Comparación de la efectividad de la terapia con realidad virtual y terapia convencional sobre la marcha en pacientes con Enfermedad de Parkinson : una revisión sistemática
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Fecha
2023
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es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
Introducción: Los trastornos neurológicos son la principal causa de discapacidad y la segunda causa
de muerte en todo el mundo. La enfermedad de Parkinson (EP) es la segunda enfermedad
neurodegenerativa más común. La EP se considera como un trastorno neurodegenerativo
lentamente progresivo, que implica la muerte temprana prominente de las neuronas
dopaminérgicas en la sustancia negra. Se ha evidenciado que a medida que avanza la EP, la marcha
y el equilibrio se ven afectados de forma más grave. En este contexto, en los últimos años, se ha
incorporado la realidad virtual (RV), ofreciendo nuevas alternativas para la rehabilitación de los
pacientes con EP.
Objetivo: Comparar la efectividad de la terapia con realidad virtual y la terapia convencional en la
mejora de la marcha en pacientes con EP.
Metodología: Se realizó una revisión sistemática de ensayos clínicos aleatorizados. Las bases de
datos consultadas fueron PubMed, Scopus, WoS, Medline y Science Direct. La estrategia de
búsqueda utilizó la metodología PICO. Se evaluó la calidad de la evidencia a través de la escala de
PEDro y se utilizó el diagrama de flujo de PRISMA para la selección de los artículos.
Resultados: En nuestro análisis se incluyeron un total de 8 artículos que cumplieron con los
criterios de elegibilidad establecidos, con 324 participantes con EP. Estos estudios presentaron una
calidad de la evidencia de moderada a alta, según la escala de PEDro. Respecto al entrenamiento
de rehabilitación con RV se desempeñó mejor que el entrenamiento de rehabilitación convencional
o tradicional en todas las variables evaluadas: Velocidad (RV 10.75 cm/s GC 5.72 cm/s), DGI (RV
3.7 pts., GC 2.6 pts.), Cadencia (RV 3.56 pasos/minuto, GC 2.72 pasos/minuto), FGA (RV 6.5 pts.,
GC 2.2 pts.), Longitud de zancada (RV 8.3 cm, GC 4.7 cm).
Conclusiones: Los estudios analizados en esta revisión sistemática sugieren que la terapia basada
en RV es un medio de rehabilitación más eficaz para las variables de la marcha analizadas en
pacientes con EP en comparación a la TC. Sin embargo, se requieren una mayor cantidad de
estudios, que posean diseños metodológicos rigurosos y de alta calidad, utilizando muestras de
mayor tamaño para confirmar y ampliar estos hallazgos.
Introduction: Neurological disorders are the main cause of disability and the second cause of death worldwide. Parkinson's disease (PD) is the second most common neurodegenerative disease. PD is considered to be a slowly progressive neurodegenerative disorder, involving prominent early death of dopaminergic neurons in the substantia nigra. It has been shown that as PD progresses, gait and balance are affected more severely. In this context, in recent years, virtual reality (VR) has been incorporated, offering new alternatives for the rehabilitation of patients with PD. Objective: To compare the effectiveness of virtual reality therapy and conventional therapy in improving gait in patients with PD. Methodology: A systematic review of randomized clinical trials was performed. The databases consulted were PubMed, Scopus, WoS, Medline, and Science Direct. The search strategy used the PICO methodology. The quality of the evidence was evaluated through the PEDro scale and the PRISMA flowchart was used to select the articles. Results: A total of 8 articles that met the established eligibility criteria were included in our analysis, with 324 participants with PD. These studies had a moderate to high quality of evidence, according to the PEDro scale. Regarding rehabilitation training with VR, it performed better than conventional or traditional rehabilitation training in all the variables evaluated: Speed (VR 10.75 cm/s GC 5.72 cm/s), DGI (VR 3.7 pts., GC 2.6 pts.), Cadence (RV 3.56 steps/minute, GC 2.72 steps/minute), FGA (RV 6.5 pts., GC 2.2 pts.), Stride length (RV 8.3 cm, GC 4.7 cm). Conclusions: The studies analyzed in this systematic review suggest that VR-based therapy is a more effective means of rehabilitation for the gait variables analyzed in patients with PD compared to CT. However, a larger number of studies are required, with rigorous and high-quality methodological designs, using larger sample sizes to confirm and expand these findings.
Introduction: Neurological disorders are the main cause of disability and the second cause of death worldwide. Parkinson's disease (PD) is the second most common neurodegenerative disease. PD is considered to be a slowly progressive neurodegenerative disorder, involving prominent early death of dopaminergic neurons in the substantia nigra. It has been shown that as PD progresses, gait and balance are affected more severely. In this context, in recent years, virtual reality (VR) has been incorporated, offering new alternatives for the rehabilitation of patients with PD. Objective: To compare the effectiveness of virtual reality therapy and conventional therapy in improving gait in patients with PD. Methodology: A systematic review of randomized clinical trials was performed. The databases consulted were PubMed, Scopus, WoS, Medline, and Science Direct. The search strategy used the PICO methodology. The quality of the evidence was evaluated through the PEDro scale and the PRISMA flowchart was used to select the articles. Results: A total of 8 articles that met the established eligibility criteria were included in our analysis, with 324 participants with PD. These studies had a moderate to high quality of evidence, according to the PEDro scale. Regarding rehabilitation training with VR, it performed better than conventional or traditional rehabilitation training in all the variables evaluated: Speed (VR 10.75 cm/s GC 5.72 cm/s), DGI (VR 3.7 pts., GC 2.6 pts.), Cadence (RV 3.56 steps/minute, GC 2.72 steps/minute), FGA (RV 6.5 pts., GC 2.2 pts.), Stride length (RV 8.3 cm, GC 4.7 cm). Conclusions: The studies analyzed in this systematic review suggest that VR-based therapy is a more effective means of rehabilitation for the gait variables analyzed in patients with PD compared to CT. However, a larger number of studies are required, with rigorous and high-quality methodological designs, using larger sample sizes to confirm and expand these findings.
Notas
Actividad Final de Graduación (Magíster en Neurorrehabilitación)