A avaliação da qualidade de vida com o uso da realidade virtual em pacientes com ataxia espinocerebelar

Abstract

Introduction: Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases, featuring the presence of progressive cerebellar ataxia, whose early clinical symptoms are balance and motor coordination decline and ocular disorders. Objective: To evaluate the living standard of patients with SCAs, by applying the Vestibular Disorders Activities of Daily Living Scale (VADL) and Activities-specific Balance Confidence Scale (ABC) questionnaires, before and after rehabilitation with virtual reality (ViR). Method: A prospective cohort study was conducted with 28 patients suffering from SCA, eight females and twenty males, ages ranging from 15 to 70 years (mean of 41.6 years, ± 16.9 years). The patients underwent anamnesis, otolaryngologic examination, vestibular screening, and the application of protocols from the VADL, as well as the ABC questionnaires, applied before and after rehabilitation with ViR. Result: The most reported otoneurological complaints in the anamnesis were: imbalance (85.7%), fall (28.5%), dizziness (17.8%), diplopia (10.7%), and tremor (7.1%); vestibular screening evidenced disorders in 18 cases (64.3%), with the prevalence of peripheral vestibulopathy in 10 cases (35.7%); The comparison results between the evaluation time (T1, T2 and T3) and the dimensions (functional, locomotion and instrumental) from the VADL questionnaire did not show significant differences (p > 0.05); The results from the ABC questionnaire revealed that there was not significant differences (p > 0.05) when compared with the evaluation time (T1, T2 and T3); The result between the correlation of the VADL and ABC questionnaires showed significant results in all cases (p < 0.05). The correlation between the ages and disease length with the VADL and ABC questionnaires was significant between the age and the instrumental dimension of the VADL questionnaire, in the 3 rd assessment (p < 0.05). The correlation between the disease length and the VADL questionnaire was significant in all cases (p < 0.05); The comparison of the vestibular rehabilitation result (1 st to 10 th session) showed significant difference for all of the applied games, except for the ski slalom. The comparison of the vestibular rehabilitation result (1 st to 20 th session) showed significant difference for all of the applied games (p < 0.05) Conclusion: We can point out a direct improvement of the living standard, reflected by the reduction of falls, better balance and march, contributing to a higher self-confidence in patients in daily activities. We also point out the importance of ViR rehabilitation as the symptomatology in this kind of population improved.