Effectiveness of virtual reality supported upper extremity position matching exercises in parkinson's disease patients

Parkinson's patients have difficulties with upper extremity function due to various reasons such as loss of proprioception. The aim of this study was to investigate the effect of virtual reality (VR)-assisted upper extremity position matching exercises. The Angle Repetition Test was used to evaluate the individuals' proprioception sense, the Box and Block Test (BBT) was used to determine the functional level of the upper extremities, the Unified Parkinson's Disease Rating Scale (UPDRS) was used to determine the severity of the disease, the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) and the ACTIVLIM scale were used to determine the ability in activities of daily living, the Parkinson's Disease Questionnaire-8 (PDQ) was used to determine the quality of life, and the Intrinsic Motivation Inventory was used to determine the satisfaction level of the individuals with the treatment after treatment. Individuals were divided into two groups as those who received only conventional treatment in the control group and those who received VR treatment in addition to conventional treatment in the VR group. In VR group, upper extremity position matching exercises were performed using the application in which appropriate positions should be taken according to the obstacles. The VR group received joint positioning exercises in addition to conventional treatment approaches for 20 minutes 2 days a week for 8 weeks. The groups were similar in terms of age, gender and disease severity at baseline measurements (p>0.05). In the control group, statistically significant improvements were found in BBT (p=0.012) and UPDRS (p=0.004), while in the VR group, in addition to BBT (p<0.001) and UPDRS (p<0.001), proprioception evaluations at different angles (at 40⁰: p=0.002 /100⁰: p=0.013), ACTIVLIM scores (p=0.001) and PHA (p=0.028). Although improvements were observed in both groups, there was no significant change in DASH scores (p>0.05). There was also a significant difference in the post-treatment motivation levels of the individuals in favor of the VR group (p=0.034). The results of this study showed that upper extremity rehabilitation supported by VR has positive effects on upper extremity function, disease severity, proprioception and quality of life and is superior to conventional methods in improving disease severity and proprioception.