmeli hastalarda
kol aktiviteleri ve ağırlık aktarma, uzanma, yer değiştirme becerisini daha fazla arttırdığı
gözlenmiştir. 

Keywords

Video oyunları, sanal gerçeklik, inme, denge, nörogelişimsel tedavi

THE EFFECT OF NINTENDO WII GAMES ON BALANCE AND UPPER EXTREMITY FUNCTIONS IN PATIENTS WITH STROKE

Abstract

Purpose: The aim of this study was to investigate of the effects of Nintendo Wii (N-Wii)
games on balance and upper extremity functions in patients with stroke.

Methods: The study was performed with 42 stroke patients age between 18-85 years. The
patients were divided to two groups: N-Wii group (n=20) and Bobath Neurodevelopmental
treatment (NDT) group (n=22). Fugl-Meyer Motor Function Test and The Disabilities of the
Arm, Shoulder, Hand Questionnaire (DASH) were used to evaluate the upper extremity fun-
ctions and Postural Assessment Stroke Scale (PASS), Functional Reach Test (FRT) and Time
up and go test (TUG) were used to evaluate functional balance and postural alignment. After
the first evaluation, the treatment program was applied to the patients for 10 weeks. N-Wii
games were applied for the patients in N-Wii group for 10 weeks/5 days/1 hour. Functional
exercises were applied for the Bobath NDT group for 10 weeks/5 days/1 hour.

Results: A statistically significant improvements were detected in Fugl-Meyer, DASH, PASS,
FUT, TUG tests in both groups (p<0.05). Improvement in DASH, PASS and FUT tests score
were superios in N-Wii group when compared to NDT group (p<0.05). Fugl-Meyer and TUG
were not different between the groups (p>0.05).

Conclusion: Present results demonstrated that N-Wii games have increased arm activities,
weight bearing, reach, moving ability more than Bobath NDT approaches in stroke patients. 

Keywords

Video-games, virtual reality, stroke, balance, eurodevelopmental treatment

References

• 1. World Health Organisation. Cerebrovascular disorders: a clinical and research classification. Geneva, Switzerland: WHO; 1978. Offset publication No. 43.
• 2- Yui J, Miller WC, Eng JJ, Liu Y. Longitudinal analysis of balance confidence in individuals with stroke using a multilevel model for change. Neurorehabil Neural Repair. 2012; 26(8):999-1006.
• 3. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elder- ly population. Arch Phys Med Rehabil. 1992;73(11):1073-80.
• 4. Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66.
• 5. Gowland C, Torresin W, VanHullenaar S, Best L. Therapeutic exercise for stroke patients. In: Basmajian JV, Wolf SL, editors. Therapeutic Exercise. Baltimore, Williams & Wilkins Co, 1990; p. 207-29.
• 6. Everink IH, van Haastregt JC, van Hoof SJ, Schols JM, Kempen GI. Factors influencing home discharge after inpatient reha- bilitation of older patients: a systematic review. BMC Geriatr. 2016;16(1):5.
• 7. Graham J, V Eustace, C Brock K, Swain E. ve Irwin-Carruthers. The Bobath concept in contemporary clinical practice. Topic Stroke Rehab. 2009;16(1):57-68.
• 8. Rose F, Attree E, Johnson D: Virtual reality: an assistive te- chnology in neurological rehabilitation. Curr Opin Neurol. 1996;9(6):461-7.
• 9. Merians AS, Jack D, Boian R, Tremaine M, Burdea GC, Adamovich SV, et al. Virtual reality–augmented rehabilitation for patients following stroke. Phys Ther. 2002;82(9):898-915.
• 10. Saposnik G, Mamdani M, Bayley M, Thrope KE, Hall Cohen LG, Teasell R. Effectiveness of virtual reality using wii gaming technology in stroke rehabilitation. Stroke. 2010;41(7):1477-84.
• 11. Piron L, Turolla A, Agostini M, Zucconi C, Cortese F, Zampolini M, et al. Exercises for paretic upper limb after stroke: a combined virtual-reality and telemedicine approach. Rehabil Med. 2009;41(12):1016-20.
• 12. Liuzzo DM, Peters DM, Middleton A, Lanier W, Chain R, Barksdale B, et al. Measurements of weight bearing asymmetry using the nintendo wii fit balance board are not reliable for older adults and individuals with stroke. J Geriatr Phys Ther. 2015:18.
• 13. Lee HY, Kim YL, Lee SM. Effects of virtual reality-based training and task-oriented training on balance performance in stroke pa- tients. J Phys Ther Sci. 2015;27(6):1883-8.
• 14. Shih CH, Shih CT, Lin KT. Chiang, M. Assisting people with multiple disabilities and minimal motor behavior to control environmental stimulation through a mouse wheel. Res Dev Disabil. 2009;(30(6):1413–19.
• 15. Shih, CH. Shih CT. A new movement detector to enable people with multiple disabilities to control environmental stimulation with hand swing through a commercial mouse. Res Dev Disabil. 2009;(30(6):1196–1202.
• 16. Shih CH, Shih CT, Chiang, MS. A new standing posture detector to enable people with multiple disabilities to control environmental stimulation by changing their standing posture through a commercial Wii Balance Board. Res Dev Disabil. 2010; 31(1):281–86.
• 17. Shih CH. A standing location detector enabling people with developmental disabilities to control environmental stimulation through simple physical activities with Nintendo Wii Balance Boards. Res Dev Disabil. 2011;32(2):699–704.
• 18. Shih CH, Shih CT, Chu CL. Assisting people with multiple disabilities actively correct abnormal standing posture with a Nintendo Wii Balance Board through controlling environmental stimulation. Res Dev Disabil. 2010; 31(4):936–42.
• 19. Tsekleves E, Paraskevopoulos IT, Warland A, Kilbride C. Develop- ment and preliminary evaluation of a novel low cost VR-based upper limbstroke rehabilitation platform using Wii technology. Disabil Rehabil Assist Technol. 2016;11(5):1-10.
• 20. Todorov E, Shadmer R, Bizzi, E. Augmented feedback presented in a virtual environment accelerates learning of a difficult motor task. J Motor Behav. 1997; 29(2):147–58.
• 21. Rose FD, Attree EA, Brooks BM, Parslow DM, Penn PR, Ambihaipahan N. Training in virtual environments: transfer to real world tasks and equivalenceto real task training. Ergonomics. 2000;43(4):494–511.
• 22. Oujamaa L, Relave I, Froger J, Mottet D, Pelissier JY. Rehabilitation of arm function after stroke Literature review.Ann Phys Rehabil Med. 2009;52(3):269-93.
• 23. Fugl Meyer AR, Jaasko L, Leyman I. The post stroke hemiplegic patient. Scand J Rehabil Med. 1975;7(1):13-31.
• 24. Düger T, Yakut E, Öksüz Ç, Yörükan S, Bilgütay BS, Ayhan Ç, ve ark. Kol, Omuz, El Sorunları (Disabilities of the Arm, Shoulder and Hand-DASH) Anketi Türkçe uyarlamasının güvenirliği ve geçerli- ği. Fizyoter Rehabil. 2006;17(3):99- 107.
• 25. Benaim C, Pérennou DA, Villy J, Rousseaux M, Pelissier JY. Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999;30(9):1862–68.
• 26. Hill KD, Bernhardt J, McGann AM. A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiother Can. 1996; 48(4):257-62.
• 27. Hui Chan . Time up go test it’s reality and assosication with lower limb impairments and locamotor capabilities in people with chronic stroke. Arc Phsy Med Reh. 2005;86(8):1647-77.
• 28. Peters DM, McPherson AK, Fletcher B, McClenaghan BA, Fritz SL. Counting repetitions: an observational study of video game play in people with chronic poststroke hemiparesis. J Neurol Phys Ther. 2013;37(3):105-11.
• 29. Bower KJ, Clark RA, McGinley JL, Martin CL, Miller KJ. Clinical feasibility of the Nintendo WiiTM for balance training post-stroke: a phase II randomized controlled trial in an inpatient setting. Clin Rehabil. 2014;28(9):912-23.
• 30. Deutsch JE, Morrison RJ, Bowlby PG. Wii-based compared to standart of care balance and mobility rehabilitation for two individuals post-stroke. IEEE. 2009;117-20.
• Cho K, Lee K,Shoug C. Virtual realtiy balance training with a video gaming system improves dynamic balance in chronic stroke patient. Thoku J Exp Med. 2012;228(1):69-74.
• 32. Bower K, Clark R, McGinley J, Martin C, Miller K. Clinical feasibility of the Nintendo WiiTM for balance training post-stroke: a phase II randomized controlled trial in an inpatient setting. Clin Rehabil. 2014; 28(9):912 –92.
• 33. Sheffler LR, Knutson JS, Gunzler D. Relationship between body mass index and rehabilitation outcomes in chronic stroke. Am J Phys Med Rehabil. 2012;91(11):951-56.
• 34. Hortobagyi T, del Olmo, MF, Rothwell JC. Age reduces cortical reciprocal inhibition in humans. Exp Brain Res. 2006;171(3):322– 29.
• 35. Teasell R, Foley N, Salter K, Bhogal S, Jutai J, Speechley M. Evidence-based review of stroke rehabilitation: executive summary, 12th edition. Top Stroke Rehabil 2009;16(6):463-88.
• 36. Saposnik G, Teasell R, Mamdani M, Hall J, McIlroy W, Cheung D, et al. Effectiveness of virtual reality using wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle. Stroke. 2010;41(7):1477- 84.
• 37. Chai J, Han E, Ryun B, Kim S. Effectiveness of commercial gaming-based virtual reality movement therapy on functional recovery of upper extremity in subacute stroke patients. Ann Rehabil Med. 2014;38(4):485-93.