BACKGROUND: Stroke is a major cause of motor disability in adults and needs interventions that contribute to motor recovery. OBJECTIVE: This study aimed to compare the immediate effect of the training with virtual reality game in stroke patients according side brain injury. METHODS:The participants included 20 patients (10 right brain injury), mean age of 50.6 ± 9.2 years, and 20 healthy subjects of 50.9 ± 8.8 years. All participants made a kinematic evaluation of drinking a cup of water before and after training with the table tennis game of the XBOX 360 Kinect ® , in two series of 10 tries of 45 s, with 15 minutes rest between them, a total of 30 minutes. Data were analyzed by ANOVA. RESULTS: There was a significant difference in the number of hits between patients and healthy subjects groups, in which patients had a lower performance in all the trials (p = 0.008). After the training, only patients with right brain injury improved their shoulder and elbow angles, approaching the left upper limb movement pattern of healthy subjects (p < 0.05). CONCLUSION: Patients with right brain injury responded better to the virtual reality game, suggesting introduction of new treatment techniques that promote neurorehabilitation.

The most common source of musculoskeletal algia is the myofascial pain syndrome (MPS), its occurrence is related to excessive involuntary muscle contraction and is characterized by hardened regions. Myofascial trigger points (MTP) are hypersensitive nodules that refer pain spontaneously or under mechanical stimuli, present in 37 % of men and 65 % women, and may be classified as: active, latent, satellite, central junction. Assuming this pathological situation affects high number individuals may cause functional impairment and compromised quality life realized the need enlarge and update searches about MTP physiology. This literature review was conducted in English, Portuguese, and Spanish articles, published since 2009 (trigger points, musculoskeletal pain, MPS) in electronic databases: Bireme, PEDro and Scielo, and a book 2007. There are four important assumptions about the pathogenesis and pathophysiology of MTP: muscle spindle, the neuropathic process, scar tissue and terminal buttons and dysfunctional energy crisis. Most studies have only two classifications for MTP: active and latent, and few describe in great detail about the possible hypotheses of the pathogenesis of these. Recent literature is sparse regarding the physiology and aetiology, however, recent studies have sought to understand the pathophysiology ensure that the hypothesis with the highest validity.

BACKGROUND: Functional autonomy and social inclusion are of key importance for stroke patient's rehabilitation. OBJECTIVE: To evaluate activity and participation of chronic stroke patients by means of basic (BADL), instrumental (IADL) and social (SADL) activities of daily living. METHODS: Forty individuals, 24 patients and 16 healthy individuals fill in a functional activities habits questionnaire. RESULTS: Regarding BADL, 25% of the patients did not get out of bed and 70.8% did not use toilet by themselves. Considering IADL, 29.2% of the patients did not dial the telephone, 70.8% did not wash dishes and clothes, 58.3% did not cook, 100% did not sew, 87.5% did not carry out repairs, 41.7% did not go to the bank, 54.2% did not shop and 45.8% did not write (all p < 0.05). Regarding SADL, 87.5% of the patients were not working professionally, 41.7% did not visit friends or relatives, 75% did not travel and go to the beach and 95.8% did not dance (all p < 0.05). CONCLUSIONS: Chronic stroke patients have limitations in activity and restrictions to participation, even after few years of stroke onset, particularly regarding applying knowledge, use of communication devices, domestic life, major life areas and community, social and civic life.

BACKGROUND: Several therapies are being used for the rehabilitation of stroke patients, such as Virtual Reality (VR) which has emerged as an interactive intervention to motivate and rehabilitate post-stroke patients. However, data comparison between the virtual and real environments is inconclusive. Thus, this study aimed to compare the kinematics and performance of the affected lower limb of post-stroke patients and healthy individuals during stationary walking activity between the real and virtual non-immersive environments. METHODS: A cross-sectional study was conducted with 10 stroke patients and 10 healthy individuals, matched for gender and age. The participants performed stationary walking in a real and non-immersive virtual environment (Wii Fit Plus® –Running mode) for 3 minutes in random order. The performance was measured in both environments using the number of steps, while the kinematics was assessed by calculating the mean maximum flexion and extension of each joint (hip, knee, and ankle) of the affected lower limb. RESULTS: Post-stroke patients performed a higher total number of steps (p = 0.042), mainly in the third minute (p = 0.011), less knee flexion (p = 0.001) and total knee range of motion (p = 0.001) in the virtual compared with the real environment. CONCLUSIONS: Post-stroke patients performed more steps, with a faster cadence and smaller knee range of motion on the affected side in non-immersive virtual environment compared with the real environment.

BACKGROUND: Activity levels and disturbances of the sleep-wake pattern affect health and quality of life and need to be further explored in patients with stroke. OBJECTIVE: To evaluate activity levels and their association with sleep-wake patterns in patients with stroke. METHODS: Ten adults with (51 ± 6 years) and 10 without stroke (52 ± 7 years) participated in the study; they were matched on age, sex and educational level. Neurological status, motor function, sleep quality, and activity levels were measured. The groups were compared using Student t-tests and the association between the measures was assessed using Pearson's correlation. RESULTS: Compared to people without stroke, those with stroke had worse sleep quality (p = 0.044), twice lower 24hactivity levels (p < 0.0001), higher interdaily stability and intradaily variability, lower activity during the most active 10 h and during the least active 5 h. Sleep quality was associated with activity level (r = -0.72) and with within-day activity variability (r = 0.53). CONCLUSIONS: Activity level and fragmentation are associated with sleep-wake patterns and sleep quality in patients with stroke.