This mixed-method study examined the impact of combining virtual reality (VR) and gamification (GAM) with the practice teaching style (PTS) on students’ motor skills and perceived effort in physical education. Participants (n = 75) were divided into three groups: PTS (control), PTS + GAM and PTS + GAM + VR. Each group had two one-hour sessions per week for six weeks. Participants’ motor skills and perceived effort were evaluated quantitatively and qualitatively using tests such as the SportComp Motor, flamingo and plate-tapping tests, as well as the handgrip strength test and the Pictorical Children’s Effort Rating Table. The results indicate that the PTS group reported a higher perceived effort compared to the other groups (p < 0.001). All study groups exhibited improvements in the handgrip strength (p < 0.001) and flamingo (p < 0.05) tests, while lateral jump test improvements were observed only in the two GAM groups (p < 0.001). The VR group showed an improvement in the plate-tapping tests (p < 0.001), while the PTS group exhibited a decline in the displacement with support test (p < 0.05). Participant perceptions suggest that the activity nature, motivation from competition and rewards influenced the perceived effort and motor skills. In conclusion, GAM techniques are effective in reducing perceived effort in physical education programs, and combining GAM with VR enhances improvements in motor skills.

Background: The effectiveness of transcranial direct current stimulation (tDCS) together with conventional physiotherapy in motor rehabilitation after stroke has been widely studied. Despite this, few studies have focused on its application in gait and balance rehabilitation. This review aimed to determine the efficacy of transcranial direct current stimulation combined with conventional physiotherapy on gait, balance, and the functionality of the lower limb after stroke. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases were systematically searched for relevant articles. Randomized clinical trials in English or Spanish that evaluated the use of the transcranial direct current stimulation, combined with physiotherapy, to improve gait, balance, and lower limb functionality after stroke were included. Main results: 10 articles were included, with a total of 222 subjects. Data about population, assessment tools, protocols, sessions, and results were extracted. The methodological quality of the included studies ranged between 3 and 5. Conclusion: The use of transcranial direct current stimulation combined with physiotherapy improves gait parameters, static and dynamic balance, and lower limb functionality in stroke patients. Long-term effects have not yet been demonstrated.

Background: The effectiveness of the virtual reality (VR) for the upper extremity (UE) motor rehabilitation after stroke has been widely studied. However, the effectiveness of the combination between rehabilitation gloves and semi-immersive VR (SVR) compared to conventional treatment has not yet been studied. Methods: A systematic search was conducted in Pubmed, Web of Science, PEDRo, and Scopus, Cochrane, CINHAAL databases from inception to May 2022. Randomized controlled trials were included if patients were under rehabilitation with haptic gloves combined with SVR intervention focused on the UE rehabilitation in stroke patients. Risk of bias and methodological quality were evaluated with the Physiotherapy Evidence Database (PEDro), and the modified Cochrane library criteria. A random effects model was used for the quantitative assessment of the included studies using the standard mean difference with a 95% confidence interval. Heterogeneity among the included studies was assessed using Cochran’s Q test and the incoherence index (I²). Results: After a first screening, seven studies were included. Significant differences with a 95% confidence interval were obtained in favor of the rehabilitation glove combined with SVR in the short term (SMD—standardized mean differences = 0.38, 95% CI—confidence interval = 0.20; 0.56; Z: 4.24; p =< 0.001). In the long term, only the studies that performed an intervention based in rehabilitation glove combined with SVR with also included rehabilitation were able to maintain the improvements (SMD = 0.71, 95% CI = 0.40; 1.02; Z: 4.48; p =< 0.001). Conclusions: The combined use of rehabilitation haptic gloves and SVR with conventional rehabilitation produces significant improvements with respect to conventional rehabilitation treatment alone in terms of functionality of the UE in stroke patients.

(1) Background: the scientific literature has shown that students’ active involvement in the teaching–learning process significantly improves their learning outcomes. (2) Methods: this study shows the perceptions of seven researchers on the process of inquiring about the effects of the combined use of virtual reality (VR) and a practice teaching style in physical education in secondary educational institutions. (3) Results: the results obtained from the researchers’ diaries and the focus group, through qualitative design, are arranged in the following categories: difficulties in data collection before, during, and after the intervention; perceived differences between VR interventions in laboratory situations and educational contexts; and the perceived transferability of the use of VR devices in the educational context. (4) Conclusions: more research is needed on the use of VR in the educational context, although the results obtained indicate that the teaching–learning process can be enriched by overcoming the difficulties inherent to the use of this technology in a variable context such as education.

Background: Physical exercise is one of the main nonpharmacological treatments for most pathologies. In addition, physical exercise is beneficial in the prevention of various diseases. The impact of physical exercise has been widely studied; however, existing meta-analyses have included diverse and heterogeneous samples. Therefore, to our knowledge, this is the first meta-analysis to evaluate the impact of different physical exercise modalities on telomere length in healthy populations. Objective: In this review, we aimed to determine the effect of physical exercise on telomere length in a healthy population through a meta-analysis of randomized controlled trials. Methods: A systematic review with meta-analysis and meta-regression of the published literature on the impact of physical exercise on telomere length in a healthy population was performed. PubMed, Cochrane Library, SCOPUS, Web of Science, and Embase databases were searched for eligible studies. Methodological quality was evaluated using the Risk Of Bias In Nonrandomized Studies of Interventions and the risk-of-bias tool for randomized trials. Finally, the certainty of our findings (closeness of the estimated effect to the true effect) was evaluated using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Results: We included 9 trials that met the inclusion criteria with fair methodological quality. Random-effects model analysis was used to quantify the difference in telomere length between the exercise and sham groups. Meta-analysis showed that exercise did not significantly increase telomere length compared with the control intervention (mean difference=0.0058, 95% CI −0.05 to 0.06; P=.83). Subgroup analysis suggested that high-intensity interventional exercise significantly increased telomere length compared with the control intervention in healthy individuals (mean difference=0.15, 95% CI 0.03-0.26; P=.01). Furthermore, 56% of the studies had a high risk of bias. Certainty was graded from low to very low for most of the outcomes. Conclusions: The findings of this systematic review and meta-analysis suggest that high-intensity interval training seems to have a positive effect on telomere length compared with other types of exercise such as resistance training or aerobic exercise in a healthy population. Trial Registration: PROSPERO CRD42022364518; http://tinyurl.com/4fwb85ff

Background: The effectiveness of transcranial direct current stimulation (tDCS) in the upper limb (UL) motor rehabilitation of stroke has been widely studied. However, the long-term maintenance of its improvements has not yet been proven. Methods: A systematic search was conducted in MEDLINE/Pubmed, Web of Science, PEDRo, and Scopus databases from inception to April 2021. Randomized controlled trials were included if they performed a tDCS intervention combined with UL rehabilitation in stroke patients, performed several sessions (five or more), and assessed long-term results (at least three-month follow-up). Risk of bias and methodological quality were evaluated with the Cochrane RoB-2 and the Oxford quality scoring system. Results: Nine studies were included, showing a high methodological quality. Findings regarding UL were categorized into (1) functionality, (2) strength, (3) spasticity. All the studies that showed significant improvements retained them in the long term. Baseline functionality may be a limiting factor in achieving motor improvements, but not in sustaining them over the long term. Conclusion: It seems that the improvements achieved during the application of tDCS combined with UL motor rehabilitation in stroke were preserved until the follow-up time (from 3 months to 1 year). Further studies are needed to clarify the long-term effects of tDCS.