Árvore de decisão da análise cinemática em pacientes com acidente vascular cerebral durante jogo de dardos em ambiente virtual

Abstract

Introduction: Stroke is a major cause of disability in adults, being a lack of coordination between the arm and the hand a very important disability, and is one of the primary functional goals for rehabilitation. Virtual reality is one of the resources available for training and movement recovery, a technology that uses computers or video games to make an enriched environment for the patient. Objective: To make decision trees of kinematic analysis of the upper limb in stroke patients during darts game in virtual environments. Methodology: Eleven chronic patients, with age between 40-65 years, lesion time from six months to three years participated in the study. They were evaluated by the MEEM, NIHSS, Modified Ashworth Scale, Fugl-Meyer Scale, and MIF scales. The virtual environment was presented using XBOX 360 Kinect®, where participants made 15 attempts at the dart game in a single session, and upper limb kinematics was recorded in video for analysis in Kinovea software. Results: In the construction of decision trees, a greater frequency of patients with mild neurological impairment with elbow extension angles ≤152.5˚ and angles> 152.5 ° was observed, while patients with moderate neurological impairment performed extension angles ≤152.5 °. In the construction of the decision tree for the velocity of elbow extension during the launch, it was observed that the majority of patients with mild neurological impairment performed movements with velocities ≤40.05 cm/s, while patients with moderate impairment performed movements with velocity >40.05 cm/s. Conclusions: The analysis of the decision tree identified angles and velocities that can be determined with the use of the virtual dart game according to the degree of neurological impairment, being of great importance for the planning of the motor physical therapy of stroke patients.