The authors investigated and compared the energy expenditure and postural coordination of two groups of healthy subjects on a mechanical horse at 4 increasing oscillation frequencies. Energy expenditure was assessed from the oxygen consumption, respiratory quotient, and heart rate values, and postural coordination was characterized by relative phase computations between subjects (elbow, head, trunk) and horse. The results showed that the postural coordination of the riders was better adapted (i.e., maintenance of in-phase and antiphase) than that of the nonriders, but the energy expenditure remains the same. Likewise, we observed an energy system shifting only for nonriders (from aerobic to lactic anaerobic mode). Finally, cross-correlations showed a link between energy expenditure and postural coordination in the riders (i.e., effectiveness).

The first objective was to test the validity, reliability and accuracy of paired inertial measurement units (IMUs) to assess absolute angles relative to Vicon and OptiTrack systems. The potential impacts of slow vs. rapid and intermittent vs. continuous movements were tested during 2D laboratory analyses and 3D ecological context analysis. The second objective was to test the IMUs alone in an ecological activity (i.e., front crawl) that encompassed the previous independent variables to quantify inter-cyclic variability. Slow and intermittent motion ensured high to reasonable validity, reliability and accuracy. Rapid motion revealed an out-of-phase pattern for temporal reliability and lower validity, which was also visible in 3D. Also, spatial reliability and accuracy decreased in 3D, mainly due to discrepancies in local maximums, whereas temporal reliability remained in-phase. For the second objective, inter-cyclic variability did not exceed 12° based on root mean square error (RMSE). Therefore, IMUs should be considered valuable supplements to optoelectronic systems if users carefully position the sensors in rigid clusters and calibrate them to integrate potential offsets. Drift correction by spline interpolation or normalisation of the absolute data should also be considered as additional techniques that increase IMU performance in ecological contexts of performance.

Objective: To examine the characteristics and the effectiveness of virtual reality systems on upper limb impairments in children and young adults with cerebral palsy. Data sources: An electronic search was conducted on PubMed, PEDro, Web of Science, Central, and EMBASE. Methods: The protocol of this review was prospectively registered in the PROSPERO database (CRD42022302271). Randomized controlled trials that tested the effects of virtual reality-based interventions on the upper limb of participants with cerebral palsy were included. The methodological quality of the studies was measured by the PEDro scale. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. The data of the studies were analyzed in meta-analysis and presented in forest plots and narrative synthesis. Results: Twenty-two studies involving 746 participants were included. Ten different virtual reality systems were used in the interventions, of which six were designed specifically for rehabilitation and four commercial video games. We found an effect in favor of virtual reality when it was used in combination with conventional therapy for upper limb activity (SMD = 0.65; 95% CI (0.19 to 1.11)). However, the certainty of the evidence of the comparisons ranged from very low to low. Conclusion: Virtual reality seems to be an effective tool for upper limb activity in children and young adults with cerebral palsy. Nevertheless, future studies should present a better methodological quality, a larger sample size, and well-defined rehabilitation programs to reduce the inconsistency of the evidence in this domain.

The aim of this study was to investigate the effects of the virtual reality device on the evolution of motivation, and motor, functional and kinematic parameters of the upper limb in children with cerebral palsy. Twenty children were randomly assigned in VR and control groups. VR group scored higher than the control group in the Movement Assessment Battery for Children - Second Edition (MABC-2; standardized motor skills test), exhibited an increased range of motion, and showed improved results in various movement parameters in the interaction with the 3D virtual space. All participants presented high motivation scores in the iVR sessions. This new Immertrack tool may improve the motor, kinematic parameters, and motivation in children with CP.

Objective: From a dynamic system approach, this study evaluated the impact of a new training protocol using a mechanical horse on the postural coordination of brain-damaged patients. Methods: Eighteen volunteer brain-damaged patients (i.e., post-stroke or traumatic brain injury) were recruited and randomly divided into an experimental group (horse group; n = 10, conventional therapy associated with horse-riding exercise on the mechanical horse for 30 min, twice a week, for 12 weeks) and a control group (n = 8; conventional therapy without intervention on the mechanical horse). Postural coordination was evaluated during pre- and post-tests through discrete relative phase (DRP) computation: ϕ_Head−Horse, ϕ_{Trunk−Horse.} Results: A significant effect of used training has been showed, F_{(1, 15)} = 16.6 (p < 0.05) for all patients, concerning the trunk/horse coordination. Conclusion: This pilot study results showed the impact of this new training method on the postural coordination of these patients. After 24 sessions, the coordination of the horse group patients differed from that of the control group, showing their ability to adapt to constraints and develop specific modes of postural coordination (trunk/horse antiphase) to optimize their posture.