A Single Session of Virtual Reality Improved Tiredness, Shortness of Breath, Anxiety, Depression and Well-Being in Hospitalized Individuals with COVID-19: A Randomized Clinical Trial.

BACKGROUND: In 2020, the world was surprised by the spread and mass contamination of the new Coronavirus (COVID-19). COVID-19 produces symptoms ranging from a common cold to severe symptoms that can lead to death. Several strategies have been implemented to improve the well-being of patients during their hospitalization, and virtual reality (VR) has been used. However, whether patients hospitalized for COVID-19 can benefit from this intervention remains unclear. Therefore, this study aimed to investigate whether VR contributes to the control of pain symptoms, the sensation of dyspnea, perception of well-being, anxiety, and depression in patients hospitalized with COVID-19. METHODS: A randomized, double-blind clinical trial was designed. Patients underwent a single session of VR and usual care. The experimental group (n = 22) received VR content to promote relaxation, distraction, and stress relief, whereas the control group (n = 22) received non-specific VR content. RESULTS: The experimental group reported a significant decrease in tiredness, shortness of breath, anxiety, and an increase in the feeling of well-being, whereas the control group showed improvement only in the tiredness and anxiety. CONCLUSIONS: VR is a resource that may improve the symptoms of tiredness, shortness of breath, anxiety, and depression in patients hospitalized with COVID-19. Future studies should investigate the effect of multiple VR sessions on individuals with COVID-19.

Brain-computer interface combined with mental practice and occupational therapy enhances upper limb motor recovery, activities of daily living, and participation in subacute stroke.

Background: We investigated the effects of brain-computer interface (BCI) combined with mental practice (MP) and occupational therapy (OT) on performance in activities of daily living (ADL) in stroke survivors. Methods: Participants were randomized into two groups: experimental (n = 23, BCI controlling a hand exoskeleton combined with MP and OT) and control (n = 21, OT). Subjects were assessed with the functional independence measure (FIM), motor activity log (MAL), amount of use (MAL-AOM), and quality of movement (MAL-QOM). The box and blocks test (BBT) and the Jebsen hand functional test (JHFT) were used for the primary outcome of performance in ADL, while the Fugl-Meyer Assessment was used for the secondary outcome. Exoskeleton activation and the degree of motor imagery (measured as event-related desynchronization) were assessed in the experimental group. For the BCI, the EEG electrodes were placed on the regions of FC3, C3, CP3, FC4, C4, and CP4, according to the international 10-20 EEG system. The exoskeleton was placed on the affected hand. MP was based on functional tasks. OT consisted of ADL training, muscle mobilization, reaching tasks, manipulation and prehension, mirror therapy, and high-frequency therapeutic vibration. The protocol lasted 1 h, five times a week, for 2 weeks. Results: There was a difference between baseline and post-intervention analysis for the experimental group in all evaluations: FIM (p = 0.001, d = 0.56), MAL-AOM (p = 0.001, d = 0.83), MAL-QOM (p = 0.006, d = 0.84), BBT (p = 0.004, d = 0.40), and JHFT (p = 0.001, d = 0.45). Within the experimental group, post-intervention improvements were detected in the degree of motor imagery (p < 0.001) and the amount of exoskeleton activations (p < 0.001). For the control group, differences were detected for MAL-AOM (p = 0.001, d = 0.72), MAL-QOM (p = 0.013, d = 0.50), and BBT (p = 0.005, d = 0.23). Notably, the effect sizes were larger for the experimental group. No differences were detected between groups at post-intervention. Conclusion: BCI combined with MP and OT is a promising tool for promoting sensorimotor recovery of the upper limb and functional independence in subacute post-stroke survivors.

Effects of Ibuprofen Use on Lymphocyte Count and Oxidative Stress in Elite Paralympic Powerlifting.

BACKGROUND: Paralympic Powerlifting (PP) training tends to promote fatigue and oxidative stress. OBJECTIVE: To analyze the effects of ibuprofen use on performance and oxidative stress in post-training PP athletes. METHODOLOGY: Ten national level PP athletes (age: 27.13 ± 5.57) were analyzed for oxidative stress in post-training. The study was carried out in three weeks, (1) familiarization and (2 and 3) evaluated the recovery with the use of a placebo (PLA) and ibuprofen (IBU), 800 mg. The Peak Torque (PT), Torque Development Rate (TDR), Fatigue Index (FI), reactive substances to thiobarbituric acid (TBARS) and sulfhydryl groups (SH) were evaluated. The training consisted of five sets of five repetitions (80-90%) 1-Repetition Maximum (1-RM) in the bench press. RESULTS: The IBU showed a higher PT (24 and 48 h, p = 0.04, ɳ2 p = 0.39), a lower FI (24 h, p = 0.01, ɳ2p = 0.74) and an increased lymphocyte count (p < 0.001; ɳ2p = 4.36). There was no change in oxidative stress. CONCLUSIONS: The use of IBU provided improvements in strength and did not protect against oxidative stress.

Protocols Used by Occupational Therapists on Shoulder Pain after Stroke: Systematic Review and Meta-Analysis.

INTRODUCTION: Shoulder pain as a consequence after a stroke has multifactorial causes and can prevent the functional return of the upper limb. In addition, the effectiveness of clinical protocols applied by occupational therapists remains uncertain. OBJECTIVE: To identify the main treatments currently used by occupational therapists for pain in the shoulder after a stroke. METHOD: Articles in English published between 2015 and 2019, of the randomized clinical trial type, with populations that stroke survivors a stroke and sequelae of shoulder pain were selected. The terms and combinations used were "shoulder pain and stroke and occupational therapy," in the electronic databases, Directory of Open Access Journals (DOAJ), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), and PubMed. Statistical Review Manager (version 5.3) established the significance level P ≤ 0.05. RESULTS: Thirty-nine articles were found, but only four met the inclusion criteria. Electrical stimulation, therapeutic bandaging, and dry needling were eventually employed. For the meta-analysis, pain was the primary outcome, and range of motion (ROM) and upper limb function were secondary. Pain, ROM (external rotation, abduction, and flexion), and manual function were compared, and the meta-analysis showed improvement in the treatment group in clinical trials: pain (MD -2.08; 95% CI -3.23, -0.93; P = 0.0004), ROM (MD 4.67; 95% CI 1.54, 7.79; P = 0.0003), and manual function (MD 1.84; 95% CI 0.52, 3.16; P = 0.006). CONCLUSION: Dry needling, California tripull taping (CTPT), and functional electrical stimulation controlled by brain-machine interface (BCI-FES) are proved effective in shoulder pain and functionality.

The Acute Effect of Hyperoxia on Onset of Blood Lactate Accumulation (OBLA) and Performance in Female Runners during the Maximal Treadmill Test.

The objective of this study was to analyze the acute effect of hyperoxia during the maximal treadmill test (MTT) of runners. Participants included 10 female street runners who performed the MTT under two different conditions: hyperoxia (HYPX), inhaling oxygen (60% O2) every 3 min; and normoxia (NORM), without additional oxygen inhalation. Both groups performed the MTT with increases in the slope of the run every 3 min until voluntary exhaustion. The variables of lactate concentration, the onset of blood lactate accumulation (OBLA), peripheral oxygen saturation (SpO2), heart rate (HR), and Borg scale were evaluated. It was verified after the comparison (HYPX vs. NORM) that stage 3 (p = 0.012, Cohen's d = 1.76) and stage 4 (p < 0.001; Cohen's d = 5.69) showed a reduction in lactate under the HYPX condition. OBLA under the HYPX condition was identified at a later stage than NORM. There were no differences in Borg scale, SpO2, and HR between the different conditions. It was concluded that the HYPX condition contributed to a reduction in lactate concentration and delayed OBLA in runners.

Use of Virtual Rehabilitation to Improve the Symmetry of Body Temperature, Balance, and Functionality of Patients with Stroke Sequelae.

BACKGROUND: Stroke rehabilitation that is based on the patients' needs, experiences, and priorities requires extensive knowledge and skills to capture and integrate the perspectives of the subject. PURPOSE: The objective of this study was to evaluate the acute effect of an occupational therapy protocol associated with virtual reality (VR) on the symmetry of body temperature (BTP), balance, and functionality of patients with stroke sequelae. METHODS: Ten patients (69.84 ± 7.55 years) diagnosed with stroke between 2 and 10 years earlier were evaluated during clinical care sessions integrated with VR games. Associated with games, all patients were stimulated to use both upper and lower limbs and distribute body weight symmetrically, and perceptual stimuli of body-half training, alignment, postural control, and balance were given. The variables of thermography (temperature [°C] and body asymmetry) of the upper and lower limbs, balance (Berg scale), and functionality were analyzed before and after the test. RESULTS: BTP was reduced in the 4 upper and lower limb body regions of interest: the right arm (p = 0.024, Cohen's d = 1.02), previous direct hand (p = 0.034, Cohen's d = 1.22), right back hand (p = 0.003, Cohen's d = 1.85) and Left (p = 0.013, Cohen's d = 0.92), right thigh (p = 0.035, Cohen's d = 1.32), and left thigh (p = 0.047, Cohen's d = 0.92). The mean of the bilateral asymmetry variation of the arm in the anterior position at the pre test was classified according to the level of attention monitoring (which means that the asymmetry rate is above normal), changing its state at the end of the intervention to normal. There was an increase in the functional independence score (p = 0.015, Cohen's d = 0.50) and in the static and dynamic balance function (p = 0.001, Cohen's d = 0.07). CONCLUSION: VR associated with occupational therapeutic planning can amplify and potentiate neurological recovery following stroke.