Evaluation instruments for physical therapy using virtual reality in stroke patients: a systematic review.

BACKGROUND: Physiotherapeutic rehabilitation is essential to improve functional mobility, muscular strength, balance and quality of life of stroke patients, but conventional techniques using repeated physical activities can soon become monotonous. The use of virtual reality (VR) in rehabilitation offers a possible alternative to the traditional methods of promoting improvements in muscle strength and balance. However, there is not yet consensus about which instruments should be used to assess the effectiveness of VR in stroke rehabilitation. OBJECTIVE: To conduct a systematic review to identify the types of evaluation tools used for different VR interventions to rehabilitate stroke patients, considering balance, strength, function, quality of life, cognition and motivation. DATA SOURCES: A comprehensive literature search using MEDLINE-PubMed, Web of Science, Scopus, Lilacs and IEEE Xplore was undertaken. STUDY SELECTION: Studies on stroke patients who had undergone VR therapy and an assessment of its effectiveness using evaluative instruments. STUDY APPRAISAL AND SYNTHESIS METHODS: Data were extracted by a single reviewer using standardised forms, and were checked by a second reviewer. The extracted information included study design, number of participants, type of stroke, items that were evaluated (balance, muscle strength, functional evaluation), console used, number of rehabilitation sessions, results and conclusions. RESULTS: In total, 1836 articles were identified; of these, 29 were included in this review after consideration of the inclusion and exclusion criteria. The selected articles rated one or more of the following factors: balance (n=12), grip strength (with or without devices for direct measurement) (n=8), functionality (n=12) and quality of life (n=12). LIMITATIONS: The full text of one article was not available, despite a request to the authors to send it via email. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: The Berg Balance Scale, the Fugl-Meyer Assessment and the Stroke Impact Scale were the instruments used most frequently to assess balance, function and quality of life, respectively, in stroke patients who underwent rehabilitation using VR. Systematic review registration PROSPERO number: 87546.

Influence of overweight on functional capacity of physically active older women / Influência do sobrepeso na capacidade funcional de mulheres idosas fisicamente ativas

Abstract Aging comprises a dynamic and progressive process, characterized by physiological and functional changes. Among these changes, increase in body fat is considered relevant, since it can leads to impaired physical fitness and augmented cardiometabolic risks. Considering this, the objective of this study was to evaluate the influence of overweight on functional capacity of physically active older women. A field survey was performed with 24 older women who practiced physical exercise. Participants were submitted to anamnesis, anthropometric measures (i.e., body mass and height); the Senior Fitness test; sit and reach flexibility test; and handgrip strength test. Pearson's correlation test and multivariate logistic regression were used to verify the association between overweight and functional capacity. It was observed that hip flexibility (R=-0.494, p=0.014) and flexibility of the lower limbs (i.e., sit and reach test) showed negative correlation with the body mass index (R=-0.446, p=0.02); and after the multivariate logistic regression, negative correlation of lower limbs flexibility (B=-0,035, p=0,014) and the body mass index was observed. Thus, higher the body mass index among participants, lower hip flexibility they presented.

Resumo O envelhecimento compreende um processo dinâmico e progressivo. Caracteriza-se por alterações fisiológicas e funcionais, sendo a modificação na composição corporal com o acréscimo de gordura corpórea considerada relevante, podendo ocasionar comprometimento da aptidão física e alterações cardiometabólicas. O objetivo deste estudo foi avaliar a influência do sobrepeso na capacidade funcional em idosas praticantes de exercício físico. Foi realizada uma pesquisa de campo correlacional com 24 idosas praticantes de exercício físico. Todas as idosas foram submetidas a anamnese, analise antropométrica com avaliação da massa corporal e estatura, capacidade funcional com a bateria de testes de Rikli e Jones (Sênior Fitness test), flexibilidade com o banco de Wells e força de prensão manual com o teste de preensão manual. Utilizou-se o teste de correlação de Pearson e a regressão logística multivariada pelo método Stepwise para verificar a associação entre sobrepeso e capacidade funcional. Observou-se que a flexibilidade de Quadril (R=-0,494, p=0,014) e a flexibilidade dos membros inferiores pelo banco de Wells (R=-0,446, p=0,02) apresentaram forte correlação negativa com o índice de massa corporal (IMC). Após a regressão logística multivariada, percebeu-se uma forte correlação negativa com a flexibilidade do quadril (B=-0,035, p=0,014). Assim, a flexibilidade do quadril entre as idosas ativas com sobrepeso reduziu com o aumento do IMC.