مقاله انگلیسی رایگان در مورد بهبود ظرفیت راه رفتن در بزرگسالان – الزویر 2020

BACKGROUND: The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. OBJECTIVE: To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIAL AND METHODS: The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. RESULTS: We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95% CI: -0.90, -0.21; p=0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95%: -1.70, -0.35; P=0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. CONCLUSIONS: Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.

Introduction

Impaired functional mobility of older adults is frequently associated with loss of independence. Maintaining functional independence must be a priority in elderly care plans. Achieving autonomous participation in their own real everyday environment would contribute to improving their community involvement and as well as their overall health. The rehabilitation programs that include the practice of real activities show more effectiveness [1,2]. The use of exergames has the potential to offer treatment settings very similar to actual environments and tasks, offering the possibility of playing by practicing physical exercise in immersive and attractive environments because of its similarity to reality[3] . The involvement of the player, far from being sedentary (as in traditional video games) requires active exercises that mobilize the different parts of the body. Interactive simulations containing exergames such as Wii Fit® (Nintendo), Kinect Sports® (Xbox) or Play Sport Eye Toy® (Play Station) recreate everyday virtual environments that allow repeated physical exercise directly related to the movements needed in activities of daily living.