An?lise cinem?tica de pacientes com acidente vascular cerebral durante jogo de dardos em ambientes virtual e real

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Bibliographic Details
Main Author: Costa, Herta Janine Batista
Other Authors: 60336641400
Language:Portuguese
Published: PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA 2017
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Online Access:https://repositorio.ufrn.br/jspui/handle/123456789/23578
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Summary:Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-07-04T12:09:26Z No. of bitstreams: 1 HertaJanineBatistaCosta_DISSERT.pdf: 1722649 bytes, checksum: f76b6d868dbd593d399a9e5f9130e4d3 (MD5) === Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-07-11T14:43:49Z (GMT) No. of bitstreams: 1 HertaJanineBatistaCosta_DISSERT.pdf: 1722649 bytes, checksum: f76b6d868dbd593d399a9e5f9130e4d3 (MD5) === Made available in DSpace on 2017-07-11T14:43:49Z (GMT). No. of bitstreams: 1 HertaJanineBatistaCosta_DISSERT.pdf: 1722649 bytes, checksum: f76b6d868dbd593d399a9e5f9130e4d3 (MD5) Previous issue date: 2017-02-23 === Introdu??o: O Acidente Vascular Cerebral (AVC) ? a principal causa de incapacidade a longo prazo no mundo resultando em defici?ncias sensoriomotoras que comprometem a funcionalidade dos indiv?duos nas Atividades de Vida Di?ria (AVD?s). Assim, tecnologias de realidade virtual veem sendo cada vez mais usadas visando ? reabilita??o motora. No entanto, h? poucas evid?ncias de que os movimentos realizados em ambientes virtuais se assemelhem aos realizados em ambientes f?sicos. Objetivo: Analisar os componentes cinem?ticos do membro superior em pacientes com AVC durante um jogo de dardos em ambientes virtual e real. Metodologia: Estudo quase experimental, com amostra de 11 hemipar?ticos cr?nicos, com idade entre 40-65 anos, tempo de les?o de seis meses a tr?s anos. O ambiente virtual foi apresentado no XBOX 360 Kinect e o ambiente real usou um jogo de dardo profissional. Os participantes realizaram 15 tentativas de cada jogo e a cinem?tica do membro superior foi registrada em v?deo para an?lise no Software Kinovea. Os ambientes foram comparados usando o teste t-Student pareado. Resultados: Houve diferen?a significativa entre os ambientes virtual e real. O jogo real apresentou maior ?ngulo de extens?o de cotovelo (p=0,008), maior flex?o de ombro (p=0,008) e maior velocidade m?dia da trajet?ria do ombro (p=0,001), cotovelo (p=0,0001) e punho (p=0,001). Quantos aos picos de velocidade e acelera??o, valores m?ximos foram encontrados no jogo real para velocidade de ombro (p=0,04), cotovelo (p=0,002) e punho (p=0,002) e acelera??o de cotovelo (p=0,004) e punho (p=0,028). As velocidades de flex?o e extens?o foram maiores no jogo real para ombro (p=0,021), cotovelo (p=0,004; p=0,005) e punho (p=0,009; p=0,039). O jogo virtual obteve maior tempo de flex?o (p=0,0001) e extens?o (p=0,021) e maior desempenho (p<0,0001). Conclus?es: O jogo de dardo pode ser empregado na reabilita??o do membro superior ap?s AVC de acordo com os objetivos que a terapia quer atingir. Se for para aumentar a amplitude de movimento, velocidade e acelera??o o jogo de dardo real ? mais indicado. O jogo virtual pode contribuir para a precis?o do movimento, controle dos graus de liberdade e ajustes posturais, porque necessita de menor tempo para realiza??o do movimento. === Introduction: Stroke is the leading cause of long-term disability worldwide resulting in sensorimotor impairments that compromise functionality of individuals in Activities of daily living (ADLs). Thus, virtual reality technologies have been used increasingly aimed at motor rehabilitation. However, there is little evidence that the movements performed in virtual environments are similar to those made in physical environments. Objective: Analyze kinematics components of the upper limb in stroke patients during a game of darts in virtual and real environment. Methodology: The quasi-experimental study with a sample of 11 chronic hemiparesis, aged 40-65 years, time injury of six months to three years. The virtual environment was presented at the XBOX 360 Kinect? and the real environment used a professional dart game. Participants performed 15 trials of each game and the kinematics of the upper limb was recorded on video for analysis in Kinovea Software. The environments were compared using the t-Student test. Results: There were significant differences between the virtual and real environments. The real game showed higher elbow extension angle (p = 0.008), greater shoulder flexion (p = 0.008) and a higher mean speed of the shoulder (p = 0.001), elbow (p = 0.0001) and wrist (p = 0.001) path. As to velocity and acceleration peaks, maximum values were found in the real game shoulder (p = 0.04), elbow (p = 0.002) and wrist (p = 0.002) velocity, and elbow (p = 0.004) and wrist (p = 0.028) acceleration. The flexion and extension speeds were higher in the real game shoulder (p = 0.021), elbow (p = 0.004; p = 0.005) and wrist (p = 0.009; p = 0.039). The virtual game got longer flexion (p = 0.0001) and extension (p = 0.021) and a higher performance (p <0.0001). Conclusions: The dart game can be used in rehabilitation of the upper limb after stroke according to the goals that the therapy wants to achieve. If it is to increase the range of motion, speed and acceleration, the actual dart game is more indicated. The virtual game can contribute to the accuracy of movement, control of degrees of freedom and postural adjustments, because it requires less time to perform the movement.