The Use of Virtual Reality Rehabilitation for Individuals Post Stroke
Gabrielly Marques Moreira1, Elis Marina Romão de Lima2, Ingrid Thaíse Machado2, Ana Paula Cunha Loureiro3, Elisangela Ferretti Manffra1*
1Health Technology Graduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
2Physical Therapy Undergraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
3Department of Physical Therapy, School of Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
Background: Stroke causes somatosensory and motor deficits that compromise the static and dynamic balance. The recovery of these skills is an essential goal in the rehabilitation process and physiotherapy treatments have employed video games (VG) for therapeutic purposes.
Objective: To investigate the effects of employing VG in static and dynamic balance of individuals after stroke.
Design: Quasi-experimental study.
Method: The sample consisted of 28 individuals with hemiparesis, divided into experimental (EG) and control groups (CG), with 14 participants in each. The EG underwent conventional physiotherapy and commercial video games training. The interventions were individualized, with duration of 30 minutes, twice a week, for 10 sessions. The CG received only conventional physiotherapy. The groups were evaluated before and immediately after completion of the study. Individuals were assessed with Berg Balance Scale, MiniBESTest, Postural Assessment Scale for Stroke, Functional Reach Test and 1-minute sit-to-stand test.
Results: Both groups increased their scores on the scales. However, this increase was significant only for the EG in the Berg Balance Scale (p = 0.001), MiniBESTest (p = 0.001) and Functional Reach Test (p = 0.041). Correlation analysis indicated that the increase in functional scales was related to progress in the Tightrope game.
Conclusion: These results suggest that VG can be a valuable tool for physiotherapy practice, bringing potential benefits to improve static and dynamic balance in stroke individuals.
View / Download Pdf Breast Cancer Rehabilitation: A Critical Review of Clinical Practice Guidelines and Evidence-based Medicine in Literature
Giovanni Scibilia1, Serena V. Capobianco1*, Adriana Bonifacino2, Valter Santilli1, Teresa Paolucci1
1Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, “Sapienza” University of Rome, Rome (Italy)
2Department of Medical-Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Sant'Andrea University Hospital, Rome, Italy
3Unit of Physical Medicine and Rehabilitation, Department of Medical and Oral Sciences and Biotechnologies, DSMOB, University G. d’Annunzio of Chieti-Pescara,Italy
Breast cancer is the most common cancer affecting women over 35 years. The primary adverse consequences after surgical treatment and often after chemotherapy or radiotherapy, are pain, upper limb impairment, postural imbalances, lymphedema, fatigue, and depression. The aim of this study is to review rehabilitative Clinical Practice Guidelines in breast cancer patients after surgical treatment and to analyze recommendations and their level of evidence.
Materials and Methods: The articles were searched for the MeSH terms “breast cancer,” “guidelines,” “rehabilitation,” “lymphedema,”, “survivor,” “survivorship,” “therapy,” “exercise,” “complementary,” “cognitive,” “integrative,” “body image,” “physical therapy,” “treatment,” and “quality of life” in Cochrane Database of Systematic Reviews, PubMed, Science Direct. We restricted our search to full-text English language publications published between July 2006 and June 2017 and we considered only international practice guidelines that focus on rehabilitation after breast cancer surgery.
Results: We selected four guidelines focusing on primary care, rehabilitative approaches and integrative approaches. They recommend the early taking charge of the patient and to manage upper limb dysfunctions, lymphedema, pain, fatigue, peripheral neuropathy, body imagine concerns and lifestyle recommendations.
Conclusions: The current model of care for women with breast cancer focuses mostly on treatment of disease; this approach too often lacks attention to patients’ physical and functional well-being. Many criticisms emerge from this review.
We suggest that there is a need to strengthen the level of evidence for many commonly used clinical practices and to better describe innovative rehabilitative approaches.
Highlights
• Breast cancer is the most common cancer affecting women over 35 years;
• There is an increasing of survivor patients;
• The latest guidelines on breast cancer are not exhaustive about rehabilitation and complications after surgery;
• There is the need to strengthen the level of evidence of many commonly used clinical rehabilitation practices and to better describe rehabilitative approaches for breast cancer survivors.
• Only 4 breast cancer guidelines were interested in rehabilitation for survivor patients in the latest 10 years.
View / Download Pdf Effects of Whole-Body Vibration on Fibromyalgia: Is There Any Evidence to Support Clinical Practice?
Jousielle Márcia dos Santos1, Vanessa Amaral Mendonça1,2,3, Vanessa Gonçalves Cesar Ribeiro3, Vinicius Cunha Oliveira2, Sueli Ferreira da Fonseca3, Hércules Ribeiro Leite1,2,3, Ana Carolina Coelho de Oliveira1, Pedro Henrique Scheidt Figueiredo1,2,3, Mario Bernardo-Filho4, Vanessa Pereira Lima1,2, Ana Cristina Rodrigues Lacerda1,2,3*
1Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
2Physiotherapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerias, Brazil
3Multicenter Postgraduate Program in Physiological Sciences, Sociedade Brasileira de Fisiologia (SBFis), Diamantina, Brazil
4Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
Introduction: Whole Body Vibration (WBV) exercise has been widely applied in the clinical practice. Thus, the present review aims to provide an updated review of current literature on the effects and efficacy of WBV alone or combined with exercise in patients with fibromyalgia (FM).
Methods: The works were identified and selected from the PubMed, Cochrane-Central-Register-of-Controlled-Trials and Physiotherapy Evidence-Database (PEDro) databases. Randomized controlled trials (RCTs) and case-control studies were selected without language restrictions. Articles including single or multiple WBV sessions have been identified.
Results: Nine works were included in the review (1 case-control study and 8 RCTs). The average PEDRro score was 7.44 ± 0.95. The sample size varied from 20 to 46 participants, involving only women diagnosed with FM. The outcomes identified were pain, balance, quality of life, fatigue and disability. Only one study investigated FM-related inflammatory biomarkers.
Conclusions: Although WBV treatment appears to be safe and feasible, there is limited evidence to support WBV application in clinical practice in patients with FM.
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