Objective: To test the effects of a virtual reality (VR) balance rehabilitation program in patients diagnosed with SCAs. Materials and methods: A prospective observational study was carried out with a cohort of 28 patients diagnosed with SCAs, including eight females and 20 males, 15–70 years of age (mean, 41.5 ± 16.9 years). Patients were submitted to otorhinolaryngological assessment to exclude any kind of middle ear impairments that may hinder exam results, and vestibular evaluation to verify the existence of vestibular disorders, kind and site of the lesion. The Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and 36-item Short-form Health Survey (SF-36) questionnaires were applied before and after VR rehabilitation. The criterion for significance in before versus after VR training comparisons was p < .05. Results: Regarding to baseline, the participants showed significant improvements posttraining in their DHI and BBS scores. These improvements were accompanied by improvements in perceived quality of life (QoL) as measured by the SF-36. There were significant improvements in balance and gait, fall frequency, and patients’ self-confidence. Conclusions: Showed consistent improvement postrehabilitation in their ability to play VR games (i.e. Soccer Heading, Tightrope, Table Tilt, and Ski Slalom). VR rehabilitation may be an effective SCA therapy. The breadth of improvements evidenced here should promote physical and psychological recovery, while fostering a better QoL.

Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95% CI −0.85; −0.17) first and (p = 0.002, 95% CI −0.88; −0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95% CI −0.85; −0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95% CI −12.5; −0.3) and ski slalom games (p = 0.005, 95% CI −34.8; −6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

Resumo:Contextualização: O edema em membros inferiores é um problema comum que pode ocorrer após cirurgia de abdominoplastia. A drenagem linfática manual (DLM) é uma técnica indicada para a redução do edema no pós-operatório, e tem demonstrado resultados satisfatórios. Objetivo: avaliar a eficácia da DLM na redução do edema de membros inferiores no pós-operatório de cirurgia de abdominoplastia, bem como na diminuição da dor. Métodos: estudo de caso com uma voluntária após abdominosplastia. Foram realizadas 20 sessões diárias de DLM, pré e pós-operatórias. A cada 5 sessões foram realizadas perimetrias dos membros inferiores e coletados dados com a Escala Visual Analógica da Dor. Resultados: Foi observado redução do edema a partir da segunda perimetria, e a diminuição da dor foi relatada a cada sessão de DLM. Conclusão: Neste estudo houve eficácia da DLM no pré e pós-operatório para a redução do edema de membros inferiores e alívio da dor no caso estudado.Abstract: Background: The swelling in the lower limbs is a common problem that can occur after abdominoplasty surgery. Manual lymphatic drainage (MLD) is a suitable technique for reducing edema postoperatively, and has shown satisfactory results. Objective: To evaluate the efficacy of DLM in reducing lower extremity edema postoperative abdominoplasty surgery, as well as in reducing pain. Methods: : a case study with a volunteer after abdominoplasty. 20 daily sessions of DLM, pre and postoperative were performed. Every 5 sessions were held perimetry of the lower limbs and collected data with the Visual Analog Scale of Pain. Results: From the second perimety a reduction of swelling was observed, and after every MLD session, a reduction of pain was reported. Conclusion: In this study DLM pre-and postoperative was effective to reduce lower extremity edema and pain relief, for the case studied.

Background Neurodegenerative diseases are sporadic hereditary conditions characterized by progressive dysfunction of the nervous system. Among the symptoms, vestibulopathy is one of the causes of discomfort and a decrease in quality of life. Hereditary spastic paraplegia is a heterogeneous group of hereditary degenerative diseases involving the disorder of a single gene and is characterized by the progressive retrograde degeneration of fibers in the spinal cord. Objective To determine the benefits of vestibular rehabilitation involving virtual reality by comparing pre intervention and post intervention assessments in individuals with hereditary spastic paraplegia. Methods In this randomized controlled clinical trial from the Rebec platform RBR-3jmx67 in which allocation concealment was performed and the evaluators be blinded will be included. The participants will include 40 patients diagnosed with hereditary spastic paraplegia. The interventions will include vestibular rehabilitation with virtual reality using the Wii® console, Wii-Remote and Wii Balance Board (Nintendo), and the studies will include pre- and post intervention assessments. Group I will include twenty volunteers who performed balance games. Group II will include twenty volunteers who performed balance games and muscle strength games. The games lasted from 30 minutes to an hour, and the sessions were performed twice a week for 10 weeks (total: 20 sessions). Results This study provides a definitive assessment of the effectiveness of a virtual reality vestibular rehabilitation program in halting the progression of hereditary spastic paraplegia, and this treatment can be personalized and affordable. Conclusion The study will determine whether a vestibular rehabilitation program with the Nintendo Wii® involving virtual reality can reduce the progressive effect of hereditary spastic paraplegia and serve as an alternative treatment option that is accessible and inexpensive. Rebec platform trial: RBR-3JMX67.

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