This paper presents a wearable virtual reality system with a wireless network of inertial sensors for lower limb monitoring. The system comprises seven sensor nodes sending data wirelessly to a master node. The information is then collected, organized, and sent to a screening device via a serial interface. An application executed either on a smartphone or a personal computer features an avatar which represents the received data and mimics the sensed movements of the patient, providing online feedback during and after the execution of a therapy. The data resulting from the therapy execution can be uploaded to a web server to facilitate the assessment and decision-making by health professionals. A pendulum featuring a rotary optical encoder is used for sensor functional behavior validation.  In addition, the orientation angles measured by the proposed system are compared with respect to measurements from the motion analysis software Kinovea. The delay between the patient's body movement and the avatar is 33 ms, which is acceptable for visual feedback. This system is portable, inexpensive and enables a patient to complete physical therapy sessions at home or anywhere, with the advantage of enabling visual feedback through an avatar during rehabilitation therapy and allowing the reproduction of a therapy session for further analysis.

Introducción: El deporte paralímpico se originó como parte de procesos de rehabilitación para personas que tuvieran discapacidad. Durante la ejecución de las disciplinas paralímpicas el control motor en la región del tronco y en especial del abdomen es de gran importancia para prevenir lesiones y mejorar el registro de la marca deportiva. Son muchas las herramientas utilizadas por los entrenadores deportivos para mejorar la fuerza muscular y por consiguiente la estabilidad de tronco, buscando disminuir el riesgo en el ámbito deportivo. Sin embargo, las investigaciones sobre el uso de realidad virtual, junto con plataformas de estabilometría para el entrenamiento de deportistas paralímpicos con lesiones físicas, son escasos. Objetivo: Establecer el efecto de un programa de entrenamiento del tronco apoyado en realidad virtual en deportistas de alto rendimiento paralímpicos, lanzadores de bala y jabalina con lesiones físicas y que compiten en sillas de lanzamiento. Materiales y método: La investigación fue diseñada como un estudio cuasiexperimental intrasujeto. Se evaluaron cinco sujetos deportistas paralímpicos de alto rendimiento con discapacidad física. Se empleó un software de realidad virtual que incluye patrones y juegos lúdicos ajustables en tiempo e intensidad y una plataforma de bipedestación dinámico como parte del equipo de intervención, ajustable al paciente, que permite reeducar el equilibrio, la propiocepción, fortalecer y lograr el control del tronco. Las variables de análisis fueron el nivel del desplazamiento anteroposterior y lateral del tronco y los cambios en el volumen de acción. Se realizó una evaluación inicial, una intervención que duró de seis semanas y la evaluación final. Resultados: En las evaluaciones iniciales de todos los atletas se observó una tendencia al desplazamiento en sentido posterior. En la evaluación final, los rangos de desplazamiento aumentan en casi todos los sujetos con excepción del sujeto 5, cuyos valores permanecen casi estables tanto en las evaluaciones iniciales como las finales. La diferencia en el desplazamiento entre la prueba inicial y final en promedio de los participantes fue de 6.26 grados. Conclusiones: los resultados positivos del entrenamiento del tronco apoyado en realidad virtual para los participantes constituyen un aporte al conocimiento sobre el tema y abren la posibilidad de incluir esta tecnología en protocolos de entrenamiento en deporte paralímpico.

Background Neuropathic pain (NP) is one of the most frequent spinal cord injury (SCI) complications. Pain, quality of life, and functionality are associated and can lead to pain catastrophization. Pharmacological management of patients with NP secondary to SCI is widely known and there is increasing evidence in the area. Nevertheless, nonpharmacological management is not fully elucidated since its efficacy is inconclusive. Objective We hypothesize that (1) hydrotherapy is effective in reducing NP secondary to SCI. Additionally, our secondary hypotheses are that (2) hydrotherapy decreases the catastrophization of NP, and that (3) hydrotherapy improves life quality and minimizes the degree of disability, when compared to physical therapy. Methods A sample of approximately 20 participants will be randomly assigned to either the intervention (hydrotherapy) or control group (standard physical therapy). Both interventions will be administered twice a week over a 9-week period (18 sessions in total). Primary outcomes are changes in neuropathic pain perception and pain catastrophization. Secondary outcomes are changes in disability and quality of life scores. They will be assessed at baseline and follow-up at 4 weeks after discharge. Validated Spanish language scales that will be used are the following: Numerical Pain Rating Scale, Pain Catastrophization, Health-related Quality of life, and the World Health Organization’s Disability Assessment Schedule 2.0. Generalized mixed linear models will be used for comparing baseline and postintervention means of each group and their differences, together with 95% CIs and P values. A P value of less than .05 will be considered significant. Results Recruitment began in April 2019, and we recruited the last participants by December 2019, with 10 individuals assigned to hydrotherapy and 8 to physical therapy (control). Results from this study will be disseminated via scientific publication, in ClinicalTrials.gov, and in national and international conferences in the latter half of 2022. Conclusions This trial will explore the effects of hydrotherapy on neuropathic pain, together with functionality and quality of life, in patients with SCI. Furthermore, this study aims to evaluate these therapeutic modalities, including perception variables, and mental processes, which may affect the clinical condition and rehabilitation outcomes in these patients. Hydrotherapy is likely to be a safe, efficient, and cost-effective alternative to the current standard of care for NP secondary to SCI, with comparable results between the two. Trial Registration ClinicalTrials.gov NCT04164810; https://clinicaltrials.gov/ct2/show/NCT04164810 International Registered Report Identifier (IRRID) DERR1-10.2196/37255

BACKGROUND Neuropathic pain (NP) is one of the most frequent spinal cord injury (SCI) complications. Pain, quality of life, and functionality are associated and can lead to pain catastrophization. Pharmacological management of patients with NP secondary to SCI is widely known and there is increasing evidence in the area. Nevertheless, nonpharmacological management is not fully elucidated since its efficacy is inconclusive. OBJECTIVE We hypothesize that (1) hydrotherapy is effective in reducing NP secondary to SCI. Additionally, our secondary hypotheses are that (2) hydrotherapy decreases the catastrophization of NP, and that (3) hydrotherapy improves life quality and minimizes the degree of disability, when compared to physical therapy. METHODS A sample of approximately 20 participants will be randomly assigned to either the intervention (hydrotherapy) or control group (standard physical therapy). Both interventions will be administered twice a week over a 9-week period (18 sessions in total). Primary outcomes are changes in neuropathic pain perception and pain catastrophization. Secondary outcomes are changes in disability and quality of life scores. They will be assessed at baseline and follow-up at 4 weeks after discharge. Validated Spanish language scales that will be used are the following: Numerical Pain Rating Scale, Pain Catastrophization, Health-related Quality of life, and the World Health Organization’s Disability Assessment Schedule 2.0. Generalized mixed linear models will be used for comparing baseline and postintervention means of each group and their differences, together with 95% CIs and <i>P</i> values. A <i>P</i> value of less than .05 will be considered significant. RESULTS Recruitment began in April 2019, and we recruited the last participants by December 2019, with 10 individuals assigned to hydrotherapy and 8 to physical therapy (control). Results from this study will be disseminated via scientific publication, in ClinicalTrials.gov, and in national and international conferences in the latter half of 2022. CONCLUSIONS This trial will explore the effects of hydrotherapy on neuropathic pain, together with functionality and quality of life, in patients with SCI. Furthermore, this study aims to evaluate these therapeutic modalities, including perception variables, and mental processes, which may affect the clinical condition and rehabilitation outcomes in these patients. Hydrotherapy is likely to be a safe, efficient, and cost-effective alternative to the current standard of care for NP secondary to SCI, with comparable results between the two. CLINICALTRIAL ClinicalTrials.gov NCT04164810; https://clinicaltrials.gov/ct2/show/NCT04164810 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/37255