Abstract
Objective: To evaluate the usability and feasibility of four Immersive Virtual Reality (IVR) games as a possible treatment for upper limb dysfunction in patients with Parkinson's Disease (PD). Methods: Ten patients with moderate PD symptoms according to the Hoehn e Yahr classification took part in this study. The usability of the games and the device was assessed using questionnaires such as the Sickness Simulator Questionnaire (SSQ), the System Usability Scale (SUS), the Game Experience Questionnaire (GEQ post-module) and the modified Borg scale. Game scores in two training sessions, separated by a 30-minute interval, were recorded as a measure of training feasibility. Results: The usability of the system was considered "best imaginable" (94.5/100) according to the SUS. Side effects were classified as "minimal symptoms" (9.3 points on the SSQ) and did not interrupt training. The games and the device achieved 3.85/4 points on the GEQ. Participants improved significantly in all four games between the first and second training sessions. Conclusion: Game scores increased progressively. The results suggest the usability and feasibility of IVR games, but more extensive studies are needed to confirm these preliminary results.
References
AMIRTHALINGAM J, et al. Virtual Reality Intervention to Help Improve Motor Function in Patients Undergoing Rehabilitation for Cerebral Palsy, Parkinson’s Disease, or Stroke: A Systematic Review of Randomized Controlled Trials. Cureus, 2021.
ARMSTRONG MJ e OKUN MS. Diagnosis and Treatment of Parkinson Disease. JAMA, 2020; 323: 548–60.
BALESTRINO R e SCHAPIRA AHV. Parkinson disease. European Journal of Neurology, 2019; 27: 27–42.
BANGOR A, et al.User Experience Magazine. Determining What Individual SUS Scores Mean: Adding an Adjective Rating ScaleJUS. Uxpajournalorg, 2020.
BIMBERG P, et al. On the Usage of the Simulator Sickness Questionnaire for Virtual Reality Research. 2020 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW), 2020.
CALABRESI P, et al. Dopamine-mediated regulation of corticostriatal synaptic plasticity. Trends in Neurosciences, 2007; 30: 211–9.
CAMPO-PRIETO P, et al. Wearable Immersive Virtual Reality Device for Promoting Physical Activity in Parkinson’s Disease Patients. Sensors, 2022; 22: 3302.
CARNEVALE A, et al. Virtual Reality for Shoulder Rehabilitation: Accuracy Evaluation of Oculus Quest 2. Sensors, 2022; 22: 5511.
CARVALHO MR de, et al. Simulator Sickness Questionnaire: tradução e adaptação transcultural. Jornal Brasileiro de Psiquiatria, 2011; 60: 247–52.
CHEN Z, et al. Autonomic dysfunction in Parkinson’s disease: Implications for pathophysiology, diagnosis, and treatment. Neurobiology of Disease, 2020; 134: 104700.
DORSEY ER e Bloem BR. The Parkinson Pandemic—A Call to Action. JAMA Neurology, 2018; 75: 9.
Goodwin VA, et al. The effectiveness of exercise interventions for people with Parkinson’s disease: A systematic review and meta-analysis. Movement Disorders, 2008; 23: 631–40.
HUANG K-T. Exergaming Executive Functions: An Immersive Virtual Reality-Based Cognitive Training for Adults Aged 50 and Older. Cyberpsychology, Behavior, and Social Networking, 2019.
IJSSELSTEIJN WA, et al. The Game Experience Questionnaire. Researchtuenl 2013. Disponível em: https //research.tue.nl/en/publications/the-game-experience-questionnaire. Acessado em: 09 de agosto de 2024.
KIM A, et al. Walking in fully immersive virtual environments: an evaluation of potential adverse effects in older adults and individuals with Parkinson’s disease. Journal of NeuroEngineering and Rehabilitation . 2017; 14.
LIANG Y e LAU PWC. Effects of Active Videogames on Physical Activity and Related Outcomes Among Healthy Children: A Systematic Review. Games for Health Journal, 2014; 3: 122–44.
LOURENÇO DF, et al. Translation and Cross-Cultural Adaptation of the System Usability Scale to Brazilian Portuguese. Aquichan, 2022; 22: 1–16.
MA M e ZHENG H. Virtual Reality and Serious Games in Healthcare. Advanced Computational Intelligence Paradigms in Healthcare 6 Virtual Reality in Psychotherapy, Rehabilitation, and Assessment, 2011; 169–92.
MENDES FA Dos S, et al. Motor learning, retention and transfer after virtual-reality-based training in Parkinson’s disease – effect of motor and cognitive demands of games: a longitudinal, controlled clinical study. Physiotherapy, 2012; 98: 217–23.
PENKO AL, et al. Borg scale is valid for ratings of perceived exertion for individuals with Parkinson’s disease. International Journal of Exercise Science, 2017; 10: 76–86.
RADDER DLM, et al. Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities. Neurorehabilitation and Neural Repair, 2020; 34: 154596832095279.
SARIC L, et al. Usability of Two New Interactive Game Sensor-Based Hand Training Devices in Parkinson’s Disease. Sensors 2022; 22:6278.
TRIEGAARDT J, et al. Correction to: The role of virtual reality on outcomes in rehabilitation of Parkinson’s disease: meta-analysis and systematic review in 1031 participants. Neurological Sciences 2020; 41:731–2.
