4. Discussion
hypoxia, orthostasis
HYPOXIA
The results of the present study demonstrated that the older women from the control group, i.e., those who did not undergo any kind of intervention during the studied period, presented a worsening of the plantar tactile sensitivity in both feet, with predominance in the left foot.The impairment of the plantar tactile sensitivity that was observed in the older women of the control group may have made them more susceptible to suffering falls or to present difficulties in locomotion on uneven surfaces so that, according to Cenci et al. [In relation to the older women submitted to proprioceptive conventional and games with motion monitoring training, an improvement in the plantar tactile sensitivity of the right and left feet was evidenced in both groups. The improvement of this sensitivity can be attributed to the multisensory stimuli provided by proprioceptive training since studies have shown that physical exercises that promote stimuli and vary in texture, weight, and shape, whether associated or not with sound and visual stimuli, improve the blood supply to the lower limbs, thus contributing to the reduction in endoneural hypoxia and an improvement in nerve conduction [Santos et al. [Studies have concluded that orthostasis on textured surfaces with varying densities caused an increase in peripheral nerve activity for healthy individuals as a function of changes in the transmission of afferent signals from the sole of the foot [Regarding training with games and motion monitoring (GMM), although no studies have been found on its effects on plantar tactile sensitivity, the present study showed that this training modality contributed to an improvement in sensitivity. This resource consists of the reproduction of tasks that can be performed by the individual in interaction with a multidimensional and multisensory environment created by a computer that can be explored in real-time, thus contributing to sensory stimulation [One possible explanation for the improvement in plantar tactile sensitivity from VR is that this type of training is able to provide tactile feedback to the central nervous system. The additional sensory stimulation of plantar cutaneous receptors improves tactile sensitivity, favoring the performance of activities and preventing risks of accidents since the perception of movement is favored when tactile feedback is available [According to some authors, training based on VR allows for a greater number of repetitions, high variability of movements, and auditory and visual feedback [The results of the present study showed that when the three groups of older women were compared, the plantar tactile perception presented significant differences when analyzing the before and after interventions, in which the conventional and exergame groups obtained better effects when compared to the control group. However, no significant differences were observed in plantar tactile sensitivity between the conventional and exergame groups.Based on these results, it is possible to state that the improvement of plantar tactile sensitivity in older women could be achieved with a physiotherapeutic intervention of easy access and low cost, as in the case of conventional training. The proposal of training, with games and motion monitoring, must be considered a great advance in the health area, since in the globalized world, participation in the technological process is inevitable, and the use of these advances by the health sciences is undeniable.Although VR is a resource that has higher costs than conventional physical therapy, it has shown positive results in several clinical areas. Similar to conventional training, VR is a therapeutic modality that can be performed in physical therapy clinics, in long-stay institutions for the elderly, or even at home, facilitating the treatment of people who do not have access to a rehabilitation center. In view of all the findings, both types of training must complement each other, always seeking the physical and emotional well-being of the elderly population.It is important to emphasize the need for further studies that can describe more characteristics and factors that are related to the effects of different exercise modalities on the sensory and functional responses of older women since this was one of the limitations of the present study.Another limitation of the present study was that a follow-up was not carried out to verify how long the effects of the intervention lasted after its completion. Thus, further studies are suggested, given the importance of gaining a greater understanding of this subject for possible reference measures and an improvement in the quality of life of this population.