Hemiparesis resulting from a stroke has a direct impact on patients’ daily activities. New approaches for motor rehabilitation include Serious Games (SG) because they include (in a motivating way) the three fundamental elements for rehabilitation: intensive, repetitive and task-oriented training. This study aims to evaluate the therapeutic effects of a biomedical SG and a scoring system developed for lower limb motor rehabilitation of hemiparetic stroke patients. The SG was inspired by the classic videogame called Pong, where the goal is to control a tennis racquet, but using muscular strength. A knee extensor apparatus was adapted with a load cell and mechanical adjustments for measuring the muscular strength of the quadriceps femoris (QFG) and hamstrings (HSG). A scoring system was proposed to evaluate muscular control. Eleven hemiparetic stroke patients participated in an exercise program using the SG twice a week for ten weeks and only the paretic side was trained. Significant Effect Sizes (d) were found for QFG strength (d=0.5; p=0.021), QFG control (d=1.1; p<0.001), HSG strength (d=1.1; p=0.001), HSG control (d=1.5; p=0.003), functional mobility (d=0.3; p<0.001), gait speed (d=0.4; p=0.007) and motor recovery (d=1.0; p<0.001). Results indicate that the intervention of a SG with both proper apparatus and evaluation system may effectively promote lower limb motor rehabilitation of hemiparetic stroke patients.

Hemiparetic stroke patients can have several muscular and postural disorders which compromise their balance. Serious Games (SG) emerged as a new approach to enhance conventional treatment by making it a motivating method to meet individual needs. This paper evaluated the therapeutic effects of a biomedical SG system developed for balance evaluation and training of hemiparetic stroke patients. The system consists of a balance board with inertial sensors and a computer system that runs the game. A novel scoring system for balance evaluation which extracts metric information regarding patients’ performance while gaming was proposed. A quasi-experimental study was performed with six hemiparetic patients in an exercise program using the SG twice per week for 10 weeks. Twelve healthy subjects were recruited for determining the baseline score for balance by using the proposed system. Significant Effect Sizes (ES) were observed for dynamic balance (ES=0.9), functional mobility (ES=0.4) and center of pressure displacement of the balance board (ES=1.9). Significant correlations between game scores and clinical scales suggest that the use of the scoring system for balance evaluation is feasible. The results of this study support the clinical potential of a biomedical SG for balance rehabilitation of hemiparetic stroke patients.

Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Results Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). Conclusion A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.

Introduction: Hemiparesis post-stroke usually results in locomotor limitations. As conventional rehabilitation is monotonous, the Serious Games (SG) represents an excellent treatment strategy, allowing to perform physical training in an interesting and enjoyable way. Objective: To evaluate the effects of an exercise program using the SG developed for hemiparetic stroke patients’ locomotor rehabilitation. Method: Non-Randomized Controlled Clinical Trial. Twenty-four hemiparetic stroke patients with subacute or chronic stroke (twelve men), mean age of 57.8 ± 10.4 years (injury time of 16.8 ± 19.6 months) participated in the study. The experimental group (n = 16) participated in an exercise program with the SG for lower limb rehabilitation. The control group (n = 8) received conventional treatment (kinesiotherapy). The intervention consisted of sessions twice a week for ten weeks. The following parameters were assessed: muscle strength (dynamometry), spasticity (Modified Ashworth Scale), functional mobility (Timed Up and Go Test - TUGT), and the gait speed (GS). Results: Both groups showed improvements, but the experimental group was better in all the studied variables, the muscular strength of the lower limb paresis and of the quadriceps femoris (p = 0.002; d = 0.7); and for the hamstrings (p < 0.001; d = 1.3), TUGT (p < 0.001; d = 0.4), and GS (p = 0.001; d = 0.4). Conclusion: The exercise program with the SG was useful for the patients treated in this study. The results showed a superiority of the SG regarding the conventional treatment in all the controlled variables. This was probably because of the greater repeatability of the exercises and the increased attention and motivation.

O envelhecimento traz modificações na composição corporal do idoso, caracterizadas pela redução da massa muscular e densidade óssea, aumento da redistribuição de gordura corporal, e diminuição de massa corporal. Essas alterações estão associadas à falta de hábitos saudáveis, como exercício físico regular e boa alimentação, podendo levar a um provável diagnóstico de Sarcopenia. Objetivo: Observar a relação da idade e composição corporal de idosas comunitárias ativas e institucionalizadas com os critérios diagnósticos da Sarcopenia. Método: Foram selecionadas 132 idosas, com idade ≥70 anos, sem traços demenciais e/ou depressivos. Após a determinação do índice de massa corporal (IMC) foram classificadas em três grupos (n= 13 com baixo peso 27 kg/m²). Foram avaliados ainda, o índice de massa muscular total (IMMT) por equação preditiva, e a força de preensão manual (FPM) por dinamometria. Resultados: Foi observado que com o avançar da idade ocorre redução do IMC, assim como diminuição do IMMT e FPM no grupo baixo peso. Também houve uma correlação positiva muito forte entre o IMC e o IMMT no sobrepeso, mostrando que quanto maior o IMC, maior será o IMMT. Conclusão: Idade e IMC estão relacionados com os critérios diagnósticos da Sarcopenia. Assim, é de extrema importância a avaliação minuciosa da composição corporal, estado nutricional e da força muscular em idosos.

A hemiparesia é o quadro clínico típico do Acidente Vascular Cerebral (AVC), resultando em importantes perdas funcionais que comprometem a qualidade de vida (QV) dos pacientes. Embora a fisioterapia convencional seja benéfica na reabilitação, existem algumas limitações. Jogos Sérios (JS) correspondem à uma alternativa viável na reabilitação pois tornam o processo mais motivador. O objetivo foi verificar os efeitos terapêuticos de um programa de exercícios utilizando um JS sobre as funções motoras de membros inferiores, mobilidade funcional e QV de hemiparéticos pós-AVC. Trata-se de um ensaio clínico controlado não-randomizado, envolvendo 24 pacientes em fase subaguda ou crônica da doença. O grupo experimental (GE n=16) recebeu tratamento para o membro inferior parético utilizando o JS mim-Pong. O grupo controle (GC n=8) recebeu tratamento com cinesioterapia convencional. Foram realizadas 20 sessões (duas vezes por semana), com duração de aproximadamente 30 minutos. Foram avaliados: comprometimento motor (Fugl-Meyer-EFM), nível cognitivo (Mini Exame do Estado Mental), mobilidade funcional (Timed Up and Go Test), percepção de QV (Perfil de Saúde de Nottingham-PSN) e percepção de melhora (Escala Likert). Melhoras significativas foram observadas apenas no GE. Destaca-se o grande tamanho do efeito (TDE) obtido nas variáveis avaliadas com o PSN (TDE=0,5) e com a EFM (TDE=0,6). Existiu ainda superioridade do GE na percepção de melhora. Conclui-se que o JS mim-Pong pode ser considerado como um recurso valioso na reabilitação de hemiparéticos pós-AVC, pois foi capaz de proporcionar melhoras motoras e funcionais, que impactaram diretamente na qualidade de vida dos pacientes, sendo estas melhoras superiores às obtidas com a fisioterapia convencional.