Nível de evidência do uso de videogames comerciais no tratamento de crianças com paralisia cerebral: revisão sistemática

Abstract

Introduction: Cerebral palsy (CP) is a movement disorder due to brain injury during the pre, peri or postnatal period. It is the most common motor manifestation of childhood and its prevalence in Brazil is estimated at about 30,000 to 40,000 new cases per year. Symptoms of CP vary, but all individuals have problems with motor function, and are often accompanied by disorders of sensation, perception, cognition, communication, and behavior. With the advancement of technology, commercial games have been explored as an intervention to improve motor function in children with CP. Objective: To perform a systematic review on the effect of commercial games used on children with Cerebral Palsy, classifying the evidence found in the domains of the ICF. Methods: This was a systematic review prepared in accordance with the guidelines for systematic reviews and meta-analyzes (PRISMA) and followed the recommendations of GRADE (Grading of Recommendations, Assessment, Development and Evaluations). The electronic bases Scielo, PEDro, Lilacs, Cochrane and PubMed were used for searches. Screening and selection of articles was performed by two independent evaluators, where a third was consulted if in doubt. Results: We identified 292 studies, of which 32 were analyzed and 7 were included in the systematic review. A total of 79 participants were involved, with GMFCS between I-IV. The game consoles used were Wii® Fit (NINTENDO), PlayStation® (SONY) through the EyeToy® app and the Move® and Xbox® (MICROSOFT) Kinect® system, all associated with conventional physical therapy performed 3 to 5 times per 30 to 40 minutes, with an average duration of 4 to 12 weeks. Conclusion: The results of this systematic review demonstrated moderate to high methodological quality of articles proving the effectiveness of video game use in children with CP. However, it does not exclude the need for joint application with conventional physical therapy. The greatest benefits presented were in the domains of function and activity within the ICF, with personal factors being third. It is concluded that a larger number of randomized controlled trials evaluating the efficacy of outcomes in the other ICF domains is needed.