Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. As a result of the rapid progression and severity of the disease, people with ALS experience loss of functionality and independence. Furthermore, it has already been described presence of autonomic dysfunction. Despite the increasing use of virtual reality (VR) in the treatment of different diseases, the use of virtual reality environment as an intervention program for ALS patients is innovative. The benefits and limitations have not yet been proven. Our objective was to evaluate the autonomic function of individuals with amyotrophic lateral sclerosis throughout the virtual reality task. The analysis of autonomic function was completed before, during, and after the virtual reality task using the upper limbs; also, all steps lasted ten minutes in a sitting position. Heart rate variability (HRV) was taken via the Polar® RS800CX cardiofrequencymeter. The following questionnaire was enforced: Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS) and Fatigue Severity Scale (FSS). Different types of HRV were revealed for the groups, indicating that the ALS group has reduced HRV, with most of the representative indices of the sympathetic nervous system. Besides, the physiological process of reducing parasympathetic activity from rest to VR activity (vagal withdrawal), with reduction in HF (ms2) and an increase in HR from rest to activity, and a further increase throughout recovery, with withdrawal of sympathetic nervous system, occurs just for the control group (CG), with no alterations between rest, activity, and recovery in individuals with ALS. We could conclude that patients with ALS have the reduction of HRV with the sympathetic predominance when equated to the healthy CG. Besides that, the ALS individuals have no capability to adapt the autonomic nervous system when likened to the CG during therapy based on VR and their recovery.

Purpose: To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP). Methods: Single-subject design, type A–B-follow-up, with four participants (P) with CP, 15–18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo® Wii games in six sessions (90 min) per week. Outcome variables were semi-static balance (Pressure Center Oscillation—PCO), gait speed (Ten Meter Walk Test at usual speed—TMWT-U; and fast speed—TMWT-F), mobility (Timed Up and Go test—TUG), endurance (sit-to-stand test 5 times—STS-5), and gross motor activity (Gross Motor Function Measure—GMFM). Results: Statistical improvements were observed in GMFM-D (P2–P3), TMWT-F (P2–P3–P4) and TMWT-U (P2), STS-5 (P3–P4), TUG (P3), and PCO (P2–P3), assessed by level, trend, latency, and visual inspection to analyze change. Conclusions: This study shows that a short-term intensive intervention using Nintendo® Wii-based games in adolescents, GMFCS level II, can be an effective therapy, leading to some recovery of functioning in these young people.

INTRODUCTION: Interventions in different joints may be necessary to correct crouch gait and others musculoskeletal changes that occur as time passes for Cerebral Palsy (CP) children. Multilevel surgery reduces the number of hospitalizations, contributes to the prevention of secondary disabilities, and improves ambulation ability of children with diplegia. OBJECTIVE: Document the changes in mobility outcomes of a bilateral CP child, type diplegia, child after lower limbs multilevel surgery in the Brazilian context MATERIAL AND METHODS: The participant was an eight-year-old girl, Gross Motor Function Classification System level III. The mother signed the informed consent form. The Gross Motor Function Measure–66 (GMFM-66) was performed one day before surgery and one, three, six and twelve months after surgery. To complete the child’s evolution records, additional information was obtained through the electronic system of the hospital. RESULTS: The GMFM-66 total score was: 49.6 pre-operative (CI95%: 47.3-51.9); 42.8 after one month (CI95%: 40.7-45.0); 49.9 after three months (CI95%: 47.6-52.1); 52.6 after six months (CI95%: 50.2-55.0) and 56.9 after one year (CI95%: 54.6-59.2), increasing after 6 months of surgery (*p<0.05). The participant presented satisfactory adherence to physiotherapy. CONCLUSION: This study describes the case of a Brazilian child with CP, using the public health system. The impact of multilevel surgery was predominant in mobility, with worsening of capacity soon after surgery and progressive improvement over the months. Factors that may have contributed to our results were adherence, frequency, contextual factors.

Introduction: Virtual reality (VR) is used nowadays as an assessment and intervention tool in rehabilitation. One of the capabilities that can be assessed through VR is coincident timing, a perceptual-motor ability to execute a motor response in synchrony with an external stimulus. Visually impaired (VI) people need this synchronization of movements with external objects in their daily and leisure activities. Objective: To investigate the performance of VI individuals in a VR coincident timing task. Methods: Quantitative cross-sectional study with an interventional, quasi-experimental, descriptive, and explanatory nature. Sixty individuals participated in this study: 20 VI, 20 blindfolded and 20 non-VI, over 18 years of age. A semi-structured interview and a virtual coincident timing task were used. Results: VI individuals started the task with the worst performance (Absolute error = group VI 945ms x blindfolded group 591ms x control group 557ms), but they improved throughout the task, as well as all groups, reducing the number of errors (mean absolute error= 698ms to 408ms). Furthermore, all groups increased task speed (mean variable error= last acquisition block 408ms x immediate transfer 227ms x late transfer 247ms). Conclusion: It is concluded that VI individuals can develop motor learning from tasks in VR, showing the importance of taking advantage of these technological advances in this area, not only as a facilitator of task execution, but also as an instrument that enable rehabilitation programs to ensure functional improvements for real everyday tasks.