Isabel María Alguacil Diego

A telerehabilitation program by virtual reality-video games improves balance and postural control in multiple sclerosis patients

BACKGROUND Balance and postural control (PC) disorders are frequent motor disorder symptoms associated with multiple sclerosis (MS). OBJECTIVE To demonstrate the potential improvements in balance and PC among patients with MS who complete a virtual reality telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. METHODS 50 patients was recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received telerehabilitation treatment using the Xbox 360® console monitored via videoconference. Experimental group attended 40 sessions, four sessions per week (20 min per session). The treatment schedule lasted 10 weeks for both groups. A computerised dynamic posturography and clinical outcomes (Berg Balance and Tinettti scales) were used at baseline and at the end of the treatment. RESULTS Results showed an improvement over general balance in both groups. Visual preference, the contribution of vestibular information, mean response time and Tinetti test yielded significant differences in the experimental group. An ANOVA revealed significant between-group post-treatment differences in the composite equilibrium score, Berg and Tinetti scales in the experimental group. CONCLUSION We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

Programas de rehabilitación cardiaca y calidad de vida relacionada con la salud. Situación actual

Cardiovascular disease is the main health problem in developed countries. Prevention is presented as the most effective and efficient primary care intervention, whereas cardiac rehabilitation programs are considered the most effective of secondary prevention interventions; however, these are underused. This literature review examines the effectiveness and the levels of evidence of cardiac rehabilitation programs, their components, their development and role in developed countries, applications in different fields of research and treatment, including their psychological aspects, and their application in heart failure as a paradigm of disease care under this type of intervention. It is completed by a review of the impact of such programs on measures of health-related quality of life, describing the instruments involved in studies in recent scientific literature.

Detecting intention to walk in stroke patients from pre-movement EEG correlates

BackgroundMost studies in the field of brain-computer interfacing (BCI) for lower limbs rehabilitation are carried out with healthy subjects, even though insights gained from healthy populations may not generalize to patients in need of a BCI.MethodsWe investigate the ability of a BCI to detect the intention to walk in stroke patients from pre-movement EEG correlates. Moreover, we also investigated how the motivation of the patients to execute a task related to the rehabilitation therapy affects the BCI accuracy. Nine chronic stroke patients performed a self-initiated walking task during three sessions, with an intersession interval of one week.ResultsUsing a decoder that combines temporal and spectral sparse classifiers we detected pre-movement state with an accuracy of 64 % in a range between 18 % and 85.2 %, with the chance level at 4 %. Furthermore, we found a significantly strong positive correlation (r = 0.561, p = 0.048) between the motivation of the patients to perform the rehabilitation related task and the accuracy of the BCI detector of their intention to walk.ConclusionsWe show that a detector based on temporal and spectral features can be used to classify pre-movement state in stroke patients. Additionally, we found that patients’ motivation to perform the task showed a strong correlation to the attained detection rate of their walking intention.