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Physiotherapist and researcher Pablo Campo participates in another study with this tool. «We didn’t want Covid to stop us cold,» he says.

Pontevedra university campus researcher Pablo Campo has been working for a couple of years on the use of immersive virtual reality to improve functional ability in senior citizens. How? Through ‘exergaming’, which are games created for exercising. The physiotherapist, who specialises in Parkinson’s neurorehabilitation, designed a specific programme whose results were to be presented at various conferences, including, an international event that was going to be held in Malaga last March. The event never took place as it coincided with the weekend when the first lockdown began.

Pablo says that this study was finally released, virtually, on 14th November. Nine patients from the Parkinson’s Association of Vigo had participated in the pilot test with an immersive (not augmented) total virtual reality headset and to complete it an authorised clinical trial was planned in a private residential centre in Pontevedra: Saraiva Senior. “We had everything ready to start, but the residences and day centres were shielded because of Covid and to see how the vaccine evolves. We are confident that we will be able to launch it in the first quarter of 2021”, explains the researcher from the HealthyFit group, from the Faculty of Education and Sports Science.

Can it alter stress levels?

As this study could not go ahead, they took advantage of this period to perform another investigation. This is a study that seeks to determine if the use of virtual reality for exercise can alter stress levels. “We wanted to ensure that Covid did not stop experimental research in people entirely. So, we conducted a small trial with people close to the campus», says Pablo Campo.

33 people eventually participated in this study, including students, especially from the Faculties of Education Sciences and Physiotherapy, professors and administration and services personnel. “Physical exercise always relieves stress. But we wanted to know what happens with a new immersive virtual reality platform,” he says. Previously, the security measures of the tool were shielded so that the process was safe and the different phases were carried out under strict protocols to combat the spread of Covid-19. The field phase of the study is now complete and the HealthyFit group is working on the data analysis.

Pablo Campo emphasises that the objective of the study is to evaluate the alterations in stress levels that the use of virtual reality can produce, to develop a physical activity programme. This is done using two biomarkers, the hormone cortisol and the enzyme alpha-amylase. Participants were monitored for blood pressure and heart rate, taking several saliva samples when getting up, before the activity and after exercise. The study is completed with a control group from which three samples will also be taken. The physiotherapist points out that the saliva samples from the two groups will be analysed with a high-efficiency chromatograph (HPLC) in the Escola de Forestais laboratories by researcher Carlos Souto.

«Within our area of research, we control exertion through tension and heart rate. We don’t want it to be excessive as we are going to apply it to more frail groups», points out Pablo Campo. This researcher reveals that the mask factor was also taken into account. Wearing a mask when performing physical exercise places greater demands on the individual, requiring increased effort. Depending on the type of mask, this can be more or less of a factor. The physiotherapist emphasises that, whilst wearing a mask is recommended from a general health point of view, its use in certain groups such as people with respiratory issues or the very elderly, is not recommended as it increases cardiac stress.

Source

Evaluating the possibilities of total or immersive virtual reality to design and develop therapeutic physical activity programmes for senior citizens is the central objective of a pioneering area of research by the HealthyFit group, from the Faculty of Education and Sports Science. It takes as a starting point the hypothesis that this type of support can be attractive to generate greater adherence to physical activity and the possibilities represented when developing more personalised therapies, a first pilot study among patients with Parkinson’s, within the framework of the doctoral thesis developed by Pablo Campo under the direction of the group’s main researcher, José María Cancela, and the professor of the Faculty of Physiotherapy, Gustavo Rodríguez.

“What we want to see at first is the effect of different proposals for therapeutic intervention with virtual reality in a population with different pathological profiles,» explains Cancela, who points out that the therapeutic applications of immersive virtual reality have so far only been studied to address problems «of a psychological nature, but not for physical therapy». To develop this area of research, the HealthyFit group acquired a head-mounted display, with which it will first seek to analyse the possible application of some of the thousands of existing experiences and games for this type of device as ways to prescribe a physical activity which is adapted to the characteristics of each user. The objective, Cancela adds, is to take advantage of the “adhesion capacity» of the games to «work unconsciously on certain parameters that would otherwise be much more complicated.» Not surprisingly, this type of platform would allow activities to be carried out in a «safe environment» in which the elderly have to «respond to a series of stimuli», while making it possible to design individualised therapies, since the programme itself would allow for real-time evaluation of the parameters. «It would effectively be intervention and evaluation at the same time, which allows us to adapt the therapy based on the results achieved in the previous sessions,» says Cancela.

A programme adaptable to each person and pathology

“This is also a way of showing that therapeutic exercise programmes can be performed through technology», adds the physiotherapist Pablo Campo, who focuses the research for his thesis on the design and development of a therapeutic programme based on the use of this technology. Until now, it has carried out some initial “pilot tests” with the aim of “observing the motivation generated by the system”, while confirming that it is a safe activity for senior citizens. «The tests are being tremendously positive,» acknowledges Campo, who also worked on the adaptation into Spanish of a scale that would allow the identification of «the main symptoms associated with immersion» – a device in which users can see themselves in the middle of multiple virtual stages. After this initial analysis, his next objective is to develop with senior citizens “a programme of therapeutic exercise, which can be adapted to the characteristics of the people, such as age, pathologies, symptoms or, for example, to the pharmacology associated with them», and which will facilitate working from aspects of improving coordination, balance, reflexes or joint mobility to specific issues related to certain pathologies, such as gait disturbances in Parkinson’s patients.

A long-term line of work

As Cancela points out, this pilot study constitutes the starting point of a “long-term” line of work for the HealthyFit group, who recently signed collaboration agreements with two companies specialising in virtual reality and software development. «Immersive virtual reality was born as a game, and there are countless games that, with just a small modification, can be used as therapy for these groups», highlights the researcher. In this way, in a first phase, the research will focus on evaluating which games and programmes already in existence «are more suited to a certain pathology, due to their characteristics», and then «adapt them as therapies». With the collaboration of the companies, the group will also seek to be able to design «therapeutic intervention proposals» based on virtual reality, with the final purpose of «trying to create an online therapeutic platform» with the resources developed.

The first test, with Parkinson’s patients

With the collaboration of the Parkinson’s Association of Vigo, in recent weeks Campo was able to carry out a pilot study with people affected by this disease. “We looked for a game profile that was easy to interpret, with the idea of stimulating patients with a type of therapeutic exercise that would be attractive to them and that would trigger their attention mechanisms,» says Campo. These tests sought to verify whether the proposal was «attractive, feasible and safe», also taking into account the potential of virtual reality in the treatment of a pathology in which physical exercise programmes produce greater effects when they add «cognitive strategies such as attracting attention, which implies the execution of tasks with focused attention to adapt responses to the stimuli presented”, as in this case those proposed through a virtual environment would be.

Among the first to test this proposal were members of the association including Daniel Rodríguez, 89, who recognises that the physical activity he performed through games included «many of the movements we perform in physiotherapy»; and Salvador Rey, 68, who highlighted the advantage of being able to perform a personalised activity. After testing the device, the 61-year-old, also a member of the Moises Ogando association, also praised the appeal of using a game “that allows, in virtual reality, but a totally controlled manner, to develop activities that help us in aspects that we have damaged, such as coordination”.

The HealthyFit research group has agreements with various companies, associations and public administrations that allow the development of its scientific and professional work.

Smartphones have become a great tool for exercise through the new dynamic of self-service mobile applications oriented to physical exercise and providing advice from personal trainers.

Ger-Fit was conceived in this model, an application developed within the Research Network in Gerontology, Physical Exercise and Tics, aiming to develop physical exercise sessions for senior citizens based on their capabilities, pathologies and availability of material. This application has over 5000 combinations of exercises, which the user can listen to, read or watch, allowing them to develop a personalised plan based on their goals and physical condition.

Access is free via the following link:   http://appgerfit.webs.uvigo.es/

The doctorate in Education, Sports and Health (EDyS) was born thanks to the effort and commitment of several research groups at the Universidad de Vigo, who see in it an opportunity to train professionals who are capable of producing new ideas, using the main sources of knowledge: observation, experimentation, inductive and deductive reasoning.

More information:  www.edys.es

email: info@edys.es

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