Atividade cortical e desempenho motor durante a execução de um jogo virtual em pacientes com acidente vascular cerebral

Abstract

Sensorimotor deficits resulting from stroke indicate the need for interventions that favor the functional recovery of these patients. Objective: This study aimed to assess cortical activity and motor performance during the execution of a virtual reality game in stroke patients. Method: 12 patients participated in the study, 6 with left brain injury (LP), mean age 54.1 years (± 9.4) and 6 with right injury (RD), mean age ± 50.6 years (± 5.8) and 12 healthy individuals who activated the left (LH) and right (RH) hemispheres. Participants underwent an electroencephalographic evaluation when performing training with 3 blocks of 5 attempts of the virtual darts game (XBOX Kinect). Game performance was recorded using absolute (AE), constant (CE) and variable (VE) error measures. Data were analyzed using ANOVA with Tukey's post hoc test. Results: Patients with lesions in the left cerebral hemisphere showed changes in the activation of the alpha frequency in areas related to motor planning (AF3) and integration of visual-perceptual information (P7). In beta frequency, these patients had problems in activating the left primary motor cortex (FC5) and the somatosensory and left association cortex (P7), suggesting difficulties in motor control and correction of visualmotor errors during the execution of the virtual game. Patients with right brain injury had lower alpha activation potency in the right temporal cortex (T8), indicating that they had to evoke more memory and mentally rehearse the task to fulfill the demands of the game. Patients showed higher AE and CE values than healthy ones (p = 0.015). Conclusion: The behavior of cortical activation, correlated with motor performance in stroke patients, indicates the need to observe the laterality of the lesion when executing a virtual reality game within neurorehabilitation.