Influence of game therapy on urinary incontinence patients: a systematic review

This study performed a systematic review of game therapy effects on urinary incontinence patients. Eleven databases (PubMed, SCOPUS, SciELO, LILACS, Web of Science, EMBASE, Cochrane library, LIVIVO, OpenGrey, OpenThesis, and OATD) were used as research sources. The search was conducted in January 2021 with the following keywords: urinary incontinence, urinary stress incontinence, pelvic floor muscle, pelvic floor training, virtual reality, game therapy, virtual reality exposure, and virtual reality therapy. The review included only clinical studies using game therapy for treating urinary incontinence in women without restrictions on language, year, and publication status. Only three studies fulfilled the eligibility criteria. The extracted data comprised sample characteristics (the number of patients in each study and average age) and treatment characteristics (game type, associated therapies, treatment duration, evaluated objectives, and result-measuring methods). The methodological quality of the articles showed a low risk of bias. One-hour pad test values decreased in all studies, and ICIQ-SF scores reduced in two articles. One study reported treatment adherence (92%), and another showed neuropsychological index improvements. The reduction of urinary symptoms was similar between the group associating game therapy with treatment and the group using only conventional pelvic floor muscle training. Game therapy, as a resource of pelvic floor muscle training, seems beneficial to urinary incontinence, including decreased urinary symptoms, lower one-hour pad test scores, and neuropsychological index improvements.

O modelo biopsicosocial na reabilitação por gameterapia na paralisia cerebral: revisão sistemática / The biopsychosocial model in gametherapy rehabilitation in cerebral palsy: systematic review

Objetivo: Investigar os efeitos das intervenções com uso de Realidade Virtual (RV) para crianças com Paralisia Cerebral (PC) baseando-se na estrutura da Classificação Internacional de Funcionalidade, Incapacidade de Saúde (CIF). Método: Trata-se de revisão sistemática de ensaios clínicos randomizados, realizada em julho de 2022. Foram investigadas intervenções relacionadas a fisioterapia associada aos jogos de RV para crianças com PC, idade de 6 a 12 anos nas bases de dados: PubMed, Cochrane, MedLine e PEDro. A qualidade metodológica foi avaliada pela Escala PEDro. Foram incluídos 9 estudos envolvendo total de 310 participantes, destes, 5 estavam inseridos em estrutura e funções do corpo, 9 artigos em atividade e nenhum estudo investigaram o componente participação ou fatores contextuais, sendo que alguns foram incluídos em mais do que um componente da CIF. Resultados: A função manual e o equilíbrio corporal foram os desfechos mais avaliados. Como limitação, destaca-se o pequeno número de estudos e a falta de dados sobre os componentes de participação e fatores contextuais. O ponto forte do estudo foi associar a CIF a uma categoria de reabilitação fisioterapêutica para esta população. Conclusão: Pesquisas experimentais recentes relacionadas ao uso da RV na fisioterapia de crianças com PC estão em sua maioria direcionadas ao componente de atividade da CIF. Mais estudos são necessários a fim de investigar se o aprendizado no ambiente terapêutico é transferido no contexto de vida desses indivíduos e se há impacto na participação e funcionalidade. Número de registro na Prospero: CRD42021260011.

Objective: To investigate the effects of interventions using Virtual Reality (VR) for children with Cerebral Palsy (CP) based on the structure of the International Classification of Functioning, Health Disability (ICF). Method: This is a systematic review of randomized clinical trials, carried out in July 2022. Interventions related to physiotherapy associated with VR games for children with CP, aged 6 to 12 years, were investigated in the databases: PubMed, Cochrane, MedLine and PEDro. Methodological quality was assessed using the PEDro Scale. Nine studies were included involving a total of 310 participants, of which 5 were inserted in the structure and functions of the body, 9 articles in activity and no study investigated the participation component or contextual factors, and some were included in more than one component of the CIF. Results: Manual function and body balance were the most appreciated results. As a limitation, the small number of studies and the lack of data on participation components and contextual factors stand out. The strong point of the study was to associate an ICF with a physiotherapeutic rehabilitation category for this population. Conclusion: Recent experimental studies related to the use of VR in the physical therapy of children with CP are mostly focused on the activity component of the ICF. More studies are needed in order to investigate whether learning in the therapeutic environment is transferred in the context of these individuals' lives and whether there is an impact on participation and functionality. Prospero registration number: CRD42021260011

The use of serial casting in the treatment of children with cerebral palsy: a study protocol

Introduction: Cerebral Palsy (CP) is characterized by a disorder of posture and movement, commonly leading to disabling orthopedic alterations, including muscle shortening, especially in the lower limbs. Stretching methods, performed gradually, are necessary to delay the impairment in function from muscle shortening. The use of serial casting aims to promote proper alignment, and an ideal and stable support base, in addition to better bone and joint health, leading to better posture, mobility, muscle function, and, subsequently, increased fitness and health.Objective: evaluate range of motion, postural control, and motor performance in children with CP, using serial casting, as well as to measure its effect on fitness through the autonomic nervous system (ANS).Methods: Sixty children and adolescents with CP, of both sexes, 3 to 12 years of age, will be divided into three groups: Groups A, B, and C, with 20 individuals each. Group A will use serial casting, Group B will use the orthosis continuously (with removal only allowed for bathing), and Group C will use the orthosis in their daily routine. Range of motion of the ankle of first and second resistance levels (R1 and R2), gross motor function measure (GMFM), and balance (measured by BERG scale) will be used in the initial and final assessments, and after 6 months and one year of follow-up. Timed-up-and-go (TUG), load distribution (baropodometry), motor performance measured through a real basketball game and the virtual MoveHero game, analysis of body angulation with "mydartfish", and cardiac autonomic modulation through heart rate variability will be assessed in three different situations: barefoot, with orthosis, and with casting.Conclusion: Serial casting demonstrates the potential to produce positive results in the treatment of individuals with CP regarding better alignment, with consequent motor and autonomic improvement.

Long-term effects of virtual reality-based therapy in cardiovascular rehabilitation: A longitudinal study.

BACKGROUND: In Cardiovascular Rehabilitation (CR), patient adherence to the maintenance phase is a major challenge. Virtual reality-based therapy (VRBT) promotes acute hemodynamic and autonomic repercussions similar to traditional rehabilitation and can increase patient adherence to the program. However, it is unknown whether the combination of VRBT to a traditional CR manages to maintain or even improve clinical and autonomic variables in long term. OBJECTIVE: To analyze whether VRBT combination in a traditional CR can maintain or improve clinical and autonomic variables in cardiac patients in the maintenance phase of these programs. METHODS: Twenty-six volunteers (62.04 ± 12.22 years) were evaluated, who underwent an initial assessment and two other assessments (in the sixth and 12th week) of the following outcomes: systolic and diastolic blood pressure, respiratory rate, pulse saturation of oxygen, heart rate, perceived exertion, and cardiac autonomic modulation, using linear and non-linear heart rate variability methods. RESULTS: Except for the apparent lack of clinical significance observed in Shannon Entropy, LF (nu), and HF (nu), the combination of VRBT as routine in a traditional program did not cause significant changes in the analyzed variables. CONCLUSION: combination of VRBT was able to maintain the chronic hemodynamic and autonomic repercussions caused by traditional CR.

Imagem guiada para qualidade de vida de mulheres com câncer cervical: estudo quase experimental / Guided image for quality of life of women with cervical cancer: quasi-experimental study / Imagen guiada para la calidad de vida de mujeres con cáncer de cuello uterino: estudio cuasi-experimental

Introdução: As terapias mente-corpo, como o relaxamento com imagem guiada, que estão entre as principais práticas integrativas utilizadas por pacientes oncológicos, são essenciais para manter equilíbrio saudável entre a excitação simpática e parassimpática no cérebro. Objetivo: Avaliar o efeito do relaxamento por imagem guiada, com o uso da realidade virtual, na qualidade de vida relacionada à saúde de mulheres com câncer de colo uterino em tratamento concomitante com quimiorradioterapia. Materiais e Método: Estudo quase experimental, realizado em um hospital de referência em oncologia no Sul do Brasil, de outubro de 2019 a janeiro de 2021. Participaram 52 mulheres, divididas em dois grupos, experimental (intervenção relaxamento por imagem guiada com realidade virtual), e controle (rotina padrão). Utilizou-se para avaliação dos escores da qualidade de vida relacionada à saúde o instrumento Functional Assessmentof Cancer Therapy Cervix Cancer,aplicado antes, 14 dias após e, ao término do tratamento, em aproximadamente 35 dias. As análises foram realizadas pelo modelo linear generalizado misto, com a matriz de covariância autorregressiva de ordem 1, e a significância foi confirmada pelo teste de Sidak. Resultados: Houve diferença estatisticamente significativa para o grupo experimental nos domínios físico (p=0,02), funcional (p=0,00), sintomas específicos do câncer de colo de útero e efeitos do tratamento (p=0,03) e qualidade de vida global (p=0,02). Conclusão: O relaxamento por Imagem Guiada contribuiu na melhora na Qualidade de Vida Relacionada à Saúde das pacientes com câncer de colo do útero, durante o tratamento com quimiorradiação.

Introduction: Mind-body therapies, such as guided imagery relaxation, which are among the main integrative practices used by cancer patients, are essential for maintaining a healthy balance between sympathetic and parasympathetic arousal in the brain. Objective: To evaluate the effect of guided image relaxation, with the use of virtual reality, on the health-related quality of life of women with cervical cancer undergoing concomitant treatment with chemoradiotherapy. Materials and Method: A quasi-experimental study, carried out in an oncology referral hospital in southern Brazil, from October 2019 to January 2021. 52 women participated, divided into two groups, experimental (relaxation intervention guided by imagery with virtual reality), and control (default routine). The Functional instrument was used to assess health-related quality of life scores. Assessment of Cancer therapy cervix cancer, applied before, 14 days after and at the end of treatment, in approximately 35 days. The analyzes were performed using the mixed generalized linear model, with an autoregressive covariance matrix of order 1, and the significance was confirmed by the Sidak test. Results: There was a statistically significant difference for the experimental group in the physical (p =0.02), functional (p =0.00), specific symptoms of cervical cancer and treatment effects (p =0.03) and overall quality of life (p =0.02). Conclusion: Guided Image Relaxation contributed to an improvement in the Health-Related Quality of Life of patients with cervical cancer during treatment with chemoradiation.

Introducción: Las terapias de mente y cuerpo, como la relajación de imágenes guiadas, que se encuentran entre las principales prácticas integradoras utilizadas por los pacientes con cáncer, son esenciales para mantener un equilibrio saludable entre la activación simpática y parasimpática en el cerebro. Objetivo: Evaluar el efecto de la relajación de imagen guiada, con el uso de realidad virtual, sobre la calidad de vida relacionada con la salud de mujeres con cáncer de cuello uterino en tratamiento concomitante con quimiorradioterapia. Materiales y Método: Estudio cuasi-experimental, realizado en un hospital de referencia de oncología en el sur de Brasil, de octubre de 2019 a enero de 2021. Participaron 52 mujeres, divididas en dos grupos, experimental (intervención de relajación guiada por imaginería con realidad virtual), y control (rutina por defecto). El instrumento funcional se utilizó para evaluar las puntuaciones de calidad de vida relacionada con la salud. Evaluación de Cáncer terapia cuello uterino cáncer, aplicado antes, 14 días después y al final del tratamiento, en aproximadamente 35 días. Los análisis se realizaron utilizando el modelo lineal generalizado mixto, con una matriz de covarianza autorregresiva de orden 1, y la significación fue confirmada por la prueba de Sidak. Resultados: hubo una diferencia estadísticamente significativa para el grupo experimental en la calidad de vida física (p = 0,02), funcional (p = 0,00), síntomas específicos del cáncer de cuello uterino y efectos del tratamiento (p = 0,03) y en general (p = 0,02).). Conclusión: La Relajación por Imagen Guiada contribuyó a mejorar la Calidad de Vida Relacionada con la Salud de las pacientes con cáncer de cuello uterino durante el tratamiento con quimiorradioterapia.

Is There a Relation between Brain and Muscle Activity after Virtual Reality Training in Individuals with Stroke? A Cross-Sectional Study.

Objective-The aim was to verify the correlation between cerebral and muscular electrical activity in subjects trained in virtual reality after a stroke. Method-The trial design was a cross-sectional study. Fourteen volunteers who were diagnosed with a stroke participated in the study. The intervention protocol was to perform functional activity with an upper limb using virtual reality. The functional protocol consisted of four one-minute series with a two-minute interval between series in a single session. Results-We observed, at initial rest, a positive correlation between brachii biceps and the frontal canal medial region (F7/F8) (r = 0.59; p = 0.03) and frontal canal lateral region (F3/F4) (r = 0.71; p = 0.006). During the activity, we observed a positive correlation between the anterior deltoid and frontal anterior channel (AF3/AF4) (r = 0.73; p = 0.004). At final rest, we observed a positive correlation between the anterior deltoid and temporal region channel (T7/T8) (r = 0.70; p = 0.005). Conclusions-We conclude that there was no correlation between brain and muscle activity for the biceps brachii muscle in subjects trained with virtual reality. However, there was a positive correlation for the deltoid anterior muscle.

Perceptions and preferences of patients with cardiac conditions to the inclusion of virtual reality-based therapy with conventional cardiovascular rehabilitation: A qualitative study.

BACKGROUND: Virtual reality-based therapy (VRBT) has been recently used in rehabilitation programs, as it can improve patient's adherence to treatment. However, patients' acceptance of VRBT has been scarcely investigated. OBJECTIVE: To qualitatively analyze the perceptions and preferences of patients about the inclusion of VRBT to a conventional cardiovascular rehabilitation program (CRP). METHODS: Fifteen patients from a randomized clinical trial participated in focus groups for qualitative assessment. RESULTS: Patients demonstrated good acceptance and satisfaction of VRBT. Physical and psychosocial benefits were highlighted, and patients reported the perception of higher exercise intensity in VRBT then when doing conventional training. In addition, the frequency of VRBT (once a week), associated with conventional treatment was reported as satisfactory. Cognitive aspects that influenced participation to the new approach were also raised by study participants. CONCLUSION: Patients with cardiac conditions demonstrated satisfaction with the inclusion of VRBT in a conventional CRP, demonstrating that VRBT has the potential to be a new approach for this patient population, allowing training diversification. Benefits perceived by patients include physical, mental, and social aspects. TRIAL REGISTERED: NCT04336306 (https://clinicaltrials.gov/ct2/show/NCT04336306).

Comparação da resposta hemodinâmica entre terapia convencional e realidade virtual em pacientes com insuficiência cardíaca internados na unidade de emergência / Comparación de la respuesta hemodinámica entre la terapia convencional y la realidad virtual en pacientes con insuficiencia cardiaca ingresados en urgencias / Comparison of hemodynamic responses between conventional and virtual reality therapies in patients with heart failure admitted to an emergency room

RESUMO O objetivo deste estudo foi avaliar e comparar a resposta aguda de parâmetros hemodinâmicos de acordo com o uso de realidade virtual (RV) semi-imersiva e terapia convencional (TC) em indivíduos internados no serviço hospitalar de emergência por insuficiência cardíaca (IC). Trata-se de estudo de viabilidade com 11 indivíduos submetidos a sessões de terapia com e sem o uso da RV. Na TC, os participantes realizaram alongamentos, exercícios ativos ou ativo-assistidos e inspiração fracionada. Já na terapia com realidade virtual (TRV) utilizou-se os óculos VR box - virtual reality glasses aplicando VR relax associado à TC. Os parâmetros hemodinâmicos avaliados foram: frequência cardíaca, pressão arterial sistólica e diastólica e saturação de oxigênio. Para análise, foram utilizados os testes t de Student e de Mann-Whitney (p<0,05). Ao avaliar os parâmetros hemodinâmicos basal e final em ambos os grupos, não foi verificada diferença significativa entre os momentos (p>0,05). Com relação à comparação das variações absolutas entre a TC e a TRV, não foi observada diferença significativa entre as respostas hemodinâmicas (p>0,05). Os resultados demonstraram que a implementação da TRV e da TC promoveram alterações fisiológicas nas respostas dos parâmetros hemodinâmicos em indivíduos com IC hospitalizados em uma unidade de emergência, não havendo diferenças significativas entre as duas intervenções. O estudo sugere que a RV é um método hemodinamicamente seguro para aplicação em unidade de emergência.

RESUMEN El objetivo de este estudio fue evaluar y comparar la respuesta aguda de los parámetros hemodinámicos según el uso de realidad virtual (RV) semiinmersiva y terapia convencional (TC) en individuos ingresados por insuficiencia cardiaca (IC) en el servicio de urgencias de un hospital. Este es un estudio de factibilidad con la participación de 11 personas, quienes se sometieron a sesiones de terapia con el uso de RV y sin este. En la TC, los participantes realizaron estiramientos, ejercicios activos o activos-asistidos e inspiración fraccionada. En la terapia de realidad virtual (TRV), utilizaron gafas VR box virtual reality glasses aplicando realidad virtual VR relax asociada a la TC. Los parámetros hemodinámicos que se evaluaron fueron los siguientes: frecuencia cardiaca, presión arterial sistólica y diastólica, y saturación de oxígeno. El análisis de datos utilizó las pruebas t de Student y de Mann-Whitney (p<0,05). Al evaluar los parámetros hemodinámicos basales y finales en ambos grupos, se observó que no hubo diferencia significativa entre los momentos (p>0,05). En cuanto a la comparación de las variaciones absolutas entre TC y TRV, no se observó diferencia significativa entre las respuestas hemodinámicas (p>0,05). Los resultados mostraron que la implementación de la TRV y la TC posibilitó cambios fisiológicos en las respuestas de los parámetros hemodinámicos en individuos con IC hospitalizados en una unidad de urgencias, sin diferencias significativas entre las dos intervenciones. El estudio apunta que la RV es un método hemodinámico seguro para aplicarse en la unidad de urgencias.

ABSTRACT This study aimed to evaluate and to compare the acute response, due to semi-immersive virtual reality (VR) and conventional therapies (CT), of hemodynamic parameters in hospitalized individuals admitted to an emergency unity for heart failure (HF). This is a viability study with 11 individuals subjected to sessions with and without VR. At CT, stretching, active or active-assisted exercises, and fractional inspiration were performed. In VR therapy (VRT), VR box glasses were used to promote VR relaxation associated with CT. The hemodynamic parameters evaluated were heart rate, systolic and diastolic blood pressure, oxygen saturation, and double product. To analyze them, Student's t- and Mann Whitney tests were used (p<0.05). Comparing baseline and final evaluations showed no significant differences in the hemodynamic parameters of both groups (p>0.05). Comparing absolute variations between CT and VRT also produced no significant differences between hemodynamic responses (p>0.05). Results showed that administering VRT and CT promoted physiological changes in the responses of hemodynamic parameters in individuals with HF hospitalized in an emergency unit without significant differences between the two interventions. This study suggests that VRT is a hemodynamically safe method for treating patients in emergency units.

Comparison of acute response of cardiac autonomic modulation between virtual reality-based therapy and cardiovascular rehabilitation: a cluster-randomized crossover trial.

OBJECTIVE: To assess the acute response of cardiac autonomic modulation (ACAM) during and after a session of virtual reality-based therapy (VRBT) compared to a session of conventional cardiovascular rehabilitation (CR) and to evaluate the effects of 12 weeks of training on this response. METHODS: We assessed 28 volunteers (63.4 ± 12.5 years). The ACAM was judged by linear indexes of heart rate variability (HRV) in VRBT and CR sessions. Later, patients completed 12 weeks of VRBT+CR and the assessment was repeated at the 12th week. RESULTS: Throughout the 1st VRBT session vagal withdrawal occurred (RMSSD/HFnu); sympathetic nervous system stimulation (LFnu) and progressive decrease of global HRV (SDNN). During the recovery, the SDNN, HFnu, and LFnu improved from the 5thminute on both therapies. After 12 weeks, the LFnu, HFnu, and the LF/HF-ratio revealed no significant changes in Ex3-Ex4 equated to Rep during VRBT. In recovery, the HFnu and LFnu improved before the 5thminute on both therapies. CONCLUSIONS: ACAM during and after the VRBT was comparable to CR, yet, the extents were greater in the VRBT. After 12 weeks of VRBT training, the subjects adapted to the exercises from the 15thminute and exhibited faster recovery of HFnu and LFnu indexes compared to the 1st week.

Realidade virtual imersiva nos Cuidados Paliativos: perspectivas para a Reabilitação Total / Immersive virtual reality in Palliative Care: prospects for Total Rehabilitation

Resumo Introdução A Realidade Virtual se apresenta como ferramenta promissora para aprimoramento de tecnologias em saúde e potencialização de intervenções para a melhora da funcionalidade e qualidade de vida de pacientes e familiares que enfrentam doenças e/ou condições progressivas ameaçadoras da vida. Objetivo Este ensaio discute o papel promissor da Realidade Virtual Imersiva na reabilitação em Cuidados Paliativos e propõe o conceito de Reabilitação Total como possibilidade para ampliação da concepção de reabilitação atual. Método Apresentamos reflexões baseadas na teoria de Dor Total, própria dos Cuidados Paliativos, e a inserção das Novas Tecnologias na saúde, especialmente no âmbito da reabilitação, por meio de documentos baseados na linha reflexiva que os autores pretendem submeter à apreciação e ao debate público. Resultados É importante e promissor o papel da Realidade Virtual Imersiva em intervenções de saúde, bem como a proposta conceitual de ampliação do conceito e compreensão de Reabilitação, cunhando o termo Reabilitação Total. Além disso, fomentou-se o processo reflexivo de debate sobre as possibilidades terapêuticas e suas inovações. Conclusão A partir da Reabilitação Total, inovações relativas ao cuidado em saúde, sejam tecnológicas e/ou das práticas clínicas, podem ser aprimoradas e disponibilizadas através de intervenções em ambientes físicos e/ou virtuais, tendo como premissas para os processos de reabilitação a funcionalidade global e dignidade da pessoa humana, com ações que envolvam as dimensões física, social, psicológica e espiritual, tal como apresentado pelo conceito de Dor Total.

Abstract Introduction Virtual Reality presents itself as a promising tool for improving health technologies and enhancing interventions to improve the functionality and quality of life of patients and families facing progressive diseases and/or life-threatening conditions. Objective This essay discusses the promising role of Immersive Virtual Reality in Palliative Care rehabilitation and proposes the concept of Total Rehabilitation as a possibility to expand the current conception of rehabilitation. Method We present reflections based on the Total Pain theory, typical of Palliative Care, and the inclusion of New Technologies in health, especially in the field of rehabilitation, through documents based on the reflexive line that the authors intend to submit for consideration and public debate. Results The role of Immersive Virtual Reality in health interventions is important and promising, as well as the conceptual proposal for expanding the concept and understanding of Rehabilitation, coining the term Total Rehabilitation. In addition, the reflective process of debate on therapeutic possibilities and their innovations was fostered. Conclusion From Total Rehabilitation, innovations related to health care, whether technological and/or clinical practices, can be improved and made available through interventions in physical and/or virtual environments, having global functionality and human dignity as premises for rehabilitation processes, with actions that involve the physical, social, psychological and spiritual dimensions, as presented by the concept of Total Pain.

Guided imagery relaxation in quality of life of patients undergoing hematopoietic stem cell transplantation: a quasi-experiment.

OBJECTIVE: The aim of this study was to evaluate the effects of the relaxation technique with guided imagery by means of virtual reality on health-related quality of life in patients undergoing hematopoietic stem cell transplantation. METHODS: A quasi-experiment conducted in a Bone Marrow Transplantation Service of a public hospital in southern Brazil. From October 2019 to October 2020, forty-two adult participants who underwent transplantation were included, 35 in the intervention group and seven in the control group. A guided imagery intervention, with audio guiding the relaxation associated with nature images in 360º, was performed during the hospitalization period. Data were collected on the first day of hospitalization, on the transplantation day, during the neutropenia stage, and at pre-hospital discharge. The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) and Functional Assessment of Cancer Therapy-Neutropenia (FACT-N) were used to assess health-related quality of life, fatigue and neutropenia. Data were analyzed using the Generalized Linear Mixed Model for the evolution of the health-related quality of life assessments over time, considering the groups and stages. Pearson's correlation coefficient was adopted for the correlation analyses. RESULTS: Allogeneic transplantation was predominant: 28 (80%) in the intervention group and 5 (71.43%) in the control group. There were improvements in the health-related quality of life scores, although not significant. A significant difference was found among the stages (p <0.050) and a significant positive correlation (p <0.000) among the variables on general quality of life, additional concerns, fatigue and neutropenia in all stages. CONCLUSION: Patients undergoing hematopoietic stem cell transplantation suffer changes in their quality of life. Interventions based on integrative practices emerge as an option to minimize them. 
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Treinamento pliométrico e virtual para prevenção de lesões em mulheres jovens: uma abordagem qualitativa / Pliometric and virtual training for prevention of injury in young women: a qualitative approach

O objetivo do estudo foi explorar as opiniões das voluntárias de um protocolo de treinamento pliométrico associado a exercícios resistidos (TPER) e virtual (TV) para prevenção de lesões. Essa abordagem foi escolhida, pois as percepções dos pacientes em geral podem ser negligenciadas. A coleta de dados ocorreu com dois grupos focais (GFs), e para isso formalizou-se o convite a sete participantes de cada um deles que já houvessem finalizado o treinamento. Realizou-se um encontro, com duração média de 60 minutos para cada grupo de intervenção, e um moderador treinado o conduziu; as sessões foram gravadas em áudio e transcritas posteriormente para análise. As participantes relataram em ambos os treinos o aumento do condicionamento físico, resistência e força muscular. Concluiu-se que no TPER foi mais destacada a melhora do equilíbrio e estabilidade de membros inferiores, já no TV isso ocorreu em relação à concentração e à disposição para a rotina diária.

The aim of the study was to explore the opinions of the volunteers about the plyometric training protocol associated with resistance (PTRE) and virtual (VT) exercises for injury prevention. This approach was chosen considering that patients' perceptions in general could be neglected. Data collection took place with two Focus Groups (FGs) and to this end, an invitation was made to seven participants from both groups who had already completed the training. A meeting was held, with an average duration of 60 minutes for each intervention group, and a trained moderator conducted it; the sessions were recorded on audio and later transcribed for analysis. The participants reported the increase of physical conditioning, endurance and muscle strength in both training sessions. It was concluded that in PTRE, the issue of improved balance and stability of lower limbs was highlighted, while in VT the improvement of concentration and disposition for the daily routine.

Relaxamento com imagem guiada para pacientes com câncer de colo de útero em tratamento de radioquimioterapia: ensaio clínico randomizado / Image-guided relaxation for patients with cervical cancer undergoing radiochemotherapy: a randomized clinical trial

Resumo: As modalidades terapêuticas para o câncer do colo uterino podem ocasionar consequências negativas para as mulheres. As abordagens, mente- corpo, entre elas, a imagem guiada com relaxamento progressivo, podem minimizar, aliviar estas consequências, e proporcionar melhor qualidade de vida relacionada a saúde. O objetivo deste estudo foi avaliar se a técnica de relaxamento por imagem guiada, com o uso da realidade virtual, diminui as alterações na qualidade de vida relacionada à saúde, das pacientes com câncer de colo uterino, durante o tratamento concomitante com quimioradioterapia. Trata-se de um ensaio clínico randomizado, realizado em um serviço de radioterapia de um hospital público no sul do Brasil, no período de outubro de 2019 a janeiro de 2021, em que foram incluídas 52 mulheres, sendo 28 alocadas no grupo experimental e 24 no grupo controle. A técnica utilizada para grupo experimental foi relaxamento com imagem guiada e para o grupo controle o tratamento padrão. A randomização foi realizada com uso de envelopes, contendo as siglas (Grupo experimental) e GC (Grupo controle), após distribuídas as siglas nos envelopes, estes foram lacrados e numerados e entregues aleatoriamente para as participantes. Os dados da Qualidade de Vida Relacionada à Saúde foram coletados em ambos os grupos, com o questionário Functional Assessment of Cancer Therapy- Cervix Cancer; a ansiedade foi avaliada com o uso do Inventário de Ansiedade Traço- Estado. Os resultados mostraram média de idade foi de 41,1 anos no grupo controle e 48,4 anos para grupo experimental; faixa etária de 24 a 39 anos foi a mais frequente em ambos os grupos. O maior grau de escolaridade presente no grupo controle foi ensino médio com 14 (58,3%), no experimental 11 (39,2%) e a renda na faixa de 01 a 03salários-mínimos ($189,20), em ambos os grupos. O Carcinoma Espinocelular foi tipo histológico mais frequente nos grupos do estudo, com maior número de casos em estadiamento IIIC no grupo controle (20,8%) e IIIB (39,3%) no grupo experimental. Na avaliação da qualidade de vida relacionada à saúde dos domínios bem-estar físico, funcional, qualidade de vida geral e fatores relacionados, especificamente, a sintomatologia do câncer de colo uterino tiveram escores mais elevados no grupo experimental, e declínio no grupo controle. Observou-se um declínio nos níveis de ansiedade no grupo experimental e um aumento no grupo controle a partir da 2ª avaliação. A terapia de relaxamento por imagem guiada demonstrou forte redução da ansiedade e impacto positivo na qualidade de vida geral das pacientes deste estudo. É necessário compreender a necessidade de adotarmos intervenções, por meio de práticas integrativas complementares, visando melhorar os fatores que comprometem sua qualidade de vida destas pacientes.

Abstract: The therapeutic modalities about cervical cancer can cause negative consequences to women. The approaches, body-mind, among them, the guided image with progressive relaxing can minimalize these consequences and provide a better life quality, when related to health. The goal of this article was to evaluate if the guided image relaxing technique, using virtual reality, decreases the changes related to the patients with cervical cancer on health and quality of life, during the treatment with chemoradiotherapy. This study is about a randomized clinical trial, making a radiotherapy services from a public hospital in the south of Brazil, in the following period: October 2019 to January 2021, in which 52 women were included, 28 were allocated as an experimental group and 24 on the control group. The used technique with the experimental group was a relaxing with the use of guided images, and for the control group, the standard pattern was used. The randomization was made with the use of envelopes that contained the letters GE (experimental group) and GC (control group), after distributing the envelopes, they were sealed, numbered, and given randomly to the participants. The data about quality of life, related to health were collected in both groups, using the Functional Assessment of Cancer Therapy- Cervix Cancer questionnaire; anxiety was evaluated with the inventory anxiety traço-estado. The results had shown an age average about 41,1 years old in the control group and 24 to 39 as the average in both groups. The scholarity degree of the group was: high school 14 (58,3%), on the experimental 11 (39,2%) and the mensal income about 01 to 03 minimum wages ($189,20), in both groups. The squamous cell carcinoma was from the most common type in the study groups, with a higher number of staging cases IIIC in the control group (20,8%) and IIIB (39,9%) in the experimental group. In the quality of life related to health evaluation, the physical welfare, functional, general quality of life, and related factors, specifically, the cervical cancer symptomatology had a higher score in the experimental group and a lower score in the control group. It was noticed that the anxiety level went down in the experimental group and a growing on the second group, starting on the second evaluation. The relaxing therapy by guided images showed a strong anxiety reduction and a positive impact on the patient's general quality of life, for the ones who have participated in this study. It is necessary to understand the necessity about adopting interventions by the use of complemental integrative practices, aiming to make the patient's quality of life better.

Effect of sensorimotor rehabilitation based on an immersive virtual reality model on mental health.

The aim of this study was to determine the immersive virtual reality-based sensorimotor rehabilitation (IVR-SRB) effect on mental health (global mental health, depression, anxiety and well-being) in older adults. METHODS: This study was experimental, with a sample of 111 older adults (control-experimental), considering an application of IVR-SRB in four different virtual settings with exteroceptive synchronization, proprioceptive and vestibular stimuli, for 6 weeks. OUTCOME VARIABLES: symptoms associated with depression and anxiety; positive mental health (psychological well-being). A descriptive and inferential approach was used to analyze the data, and the ANCOVA test was used to compare the post-intervention groups, controlled by the baseline; In case of baseline moderation, a linear regression model was applied to identify the level of moderation and a region of significance analysis. RESULTS: An IVR-SRB positive net effect was found in the reduction of symptoms of global mental health (p < 0.0001) and depression (p < 0.0001), without baseline moderation. The anxiety scores showed moderation at the beginning (p < 0.0001; b = -0.53), identifying that the greater the presence of anxiety symptoms, the greater the effect of IVR-SRB in reducing these symptoms; its effect is present from scores of 2.9 (Goldberg-12). There were no changes in well-being. CONCLUSION: IVR-SRB is recognized as a great intervention tool among elderly population, showing its multidimensional approach capacity, properly responding to the reduction of symptoms associated with mental disorders.

Comparison Between Conventional Intervention and Non-immersive Virtual Reality in the Rehabilitation of Individuals in an Inpatient Unit for the Treatment of COVID-19: A Study Protocol for a Randomized Controlled Crossover Trial.

Background: The new human coronavirus that leads to COVID-19 (coronavirus disease 2019) has spread rapidly around the world and has a high degree of lethality. In more severe cases, patients remain hospitalized for several days under treatment of the health team. Thus, it is important to develop and use technologies with the aim to strengthen conventional therapy by encouraging movement, physical activity, and improving cardiorespiratory fitness for patients. In this sense, therapies for exposure to virtual reality (VR) are promising and have been shown to be an adequate and equivalent alternative to conventional exercise programs. Aim: This is a study protocol with the aim of comparing the conventional physical therapy intervention with the use of a non-immersive VR software during COVID-19 hospitalization. Methods: Fifty patients hospitalized with confirmed diagnosis of COVID-19 will be divided in two groups under physiotherapy treatment using conventional or VR intervention: Group A: participants with COVID-19 will start the first day of the protocol with VR tasks in the morning and then in the second period, in the afternoon, will perform the conventional exercises (n = 25) and Group B: participants with COVID-19 will start the first day with conventional exercises in the morning and in the second period, in the afternoon, will perform activity with VR (n = 25). All participants will be evaluated with different motor and physiologic scales before and after the treatment to measure improvements. Conclusion: Considering the importance of benefits from physical activity during hospitalization, VR software shows promise as a potential mechanism for improving physical activity. The results of this study may provide new insights into hospital rehabilitation. Trial Registration: ClinicalTrials.gov, identifier: NCT04537858. Registered on 01 September 2020.

Relaxamento com imagem guiada para qualidade de vida relacionada à saúde durante o transplante de células-tronco hematopoéticas / Image-guided relaxation for health-related quality of life during hematopoietic stem cell transplantation

A utilização do relaxamento com imagem guiada pode trazer benefícios ao paciente submetido ao transplante de células-tronco hematopoéticas ao possibilitar alívio de sintomas físicos e emocionais, influenciando na qualidade de vida relacionada à saúde. O objetivo deste estudo foi analisar as alterações nos domínios da qualidade de vida relacionada à saúde e variáveis fisiológicas de pacientes internados submetidos ao transplante de células-tronco hematopoéticas, que receberam a técnica de relaxamento com imagem guiada por realidade virtual. Trata-se de estudo quase-experimental, longitudinal, realizado em um Serviço de Transplante de Medula Óssea de hospital público no sul do Brasil. De outubro de 2019 a outubro de 2020, foram incluídos 42 participantes adultos submetidos ao transplante de células-tronco hematopoéticas, sendo alocados 35 no grupo intervenção e 7 no grupo controle em uma razão 5:1. Para o primeiro, foi utilizado como intervenção o relaxamento com imagem guiada por realidade virtual. Foram aferidas pressão arterial, frequências cardíaca e respiratória, saturação de oxigênio, temperatura e dor imediatamente antes e após a intervenção. A coleta de dados ocorreu em quatro momentos: internação (T1), dia zero (T2), fase de neutropenia (T3) e pré-alta hospitalar (T4). Para ambos os grupos foram aplicados questionários sociodemográfico e clínico e Functional Assessment of Cancer Therapy-Bone Marrow Transplantation, Functional Assessment of Chronic Illness Therapy-Fatigue e Functional Assessment of Cancer Therapy-Neutropenia para avaliação da qualidade de vida relacionada à saúde, foram avaliados também valores de hemograma e leucograma. Os resultados mostraram média geral de idade de 37,8 anos e faixa de renda de 1 a 3 salários mínimos, 21 (70%) participantes do grupo intervenção e cinco (71,43%) no controle. O transplante alogênico foi predominante, 28 (80%) no grupo intervenção e cinco (71,43%) no controle. As leucemias foram o diagnóstico mais frequente em ambos os grupos, 13 (34,14%) no grupo intervenção e três (42,86%) no controle. Não houve diferenças entre os grupos nas avaliações de qualidade de vida relacionada à saúde, contudo foi encontrada diferença significativa entre as etapas e correlação positiva significativa entre as variáveis qualidade de vida geral, preocupações adicionais, fadiga e neutropenia em todas as etapas para o grupo intervenção. Foram encontradas diferenças significativas entre as médias das aferições antes e depois em frequência cardíaca e respiratória, temperatura, saturação de oxigênio e pressão arterial no grupo intervenção. Houve semelhança no comportamento dos valores de hemograma, leucograma e no tempo para pega medular em ambos os grupos. A intervenção é, em geral, bem aceita e não foram encontradas evidências de eventos adversos relacionados à sua aplicação. Apesar de não ter sido verificada influência da imagem guiada na qualidade de vida relacionada à saúde neste estudo, as alterações nos dados vitais demonstraram eficácia para a indução de estado de relaxamento. Assim, o relaxamento com imagem guiada por realidade virtual pode ser utilizado com segurança promovendo efeitos benéficos em pacientes submetidos ao transplante de células-tronco hematopoéticas. Os resultados encontrados apontam para a necessidade de ampliação da oferta de práticas integrativas para esses pacientes em face do comprometimento observado na qualidade de vida relacionada à saúde.

The use of guided imagery relaxation can bring benefits to patients undergoing hematopoietic stem cell transplantation by providing relief from physical and emotional symptoms, influencing health-related quality of life. The aim of this study was to analyze changes in the domains of health-related quality of life, and physiological variables, of hospitalized patients who underwent hematopoietic stem cell transplantation and received the guided imagery relaxation by virtual reality technique. This is a quasi-experimental, longitudinal, study carried out in a Bone Marrow Transplantation Service at a public hospital in southern Brazil. From October 2019 to October 2020, 42 adult participants who underwent hematopoietic stem cell transplantation were included, allocated 35 in the intervention group and 7 in the control group, in a 5:1 ratio. For the former, guided imagery relaxation by virtual reality was used as intervention. Blood pressure, heart and respiratory rates, oxygen saturation, temperature and pain were measured immediately before and after the intervention. Data collection took place in four moments : hospitalization (T1), day zero (T2), neutropenia phase (T3) and pre-hospital discharge (T4). Sociodemographic and clinical questionnaires and Functional Assessment of Cancer Therapy-Bone Marrow Transplantation, Functional Assessment of Chronic Illness Therapy-Fatigue and Functional Assessment of Cancer Therapy-Neutropenia were applied to both groups to assess health-related quality of life, and hemogram and leukogram values were evaluated. The results show a general mean age of 37.8 years and an income range of 1 to 3 minimum wages, 21 (70%) participants in the intervention group and five (71.43%) in the control group. Allogeneic transplantation was predominant, 28 (80%) in the intervention group and five (71.43%) in the control group. Leukemias were the most frequent diagnosis in both groups, 13 (34.14%) in the intervention group and three (42.86%) in the control. There were no differences between groups in healthrelated quality of life assessments, however a significant difference was found between the stages and a significant positive correlation between the variables general quality of life, additional concerns, fatigue and neutropenia at all stages for the intervention group. Significant differences were found between the averages of the measurements before and after in heart and respiratory rate, temperature, oxygen saturation and blood pressure in the intervention group. There was a similarity in the behavior of the hemogram and leukogram values and time of engraftment in both groups. The intervention is, in general, well accepted and no evidence of adverse events related to its application has been found. Although there was no influence of the guided imagery on health-related quality of life in this study, changes in vital signs demonstrate efficacy for inducing a state of relaxation. Thus, guided imagery relaxation by virtual reality can be used safely promoting beneficial effects in patients undergoing hematopoietic stem cell transplantation. The results found point to the need to expand the offer of integrative practices for these patients in the face of the impairment observed in healthrelated quality of life.

A Randomized, Controlled, Crossover Trial of Virtual Reality in Maintenance Cardiovascular Rehabilitation in a Low-Resource Setting: Impact on Adherence, Motivation, and Engagement.

OBJECTIVE: The purpose of this study was to investigate the effects of adding virtual reality (VR) to maintenance cardiac rehabilitation (CR); it was hypothesized VR would increase adherence, motivation, and engagement. METHODS: This study was a randomized, 1:1 concealed-allocation, single-blinded, 2 parallel-arm, crossover trial. Blinded assessments were undertaken at baseline (midprogram), 12 weeks, and 24 weeks after baseline. The setting was a single CR program of unlimited duration in Brazil. Participants were patients with cardiovascular diseases or risk factors who had been in the program for 3 months or longer. The CR program consisted of 3 supervised exercise sessions per week. In the VR arm, participants had 1 VR session of the 3 per week during the initial 12 weeks of the trial; this was withdrawn the subsequent 12 weeks. Measures were program adherence (% of 3 sessions/week over 12 weeks, ascertained in all participants), motivation (Behavioral Regulation in Exercise Questionnaire 3), and engagement (User Engagement Scale, adapted; vigor, dedication, and absorption subscales); all 3 were primary outcomes. RESULTS: Sixty-one (83.6%) patients were randomly assigned (n = 30 to CR + VR); 54 (88.5%) were retained at 12 and 24 weeks. At baseline, participants had been in CR on average 7 years and had high engagement and motivation. CR + VR resulted in a significant increase in adherence at 12 weeks (baseline = 72.87%; 12 weeks = 82.80%), with significant reductions at 24 weeks when VR was withdrawn (65.48%); in the usual CR care arm, there were no changes over time. There was a significant effect for arm, with significantly higher adherence in the CR + VR arm than usual CR at 12 weeks (73.51%). Motivation decreased significantly from baseline to 12 weeks (4.32 [SD = 0.37] vs 4.02 [SD = 0.76]) and significantly increased from 12 to 24 weeks in the CR + VR arm (4.37 [SD = 0.36]). Absorption was significantly lower at 12 weeks in the CR + VR arm (6.79 [SD = 0.37] vs 6.20 [SD = 1.01]). CONCLUSION: Although VR increased program adherence, interspersing it with usual CR sessions actually decreased patient motivation and absorption. IMPACT: Supplementing a maintenance CR program with VR using "exergames" resulted in significantly greater adherence (8% increase or 3 of 36 sessions), and this was quite a robust effect given it was extinguished with the removal of VR. However, contrary to the hypotheses, offering 1 session of VR per week and 2 of usual CR exercise was related to lower motivation and absorption, which has implications for how clinicians design programs for this patient population.

Virtual reality exposure therapy for neuro-psychomotor recovery in adults: a systematic review.

OBJECTIVE: To analyse the virtual reality applications in the subjects' neuro-psychomotor functions rehabilitation with motor and/or neuropsychiatric impairment. METHODS: The search was carried out in nine databases (Scopus, PubMed, Web of Science, ScienceDirect, Cochrane Library, CINAHL, PsycINFO, LILACS, and SciELO), from December 2017 to March 2019. An additional manual search was performed, taking into consideration references of the included papers, through the same eligibility criteria. The methodological quality of the included papers was evaluated using the Physiotherapy Evidence Database (PEDro). RESULTS: One hundred and twenty-two papers were selected by the initial screening, but only 33 studies participated in the final inclusion in the study (11 clinical trials and 14 experimental studies). The data extracted were: the proposed objective, the sample population, the neurological condition treated, the VR modality used in the procedures and the study intervention period. CONCLUSIONS: Virtual reality supports the rehabilitation process of neuro-psychomotor functions, allowing potential gains in the patients' recovery. Therefore, its development facilitates its availability and access in the future.Implications for rehabilitationIt has minimal adverse effects during the virtual therapies performance, such as the presence of vertigo related to cybersickness conditions, suggesting virtual reality as a safe rehabilitation tool, compared to other therapies.Virtual reality use is useful and effective in helping the rehabilitation process of motor, cognitive and psychosocial functions.It plays a role as an adjunctive and complementary therapy in the neuro-psychomotor rehabilitation process to obtain a clinically significant result.

Virtual reality as complementary treatment in pain relief in burnt children / Realidad virtual como tratamiento complementario en alivio del dolor en niños quemados / Realidade virtual como tratamento complementar no alívio da dor em crianças queimadas

ABSTRACT Objective: to report the use of virtual reality and its effects on clinical parameters, pain and its consequences in the treatment of two burned children in a Burn Treatment Center in southern Brazil. Method: case report on the use of virtual reality in two burned children treated at a reference burn treatment center in southern Brazil. Data were collected from January to February 2017, using the variables: pain, distraction, clinical parameters (heart rate and oxygen saturation) and analgesic medications. The measurements were carried out in five occasions and the intervention was applied for three days. The reports and reactions of children, guardians and the nursing team were also registered. Results: the use of virtual reality during dressings reduced the pain between two to four points on the scale used; oxygen saturation remained between 96 and 98%; heart rate decreased after the intervention. The children reported having fun, less time thinking about pain and were more collaborative during the procedure. Conclusion: this technology is innovative in the treatment of burned children and proved to be effective for the analyzed variables. New clinical studies with a larger sample are needed in the Brazilian context to contribute to these findings.

RESUMEN Objetivo: informar el uso de la realidad virtual y sus efectos bajo parámetros clínicos, dolor y sus consecuencias en el tratamiento de dos niños quemados en un Centro de Tratamiento de Quemaduras en el sur de Brasil. Método: informe de caso sobre el uso de la realidad virtual en dos niños quemados tratados en un centro de tratamiento de quemaduras de referencia en el sur de Brasil. Los datos se recopilaron de enero a febrero de 2017, a partir de las variables: dolor, distracción, parámetros clínicos (frecuencia cardíaca y saturación de oxígeno) y medicamentos analgésicos. Las mediciones se llevaron a cabo en cinco momentos y la intervención se aplicó durante tres días. También se anotaron los informes y las reacciones de los niños, tutores y el equipo de enfermería. Resultados: el uso de la realidad virtual durante el vendaje redujo el dolor entre dos y cuatro puntos en la escala utilizada; la saturación de oxígeno se mantuvo entre 96 y 98%; la frecuencia cardíaca disminuyó después de la intervención. Los niños informaron que se divirtieron, menos tiempo pensando en el dolor y fueron más colaborativos durante el procedimiento. Conclusión: esta tecnología es innovadora en el tratamiento de niños quemados y demostró ser efectiva para las variables analizadas. Se necesitan nuevos estudios clínicos con una muestra más grande en el contexto brasileño para contribuir a estos hallazgos.

RESUMO Objetivo: relatar a utilização da realidade virtual e os seus efeitos sob parâmetros clínicos, dor e suas consequências no tratamento de duas crianças queimadas em um Centro de Tratamento de Queimados do Sul do Brasil. Método: relato de caso sobre a utilização da realidade virtual em duas crianças queimadas atendidas em um centro de tratamento de queimaduras de referência do sul do Brasil. Os dados foram coletados de janeiro a fevereiro de 2017, a partir das variáveis: dor, distração, parâmetros clínicos (frequência cardíaca e saturação de oxigênio) e medicamentos analgésicos. As medidas foram realizadas em cinco momentos e a intervenção foi aplicada durante três dias. Foram anotados, também, os relatos e as reações das crianças, dos responsáveis e da equipe de enfermagem. Resultados: o uso da realidade virtual durante o curativo diminuiu a dor entre dois a quatro pontos da escala utilizada; a saturação de oxigênio manteve-se entre 96 a 98%; a frequência cardíaca obteve redução após a intervenção. As crianças relataram diversão, menor tempo pensando na dor e foram mais colaborativas durante o procedimento. Conclusão: esta tecnologia é inovadora no tratamento de crianças queimadas e mostrou-se eficaz para as variáveis analisadas. Novos estudos clínicos com uma amostragem maior são necessários no contexto brasileiro para contribuir com esses achados.

Effects of exergames and resistance training on well-being in older adults: a randomized clinical tria / Efeitos dos exergames e treinamento contra resistência no bem-estar de adultos mais velhos: um ensaio clínico randomizado

OBJECTIVE: To analyze the effects of an exergame-based training compared to resistance training on the quality of life and symptoms of depression in older adults. METHODS: This was a two-arm, non-blinded, randomized clinical trial. Thirty-five participants (62.09 ± 7.11 years) were randomized either on the Exergame-based Training Group (n = 17) or the Resistance Training Group (n = 18). Sessions lasted 50 to 60 minutes, three times per week, for 13 weeks. For the Exergame-based Training Group, we used games that simulate sports and adventure activities through Xbox360 Kinect™. The Resistance Training Group performed ten exercises per session for upper and lower limbs using free weights and machines, following linear periodization and individualized loads. Quality of life and symptoms of depression were assessed using the World Health Organization Quality of Life assessment - an abbreviated version (WHOQOL-BREF) and the Geriatric Depression Scale, respectively. We performed a two-way analysis of variance (p < 0.05). RESULTS: Only time effects were identified for overall quality of life, general health, and symptoms of depression. After the intervention, overall quality of life score increased (3.82 ± 0.95 versus 4.18 ± 0.53, p = 0.05), whereas symptoms of depression decreased (3.35 ± 1.73 versus 2.59 ± 1.54, p = 0.02) in the Exergame-based Training Group, and the general health improved in the Resistance Training Group (3.78 ± 0.81 versus 4.11 ± 0.68, p = 0.05) compared with the baseline scores. CONCLUSION: Both training groups improved different aspects of quality of life. The Exergaming-based Training Group improved the overall perception, whereas the Resistance Training Group improved the general health-related perception. Participants in the Exergame-based Training Group also decreased the number of symptoms of depression.

OBJETIVO: Analisar os efeitos de um treinamento baseado em exergames comparado ao treinamento contra resistência na qualidade de vida e nos sintomas depressivos em adultos mais velhos. METODOLOGIA: Trata-se de um estudo clínico randomizado, com dois braços e não cego. Trinta e cinco participantes (62,09 ± 7,11 anos) foram randomizados para o Grupo de Treinamento com Exergames (n = 17) ou Treinamento de Resistência (n = 18). As sessões tiveram duração de 50 a 60 minutos, três vezes por semana, durante 13 semanas. Para o Grupo de Treinamento com Exergames, foram utilizados jogos que simulavam atividades esportivas e de aventura por meio do Xbox360 Kinect™. O Grupo de Treinamento contra Resistência realizou dez exercícios por sessão, para membros superiores e inferiores, utilizando pesos livres e máquinas, seguindo periodização linear e ajuste de carga individualizado. A qualidade de vida e os sintomas depressivos foram avaliados usando o instrumento de Qualidade de Vida da Organização Mundial da Saúde ­ versão abreviada (WHOQOL-BREF) e a Escala de Depressão Geriátrica, respectivamente. Foram realizadas análises de variância two-way (p ≤ 0,05). RESULTADOS: Apenas efeitos no tempo foram identificados para qualidade de vida geral, saúde geral e sintomas depressivos. Após a intervenção, o escore de qualidade de vida geral aumentou (3,82 ± 0,95 versus 4,18 ± 0,53, p = 0,05) e os sintomas depressivos diminuíram (3,35 ± 1,73 versus 2,59 ± 1,54, p = 0,02) no Grupo de Treinamento com Exergames, e a saúde geral melhorou no Grupo de Treinamento contra Resistência (3,78 ± 0,81 versus 4,11 ± 0,68, p = 0,05) quando comparados com os escores da linha de base. CONCLUSÃO: Ambos os grupos de treinamento melhoraram diferentes aspectos da qualidade de vida. O Grupo de Treinamento com Exergames melhorou a percepção geral, enquanto o Grupo de Treinamento contra Resistência apresentou melhorias na percepção geral relacionada à saúde. Os participantes do Grupo de Treinamento com Exergames também diminuíram o número de sintomas depressivos.