VALIDATION OF A SERIUS GAME VirtuAlter FOR POSTURAL BALANCE REHABILITATION IN ELDERLY BY VIRTUAL REALITY
Virtual Reality; Rehabilitation; Postural Balance; Elderly.
Introduction: Fisiologic changes resulting aging alter postural balance and various approaches have been increasingly used for its maintenance or improvement, highlighting Virtual Reality (VR). VR enables an interactive experience through using games with enriched and complex environments. Most commercial games are used as treatment strategies, however, they were not designed to stimulate motor and cognitive domains. Serious games emerge with a purpose that goes beyond entertainment. Their development in the VR environment enables sensory, motor and cognitive training, in addition to providing content and feedback with personalized goals for the user's specificities, providing adjustments with therapeutic purpose involving learning, adherence and challenges. Objective: To perform content validation of the VirtuAlter serious game for postural balance rehabilitation in elderly by virtual reality. Methodology: This is a descriptive study that contemplates two integrated modalities: 1) Identification of upper limb lateral reach reference values in healthy elderly subjects – Analysis of the lateral reach of 20 healthy elderly people who underwent an assessment with the instruments: Socio-demographic evaluation, Berg Balance Scale, Short Physical Performance Battery; Lateral Reach Test (TAL); Lateral reach analysis using the Microsoft® Kinect motion capture system (AL Kinect). 2) Content validation of the VirtuAlter serious game by the analysis of eleven expert judges physiotherapists and professionals in the area of science and technology or correlated areas – The Delphi technique will be implemented where judges will play the game as many times as needed and express their opinions about the game content and filling the tools: Dimensions of content validation of the serious game VirtuAlter and System Usability Scale (SUS). Results: In the stage 1, it was observed values in TAL and AL Kinect of 23.2±4.77; 21.1±5.47 on the right side and 22.9±4.86; 22.7±6.42 on the left side, respectively. The Balnd-Altman dispersion model showed bias of 0.19 for left side and 2.02 for the right side. In stage 2, five physiotherapists and six professionals in the area of science and technology participated of the validation. The total IVC value of the game was 0.8 and the Cronbach alpha coefficient was 0.924. The technical elements, clarity of the game narrative, image quality and speed of motion capture need modifications and adjustments. The judges identified the game with a satisfaction score of 67.73 on the SUS scale. Conclusion: The mean values of the lateral reach in healthy elderly will be adopted with the game parameters in its applicablity in elderly with balance impairment. It is necessary the technical elements improvement before clinical execution. The VirtuAlter content is validated and corresponds to a proper technological tool for the training of postural balance of elderly with good usability.