Design and development of RehabMarket: an inspiring interactive experience for motor and cognitive rehabilitation after stroke

Nowadays, there are many cases of people who have suffered a stroke and need rehabilitation to recover motor and cognitive functions. Thus, this project intended to develop a virtual reality (VR) activity that stimulates people who suffered a stroke to stimulate their physical and mental skills. Virtual Reality is an exciting tool to help in rehabilitation, mainly because it is a more fun and motivating way of exercising. This document introduces the steps towards designing, prototyping and testing the RehabMarket, a CAVE-based activity targeting stroke survivors that allows stimulating limbs’ movements while challenging their cognitive skills. The development of the RehabMarket began with a focus group session involving several participants. This session aimed at gathering feedback and insights to inform the design and development of the game. Once the game was fully developed, user testing was conducted with 11 participants to ensure that it successfully achieved its intended goals. Results have shown that RehabMarket was a very useful tool to help in rehabilitation of people who are recovering from stroke.Hoje em dia, há muitos casos de pessoas que sofreram um AVC e precisam de reabilitação para recuperar as funções motoras e cognitivas. Assim, com este projeto, pretendeu-se desenvolver uma atividade de realidade virtual (VR) que permita às pessoas que sofreram um AVC estimular as suas capacidades físicas e mentais. A Realidade Virtual é uma ferramenta muito interessante para ajudar na reabilitação, principalmente por ser uma forma mais divertida e motivadora de exercitar. Neste documento são apresentados os passos realizados para o design, prototipagem e avaliação do RehabMarket, uma atividade baseada em CAVE direcionada a sobreviventes de AVC que permite estimular os movimentos dos membros enquanto desafia as suas habilidades cognitivas. O desenvolvimento do RehabMarket começou com uma sessão de focus group, que envolveu vários participantes. O objetivo desta sessão foi recolher feedback e opiniões que pudessem informar o design e desenvolvimento do jogo. Uma vez que o jogo foi totalmente desenvolvido, foram realizados testes de utilizador com 11 participantes para garantir que o mesmo foi bem-sucedido em alcançar os objetivos pretendidos. Os resultados mostraram que o RehabMarket foi uma ferramenta muito útil para ajudar na reabilitação de pessoas que estão a recuperar de AVC

Development of a Virtual Reality Tool for Respiratory Rehabilitation

Respiratory rehabilitation plays an important role in the management of respiratory complications after spinal cord injury. Abundant evidence supports the need for respiratory rehabilitation as a treatment for respiratory insufficiency and many other breathing conditions, having a huge impact on the physical, mental, social and laboral capacity of each patient. An exhaustive analysis of current systems for respiratory rehabilitation led us to detect some gaps and needs related to that, such as the old-fashionism of devices and, in particular, their low engagement strength. This project introduces a novel, patient-specific and easy-to-use tool for respiratory rehabilitation. We developed a custom respiratory training application, called RespiTrainer, consisting of five entertaining 2D games which are successfully combined with an innovative airflow sensing approach based on a microphone. A total of twelve healthy volunteers participated in the validation of the solution, which consisted of conducting a first conventional inspiratory and expiratory respiratory training, followed by a session with RespiTrainer. Volunteers responded to two questionnaires regarding their experience and the usability of both systems. Results showed a significant increase in the system usability score (SUS) when using our custom application. Participants felt slightly more tired after training with RespiTrainer than with the conventional system (Borg scale). All subjects felt the game was significantly much more entertaining and motivating than conventional training. Hence, we gathered preliminary evidence as to the practicability and feasibility of this solution to conduct respiratory training and improve patient satisfaction and further adherence

Functional Rehabilitation and Strength Training-Focused Interventions for an Achilles Tendon Rupture and Repair: A Case Report

Background and Purpose. Current literature identifies a lack of consensus regarding specific rehabilitation protocols following acute Achilles tendon ruptures. This case report highlights the rehabilitation of a patient following an Achilles rupture and surgical repair, who underwent a physical therapy treatment program, focusing on interventions to increase function, strength, and return to activity. Description. The patient is a 64-year-old male, evaluated in the clinic four weeks following a status-post left Achilles tendon repair surgery, and presented with left ankle pain, decreased left ankle range of motion and decreased left ankle strength. The treatments and interventions used for this patient included Blood Flow Restriction training, interferential current electrical stimulation, ASTYM, and therapeutic exercise. Outcomes. Following 9 weeks of Physical Therapy intervention, with five weeks devoted to Blood Flow Restriction and functional strength training, the patient demonstrated gaining 85% improvement in their ankle active range of motion, normal to good ankle strength, and decreased ankle pain. Patient was returning to prior level of function and performing activities such as hiking, golfing, and playing backyard football with the grandkids. Discussion. Based on the results of this case, incorporating tourniquet-assisted blood flow restriction with functional rehabilitation programs may be a safe and effective protocol component to improve strength, endurance, and overall function after an Achilles tendon ruptur

HUVI: una aplicación de realidad virtual para acercar el patrimonio argentino

En este artículo se presenta HUVI (Huellas Virtuales), una aplicación móvil con realidad virtual para acercar el patrimonio argentino a personas en situación de vulnerabilidad social. En particular HUVI se ha orientado específicamente a niño/as, a partir del diseño de su interfaz y el tipo de desafíos que se presentan, que buscan proponer una dinámica lúdica y de aprendizaje para este grupo destinatario.Red de Universidades con Carreras en Informátic

Evidence-Based Practice in Knee Osteoarthritis: A Clinical Practice Guideline Proposal for the Portuguese Physical Therapists Context

Uma prática baseada na evidência ajuda a garantir que os pacientes recebem as melhores intervenções para a sua condição. No entanto, nem sempre os pacientes são tratados segundo os conceitos da prática baseada na evidência. Um dos facilitadores para ultrapassar as barreiras relacionadas com a prática baseada na evidência são as clinical practice guidelines (em português, normas de orientação clínicas). As clinical practice guidelines ajudam os clínicos na toma de decisões, fornecendo recomendações/algoritmos para a gestão das condições dos seus pacientes. Apesar da sua importância, não foi encontrado nenhuma clinical practice guideline portuguesa para uma das patologias mais comuns na sociedade: osteoartrose do joelho. Então, o objetivo desta tese é criar uma clinical practice guideline para fisioterapeutas portugueses no tratamento de pacientes com osteoartrose do joelho. Para isso, a tese foi guiada segundo o "modelo Escandinavo" onde foram criados diferentes estudos para responder ao objetivo, nomeadamente: revisão chapéu; revisão sistemática com meta-análise; tradução e validação de um questionário; dois estudos com a implementação de um questionário e a utilização de entrevistas semiestruturadas. Conclui-se que, para o contexto português, as intervenções nível 1 são: Nutrição/Perda de peso; Educação/Autocuidado; e Exercícios Resistidos. Se houver necessidade, a estas intervenções pode ser adicionado: Exercícios em Meio Aquático; Terapia Manual; e/ou Alongamentos. Na falência destas intervenções, pode-se utilizar as intervenções do nível 2: Exercícios Aeróbios; Exercícios de Equilíbrio; Termoterapia; e/ou Auxiliares de Marcha. Quando estas intervenções também não respondem às necessidades do paciente, pode-se adicionar as intervenções nível 3: Eletroterapia; Kinesio Tape; e/ou Ultrassom. Adicionalmente, os fisioterapeutas portugueses reconhecem a importância de uma prática baseada na evidência e, sempre que possível, utilizam clinical practice guidelines na sua prática clínica diária. PALAVRAS-CHAVE: OSTEOARTROSE DO JOELHO; INTERVENÇÕES DE FISIOTERAPIA; TRATAMENTOS NÃO-FARMACÓGICOS; TRATAMENTOS NÃO-CIRÚRGICOS; NÍVEIS DE INTERVENÇÃO.An evidence-based practice helps to ensure that patients receive the best interventions for their condition. However, patients are not always treated according to evidence-based practice concepts. One of the facilitators to overcome the barriers related to evidence-based practice are the clinical practice guidelines. Clinical practice guidelines help clinicians make clinical decisions, by providing recommendations/algorithms for managing their patients. Despite its importance, no Portuguese clinical practice guideline was found for one of the most common pathologies in the society: knee osteoarthritis. Therefore, the purpose of this thesis is to create a clinical practice guideline for Portuguese physical therapists to manage knee osteoarthritis patients. Thus, this thesis was guided according to the "Scandinavian model", where different studies performed according to the objective, such as: umbrella review; systematic review and meta-analysis; questionnaire translation and validation; two studies with the implementation of a questionnaire and the use of semi-structured interviews. It could be concluded that, for the Portuguese context, the "core" interventions are Nutrition/Weight Loss, Self-Care/Education and Resistance Exercises. If necessary, the following interventions can be added: Aquatic Exercises; Manual Therapy; and/or Stretching. When these interventions fail, the "silver" interventions that can be used are: Aerobic Exercises; Balance Exercises; Thermotherapy; and/or Walking Aids. When these interventions do not respond to the patient's needs neither, "bronze" interventions can be added, namely: Electrotherapy; Kinesio Tape; and/or Ultrasound. Additionally, it was found that Portuguese physical therapists recognize the importance of an evidence-based practice and, whenever possible, use clinical practice guidelines in their daily clinical practice

Physical Therapy Following Shoulder Rotator Cuff Repair

ABSTRACT Introduction Rotator cuff (RC) tears are one of the common causes of pain and disability in the upper extremity. Currently there are no fixed guidelines for choosing testing positions for shoulder range of motion measurement. Optimal rehabilitation following RC repair is yet to be defined. Purpose and Method The purpose was to inform about postoperative Physical therapy following rotator cuff repair, with the following objectives: To systematically review the content of clinical research, which addresses various physical therapy programs. To describe validity and responsiveness of different testing positions for goniometric measurement of shoulder active external rotation. To pilot test study procedures and estimating effects of a land-based and an aquatic exercise program. Results Fourteen studies were included in the systematic review. ROM measurements in sitting and supine positions correlated moderately (r= 0.40 - 0.53). The sitting position showed greater sensitivity to change with estimates of standardized response mean (SRM) and effect size (ES) (SRM: 0.66, 1.05 and ES: 0.50, 1.02) as compared to the supine position (SRM: 0.39, 0.74 and ES: 0.37, 0.76) at 3 and 12 months postoperatively, respectively. A total of 12 patients with a 67% recruitment rate, participated. Clinic visit adherence was 95%. No one was lost to follow-up. Both land-based and land plus aquatic exercise groups showed improved flexion AROM over time (Mean change= 21°, Standard Deviation (SD)= 25° and Mean change= 22°, SD= 33° respectively). For future studies, for having 80% power (α= 0.05, β= 0.20), and to detect 20% between-group difference, a total of 33 patients per group would be needed. Conclusions The systematic review found that exercise therapy including adjunctive interventions has small to moderate effect. 29% of the patients could not undergo active shoulder external rotation testing in supine, all patients could be tested in sitting. The sitting position has higher responsiveness than the supine position. Both land-based and aquatic exercise programs are shown to be feasible. To achieve power, we recommend future studies with larger sample size. Keywords Physical therapy, rotator cuff tear, land-based exercises, aquatic exercises, systematic review, pilot study

Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach

Background: Exergames can provide encouraging exercise options. Currently, there is limited evidence regarding home-based exergaming in the postoperative phase of total knee replacement (TKR).Objective: This study aimed to investigate the effects of a 4-month postoperative home-based exergame intervention with an 8-month follow-up on physical function and symptoms among older persons undergoing TKR compared with home exercise using a standard protocol. In addition, a concurrent embedded design of a mixed methods study was used by including a qualitative component within a quantitative study of exergame effects.Methods: This was a dual-center, nonblinded, two-arm, parallel group randomized controlled trial with an embedded qualitative approach. This study aimed to recruit 100 patients who underwent their first unilateral TKR (aged 60-75 years). Participants were randomized to the exergame or standard home exercise arms. Participants followed a custom-made exergame program independently at their homes daily for 4 months. The primary outcomes at 4 months were function and pain related to the knee using the Oxford Knee Score questionnaire and mobility using the Timed Up and Go test. Other outcomes, in addition to physical function, symptoms, and disability, were game user experience, exercise adherence, physical activity, and satisfaction with the operated knee. Assessments were performed at the preoperative baseline and at 2, 4, and 12 months postoperatively. Exergame adherence was followed from game computers and using a structured diary. Self-reported standard exercise was followed for 4 months of intervention and physical activity was followed for 12 months using a structured diary. Qualitative data on patients' perspectives on rehabilitation and exergames were collected through laddering interviews at 4 and 12 months.Results: This study was funded in 2018. Data collection began in 2019 and was completed in January 2022. The COVID-19 pandemic caused an unavoidable situation in the study for recruitment, data collection, and statistical analysis. As of November 2020, a total of 52 participants had been enrolled in the study. Primary results are expected to be published by the end of 2022.Conclusions: Our study provides new knowledge on the effects of postoperative exergame intervention among older patients with TKR. In addition, this study provides a new understanding of gamified postoperative rehabilitation, home exercise adherence, physical function, and physical activity among older adults undergoing TKR.</p

An Experimental study to Compare the effect of Dynamic Muscular Stabilization Technique (DMST) and Yoga Therapy along with Moist Heat Therapy on health status and Pain in Postural Low Back Pain patients

The purpose of the study is to compare the effect of Dynamic Muscular Stabilization Technique and yoga therapy along with Moist heat therapy on health status and pain in postural low back pain patients. 30 subjects with chronic low back pain are selected for this study. Age group varies between 19-30 years and they are assessed and selected following inclusion and exclusion criteria. A clear explanation is given to every individual subject and those who are willing are selected and randomly assigned to two equal groups. Proper consent is obtained from all the participants. Group A subjects underwent Dynamic Muscular Stabilization Techniques along with Moist heat therapy. Group B subjects underwent yoga therapy along with Moist heat therapy. Following the 4 weeks of interventions, the outcomes of health status and pain is measured. Pain is measured by Visual Analogue Scale and Health status is measured by Short Form -36 Health Survey quality of life questionnaire. Student ‘t’ test was used to find the difference between the two groups. Based on this statistical analysis the Group A patients showed a marked improvement in health status and pain when compared to Group B patients. CONCLUSION: There is a significant improvement in health status in both the groups. There is a significant reduction of pain in both the groups. When compared with Group B, the Group A shows a marked improvement of health status when compared with group B, the Group A shows a marked reduction of pain. So, this study concludes that the Dynamic Muscular Stabilization Techniques along with moist heat therapy is very helpful in reducing postural low back pain than the Yoga therapy with Moist heat therapy