Análise cinemática de pacientes com acidente vascular cerebral durante jogo de dardos em ambientes virtual e real

Abstract

Introduction: Stroke is the leading cause of long-term disability worldwide resulting in sensorimotor impairments that compromise functionality of individuals in Activities of daily living (ADLs). Thus, virtual reality technologies have been used increasingly aimed at motor rehabilitation. However, there is little evidence that the movements performed in virtual environments are similar to those made in physical environments. Objective: Analyze kinematics components of the upper limb in stroke patients during a game of darts in virtual and real environment. Methodology: The quasi-experimental study with a sample of 11 chronic hemiparesis, aged 40-65 years, time injury of six months to three years. The virtual environment was presented at the XBOX 360 Kinect® and the real environment used a professional dart game. Participants performed 15 trials of each game and the kinematics of the upper limb was recorded on video for analysis in Kinovea Software. The environments were compared using the t-Student test. Results: There were significant differences between the virtual and real environments. The real game showed higher elbow extension angle (p = 0.008), greater shoulder flexion (p = 0.008) and a higher mean speed of the shoulder (p = 0.001), elbow (p = 0.0001) and wrist (p = 0.001) path. As to velocity and acceleration peaks, maximum values were found in the real game shoulder (p = 0.04), elbow (p = 0.002) and wrist (p = 0.002) velocity, and elbow (p = 0.004) and wrist (p = 0.028) acceleration. The flexion and extension speeds were higher in the real game shoulder (p = 0.021), elbow (p = 0.004; p = 0.005) and wrist (p = 0.009; p = 0.039). The virtual game got longer flexion (p = 0.0001) and extension (p = 0.021) and a higher performance (p <0.0001). Conclusions: The dart game can be used in rehabilitation of the upper limb after stroke according to the goals that the therapy wants to achieve. If it is to increase the range of motion, speed and acceleration, the actual dart game is more indicated. The virtual game can contribute to the accuracy of movement, control of degrees of freedom and postural adjustments, because it requires less time to perform the movement.