Objective: To compare the effect of motor training based on two distinct game’s combination on FOG in PPD.

Background: Freezing of gait (FOG) is a disabling phenomenon in Parkinson’s disease (PD) and related disorders. Video games have been used as a rehabilitation tool in people with PD (PPD). Although, crucial points, as the influence of the game’s selection on therapeutic results, remains without responses. Considering that therapeutic results depend on the training demands and FOG has been associated with gait and/or balance disturbances, it´s plausible to suppose distinct game’s combination focused on this abilities can interfere in the improve of FOG severity.

Method: A double-blind randomized clinical trial was conducted in 64 PPD, mean age of 63,78; on stages 1,5 according to Hoehn and Yahr Classification, following adequate inclusion criteria. PPD were blinded and randomly allocated in: Dynamic Walk Group (DWG) or Dynamic Balance group(DBG). Using the X-Box Kinect system®, the DWG performed 4 games with greater demand for gait while DBG performed 4 games with greater demand for balance. All participants performed 8 individual session (twice a week) under supervision of a physiotherapist. As primary outcomes, it were adopted the freezing severity using the FOG Questionnarie (FOG-Q) and gait stability in complex environment using the Balance Evaluation Systems Test (BESTest). As secondary outcome, it was considered the gait in long distance measure using the Six-minute Walk Test (6MWT). All outcomes were applied at baseline (BT), 1-week (FU7d) and 2-month follow-up (FU60d) by a blinded examiner.

Results: The general model for repeated measure ANOVA showed a significant effect of assessment points on FOG-Q scores (F=21,927;p=0,000;ES=0,999), BESTest-Section 6 scores  (F=9,154;p=0,000;ES=0,972) and walked distance in 6MWT (F=16,613;p=0,000;ES=0,999) at FU7d in both groups. The Tukey post-hoc test confirmed that was a significant improvement for all measures at FU7d that was remained at FU60d.

Conclusion: Training based on videogames focusing on gait or balance are able to improve the FOG severity perception and the gait performance under complex conditions and long distance in people with PD. Considering the negative impact of FOG on the functionality and the low cost of this approach, it should be considered as a therapeutic option for FOG treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-training-based-on-video-games-reduces-freezing-of-gait-regardless-of-games-combination-a-parallel-prospective-double-blind-randomized-clinical-trial/