Home-based Virtual Reality Exercise Program During the Maintenance Stage of Cardiac Rehabilitation: A Randomized Controlled Trial

Abstract Background: Home-based virtual reality technology may become an alternative to cardiac rehabilitation. Objectives: To evaluate the effects of a specific, home-based exercise program, performed either through a virtual reality (Kinect) or a conventional format (booklet) in the maintenance stage of cardiac rehabilitation for six months on functional muscle strength of the lower limbs, physical activity and exercise tolerance. Methodology: This is a randomized clinical trial (ClinicalTrials.gov — NCT02753829) with individuals with coronary artery disease from a hospital in Porto, Portugal, randomly allocated to an experimental group "1" (EG1; n = 11), submitted to a virtual reality exercise program (Kinect); an experimental group "2" (EG2; n = 11), submitted to an exercise program described in a booklet (conventional format); or a control group (CG) (n=11), submitted to routine care. Parameters of functional muscle strength of the lower limbs (sit-to-stand test), physical activity (accelerometer) and exercise tolerance (stress test) were assessed and compared between the groups. Descriptive and inferential statistics were applied, with 95% with a significance level of 0.05. Results: Significant improvements in functional muscle strength of the lower limbs were observed in EG1 compared to EG2, at three months (19.5 ± 7.7 versus 11.9 ± 4.7, p = 0.042), and at six months (23.0 ± 7.7 versus 14.6 ± 4.6, p = 0.027) of intervention. Conclusions: The program did not demonstrate superior results, in relation to the control group and among the different formats, in physical activity and effort tolerance. In relation to the functional muscle strength of the lower limbs, the virtual reality format showed significantly better results when compared to the conventional format only.

Effect of capacitive radiofrequency on the dermis of the abdominal region.

The purpose of this study is to evaluate the effects of radiofrequency (RF) on sagging skin. This is a case series study with five volunteers who received a single application of capacitive RF (BTL-6000 TR-Therapy Pro®) in the right infraumbilical abdominal region, with epidermal temperature above 40°C, for 10 min (2 min per applicator area), and the skin of the contralateral region was used as control. After 30 days, on average, the skin of the abdominal region was collected for histological analysis and stained with hematoxylin and eosin, Picro-sirus, and Verhoff. The percentage of collagen and elastic fibers found was marked by the Image J®. The statistical analysis was performed in the SPSS program (version 20), with a significance level of 95%. This was registered with the ethics and research comitee of UFTM n 3.461.688 on Jul 12, 2019 and clinical trial registration n. NCT04182542, retrospectively registered. Morphometric analysis demonstrated a remodeling of collagen and elastic fibers on the side treated with RF; however, the morphometry for collagen showed no significant difference, with an average percentage of 60.94 ± 0.32 for the control side and 61.97 ± 2.80 for the treated with p=0.32. Similarly, elastic fibers also showed no significant difference between groups, with a mean percentage of 5.67 ± 2.70 for control and 6.21 ± 2.01 for treated with p=0.19. The RF with the parameters used in this study was able to cause morphological changes in collagen and elastic fibers of the abdominal region skin; however, it showed no change in the percentage of these fibers.

Ultraviolet A/blue light-emitting diode therapy for vulvovaginal candidiasis: a case presentation.

Vulvovaginal candidiasis (VVC) is a frequent infection of the female genitourinary tract. It is considered the second most common genital infection in women, after bacterial vaginosis. VVC is treated with oral or topical azole derivatives. However, these agents may lead to adverse reactions and their chronic use might lead to resistance to antifungal agents. Given that the ultraviolet A/blue light-emitting diode (LED) is an electromagnetic radiation source with antimicrobial properties, it is hypothesized that this resource may be a non-drug alternative to the treatment of vulvovaginitis. A technical/experimental safety test was conducted to characterize the light source spectrum and temperature generation of the device, followed by a pilot study in a 52-year-old patient with a clinical diagnosis of VVC confirmed by culture and examination of fresh vaginal samples, owing to the presence of lumpy vaginal discharge and a complaint of pruritus. The vulva and vagina were exposed to 401 ± 5 nm ultraviolet A/blue LED irradiation in a single session, divided into two applications. A reassessment was performed 21 days after the treatment. The light-emitting device had a visible spectrum, in the violet and blue ranges, and a maximum temperature increase of 7 °C. During the reassessment, the culture was found to be negative for fungus, and the signs and symptoms of the patient had disappeared. A light-emitting device with a spectrum in the range of 401 ± 5 nm could potentially be an alternative treatment modality for women with VVC, as it led to the resolution of clinical and microbiological problems in our patient.