Evaluation of the quality of life of patients with hereditary spastic paraplegia after intervention: a pilot study

Abstract

Introduction: Hereditary spastic paraplegia (HSP) encompasses a heterogeneous group of degenerative diseases that cause spastic paraparesis and progressive weakness in the lower limbs. Objective: To evaluate the quality of life (QoL) of patients with HSP using the World Health Organization Quality of Life Questionnaire (WHOQOL-bref) applied pre- and post-rehabilitation with virtual reality (VR). Methods: This is a pilot randomized controlled clinical trial, registered on the Rebec Platform, test RBR-3JMX67, involving 16 adult diagnosed with HPS, regardless of the type (pure or complicated), randomly allocated into two groups: balance group (BG) and strength group (SG). All were submitted to anamnesis, otorhinolaryngological and labyrinthine evaluation. Next, the WHOQOL-bref questionnaire was applied at three moments: T0 (before rehabilitation with VR), T1 (after 10 sessions) and T2 (after 20 sessions). Results: The application of the WHOQOL-bref questionnaire showed differences in the comparison of T0, T1 and T2 in SG for the physical, psychological, environmental, and general QoL domains (p ≤ 0.009). When comparing T1 and T2, considering the VR game scores, both groups improved their performance (p ≤ 0.005). Conclusion: There was an improvement in QoL, especially in SG, after VR with the Nintendo Wii®, suggesting that the integration of strength exercises + balance exercises can improve balance and QoL. VR is a low-cost tool that improves functional capacity and reduces the risk of falling, which is fundamental for the QoL of patients with HSP. The WHOOQL-Bref quantified the effects of the therapy. Performance in the games provided motivation and rapid feedback. Future studies are needed with longer training periods, larger samples, and evaluation of other variables.