ABSTRACT
INTRODUCTION: In recent years, the rehabilitation of children with neurological disorders has taken into account the possibility of using videogaming consoles and virtual reality systems to make children's therapy more enjoyable, motivating, participated and effective. This study aims at conducting a systematic review about the use and the efficacy of digital games in pediatric neurorehabilitation. EVIDENCE ACQUISITION: In accordance with the PRISMA approach, a rather wide-ranging search was conducted on PubMed, Scopus, and Web of Science databases by using different combinations of keywords based on MeSH terms. EVIDENCE SYNTHESIS: Fifty-five papers have been included into this review, namely, 38 original studies and 17 reviews. The total number of children and adolescents is 573, with 58% of them being affected by cerebral palsy. Despite a wide variability in the adopted protocols, devices, assessment tools, and a more frequent focus on motor aspects than on cognitive ones, the results of the majority of the analyzed studies support the safety (i.e., absence of severe adverse effects) and efficacy of the videogame-based therapy. CONCLUSIONS: Videogames, when administered by means of commercial consoles or ad-hoc digital systems, seem to be a valid support for physical therapy. Further researchers are needed to deeply investigate the role of this approach in cognitive therapy and cognitive outcomes.
ABSTRACT
BACKGROUND: Rare diseases, because of their intrinsic characteristics - large number of disorders and syndromes, low individual prevalence, severity, often limited information, lack of therapies - can benefit from collaboration and sharing of expertise while maximising the limited resources available for these conditions. Therefore, the development of Centres of Expertise (CEs) and European Reference Networks (ERNs) in this field is crucial.The European Union Committee of Experts on Rare Diseases (EUCERD) has been charged to assist the European Commission with the preparation and implementation of activities in the field of rare diseases in Europe. In particular, EUCERD has assisted the EC in drawing up the recommendations issued in the Commission Communication and in the Council Recommendation. In this paper the authors focus on the EUCERD Recommendations on CEs and one on ERNs. MATERIALS AND METHODS: Recommendations on CEs and ERNs are the result of two different processes, developed through iterative reviews and discussions at workshops and EUCERD meetings, and according to the European Union documents. RESULTS: EUCERD has issued two complementary Recommendations, one on CEs (2011) and a second on ERNs (2013). Both address multiple targets (from Member States to Centres, and patient organisations), with the objective of helping them define and organise CEs and ERNs. CONCLUSIONS: The establishment, designation, financial support, and evaluation of CEs throughout Europe allow RD patients and local health care providers to identify high-quality specialised services that can simplify disease management and improve patients' care. The EUCERD Recommendations are useful instruments to help and guide stakeholders in the development of CEs and ERNs and thus ensure equity of access to services and care for rare diseases patients across Europe.
