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Previous issue date: 2015-12-21 / O AVC ? a principal causa de incapacidade a longo prazo entre os adultos e a aprendizagem motora ? primordial na reabilita??o das sequelas motoras. O objetivo do estudo foi avaliar a atividade eletroencefalogr?fica de pacientes com AVC na aprendizagem motora de um jogo baseado em realidade virtual. Participaram do estudo 10 pacientes com AVC cr?nico, destros, idade m?dia de 50,4 anos (? 8,12) sendo 5 com les?o cerebral esquerda (PE) e 5 com les?o ? direita (PD). Os participantes foram avaliados quanto ? atividade eletroencefalogr?fica (EEG) e ao desempenho na realiza??o de 15 repeti??es do jogo de dardos no XBOX Kinect e tamb?m por meio do NIHSS, MEEM, Fugl-Meyer e da escala de Ashworth modificada. Os pacientes foram submetidos a 12 sess?es de treino (fase de aquisi??o) em 4 semanas, cada qual com 45 repeti??es do jogo de dardos virtual. Ap?s o treino, os pacientes foram submetidos ? reavalia??o da atividade do EEG e do desempenho no jogo de dardos virtual (fase de reten??o). Foi utilizada a ANOVA de medidas repetidas para compara??o entre os grupos. De acordo com os resultados, houve diferen?a entre os grupos quanto ?s bandas de frequ?ncia ?Low Alfa? (p=0,0001), ?High Alfa? (p=0,0001) e Beta (p=0,0001). Verificou-se um aumento das pot?ncias de ativa??o de Alfa e diminui??o de Beta do grupo PD na fase de reten??o. No grupo PE, foi observado o aumento da pot?ncia de ativa??o de Alfa, por?m sem diminui??o da ativa??o de Beta. O grupo PD aumentou a ativa??o cerebral no hemisf?rio esquerdo com a pr?tica nas ?reas frontais. No entanto, o grupo PE apresentou maior ativa??o do hemisf?rio direito nas ?reas fronto-central, temporal e parietal. Quanto ao desempenho, foi observada uma diminui??o do erro absoluto no jogo para o grupo PD entre a fase de aquisi??o e reten??o (p=0,0001), por?m essa diferen?a n?o foi observada para o grupo PE (p=0,111). Conclui-se ent?o que os pacientes com les?o cerebral direita se beneficiaram mais do treino em ambientes virtuais no que diz respeito ao processo de aprendizagem motora, diminuindo o esfor?o neural e os erros com a pr?tica de uma tarefa. Em contrapartida, pacientes com les?o no hemisf?rio esquerdo parecem utilizar um maior esfor?o neural e ativa??o de ?reas contralesionais, sem melhoras do desempenho com a pr?tica de 12 sess?es. / Stroke is the leading cause of long-term disability among adults and motor relearning is essential in motor sequelae recovery. Therefore, various techniques have been proposed to achieve this end, among them Virtual Reality. The aim of the study was to evaluate electroencephalographic activity of stroke patients in motor learning of a virtual reality-based game. The study included 10 patients with chronic stroke, right-hande; 5 with left brain injury (LP), mean age 48.8 years (? 4.76) and 5 with injury to the right (RP), mean age 52 years (? 10.93). Participants were evaluated for electroencephalographic (EEG) activity and performance while performing 15 repetitions of darts game in XBOX Kinect and also through the NIHSS, MMSE, Fugl-Meyer and the modified Ashworth scale. Patients underwent a trainning with 45 repetitions of virtual darts game, 12 sessions in four weeks. After training, patients underwent reassessment of EEG activity and performance in virtual game of darts (retention). Data were analyzed using ANOVA for repeated measures. According to the results, there were differences between the groups (PD and PE) in frequencies Low Alpha (p = 0.0001), High Alpha (p = 0.0001) and Beta (p = 0.0001). There was an increase in alpha activation powers and a decrease in beta in the phase retention of RP group. In LP group was observed increased alpha activation potency, but without decrease in beta activation. Considering the asymmetry score, RP group increased brain activation in the left hemisphere with the practice in the frontal areas, however, LP group had increased activation of the right hemisphere in fronto-central areas, temporal and parietal. As for performance, it was observed a decrease in absolute error in the game for RP group between assessment and retention (p = 0.015), but this difference was not observed for LP group (p = 0.135). It follows then that the right brain injury patients benefited more from darts game training in the virtual environment with respect to the motor learning process, reducing neural effort in ipsilesionais areas and errors with the practice of the task. In contrast, patients with lesions in left hemisphere decrease neural effort in contralesionais areas important for motor learning and showed no performance improvements with practice of 12 sessions of virtual dart game. Thus, the RV can be used in rehabilitation of stroke patients upper limb, but the laterality of the injury should be considered in programming the motor learning protocol.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20760 |
| Date | 21 December 2015 |
| Creators | Fernandes, Aline Braga Galv?o Silveira |
| Contributors | 60336641400, http://lattes.cnpq.br/7200517552154428, Souza, Dami?o Ernane de, 79881122449, http://lattes.cnpq.br/1932273466740095, Cavalcanti, Fabricia Azevedo da Costa, 00847101444, Melo, J?lio C?sar Paulino de, 06138871405, http://lattes.cnpq.br/2930421117873633, Rocha, Kliger Kissinger Fernandes, 79204724404, http://lattes.cnpq.br/1552785998852736, Campos, T?nia Fernandes |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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