The Effectiveness of Exergaming Rehabilitation versus Conventional Physiotherapy on Quality of Life in Parkinson's Disease: A Systematic Review and Meta-Analysis

The chapter collects and analyzes evidence-based information for the presentation of the outcomes of quality of life, activities of daily living, physical and cognitive function for people with PD, under the use of exergaming rehabilitation versus conventional physiotherapy. Parkinson’s disease (PD) is a complex progressive neurodegenerative disease characterized by tremor, rigidity, and bradykinesia, with postural instability appearing in some patients as the disease progresses. Digital games and programmes that contain subject interaction with the implementation of repetitive functional activities are included in exergaming rehabilitation. Physiotherapy as it is practised today includes a number of active exercises. Five electronic databases were searched for eligible studies until February 2021. For the statistical analysis, the mean, standard deviation, and 95% confidence interval were used to calculate effect sizes between groups. To determine heterogeneity, statistical index I² was used. A total of 548 participants were included in 14 studies. Exergaming rehabilitation related with quality of life improvement (p = 0.687, 95% CI: -1.682 to -0.734), balance (p = 0.039, 95% CI: 0.364–13.689), (p = 0.018, 95% CI: 0.446–4.830), and gait (p = 0.005, 95% CI:0.351–1.924). No significant difference was found between groups regarding the Unified Parkinson’s Disease Rating Scale (p = 0.196, 95% CI: -5.970 to 1.225) and for the Timed Up and Go Test (p = 0.12, 95% CI: 0.446–4.830). Exergames as interventional tool can be used to provide alternative interactive method with positive results for quality of life in people with PD. The application of more advanced technological ER systems provides variability of gamification and simultaneous combination of exergaming programs that allow the execution of more realistic activities, raising the physical and emotional interaction between the individual and the environment. This gives the opportunity to evaluate the use and effectiveness of the intervention in mental health and motivation for people with PD, which should be considered in future studies.