Realidade virtual como ferramenta terapêutica na reabilitação vestibular em pacientes com ataxia espinocerebelar

Abstract

The spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases. They are characterized by the presence of progressive cerebellar ataxia, whose clinical manifestations deterioration of balance, coordination, and eye disorders. The SCAs are part of a group of diseases that have significant changes, involving all areas of health and, more specifically, a multidisciplinary approach in Otoneurology. Objective: To assess the benefits of vestibular rehabilitation with virtual reality in patients with neurodegenerative disease: spinocerebellar ataxia, through assessment tools Dizziness handcap Inventory (DHI), Berg Balance Scale (BBS), Quality of Life SF36 and Sitting Lift Test (SLT). Methods: A cross-sectional study was conducted. They evaluated 28 patients, 8 females and 20 males, aged between 15-70 years, mean age of 41.57 years and standard deviation of 16.98 years, directed the Department of Clinical Hospital Clinics for evaluation in Otoneurology Department of the University Tuiuti diagnosed with ACS, 13 dominant (2 SCA type 2 , 5 SCA type 3 , 1 SCA type 4 , 5 SCA type 10) , 8 SCA the recessive type (FA) and 7 SCA unspecified lying in genetic research. The diagnosis of ataxia was performed using genetic test using reaction technique on DNA Polymerase Chain enzyme (PCR, Polymerase Chain Reaction). Patients underwent the following procedures: anamnesis, ENT examination and college entrance examination, application of the Berg Balance Scale (BBS), Dizziness Handicap Inventory (DHI), SF -36, Sitting Lift Test (SLT) and Vestibular Rehabilitation with Virtual reality. Results: The most frequent complaints in anamnesis were: the imbalance (85.71%), dysarthria (35.71%) and diplopia, dizziness and dysphonia (10.71%). Regarding the games in the 1st assessment, Tightrope and Ski Slalom had positive significance for BBS and SF36 CF, in the 2nd assessment Table Tilt to SF36 CF and Tightrope for BBS and SF36 CF and 3rd assessment every game showed significant correlation with these instruments. The SLT compared between pre and post evaluation of training with game RVI presented a significant positive data. The comparison between the 1st and the 20th session was a positive for all games. Conclusion: each session patients exceeded barriers and limits imposed by the SCA, rehabilitation performed was conducted in a positive manner, including improved balance and QOL. Rehabilitation through RVI is a daily conquest, requiring continued to thus provide improved motor coordination, and performance of their ADLs, allowing independence and quality of life for patients as suffered by this progressive neurodegenerative disease.