Article

Parkinson's disease (PD) is treated by medication, less with deep brain
stimulation and physiotherapy. Different opinions on the clinical meaningfulness
of the physiotherapy or recommended intensive physiotherapy were found. Our
objectives were to design intensive target-based physiotherapy for upper
extremities suitable for telerehabilitation services and examine the clinical
meaningfulness of the exergaming at an unchanged medication plan. A
telerehabilitation exergaming system using the Kinect sensor was developed; 28
patients with PD participated in the study. The system followed the participants'
movements and adapted the difficulty level of the game in real time. The outcomes
of the study showed that seven out of 26 participants could set up the equipment
at home alone. Clinical outcomes of Box and Blocks Test (mean: 47 vs. 52,
P=0.002, Cohen's d=0.40), UPDRS III (mean: 27 vs. 29, P=0.001, d=0.22), and daily
activity Jebsen's test; writing a letter (mean: 24.0 vs. 20.6, P=0.003, d=0.23);
and moving light objects (mean: 4.4 vs. 3.9, P=0.006, d=0.46) were statistically
significant (P<0.05) and considered clinically meaningful. The Nine-Hole Peg Test
showed a statistically nonsignificant improvement (mean: 28.0 vs. 26.5, P=0.089,
d=0.22). The participants claimed problems with mobility but less with activities
of daily living and emotional well-being (PDQ-39). The findings lead to
preliminary conclusions that exergaming is feasible, but may require technical
assistance, whereas clinically meaningful results could be achieved according to
validated instruments and an unchanged medication plan in individuals with PD.

Langue : ANGLAIS