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Heart rate variability measure in breast cancer patients and survivors: A systematic review

PURPOSE In the current study, we aimed to review literature findings showing the clinical importance of cardiac autonomic modulation assessed by heart rate variability analysis in breast cancer (BC) patients and survivors. METHODS We conducted a systematic review according to The PRISMA Statement in Medline, Scopus and Web of Science (_-2015) databases. The search was limited to articles in English language, published in peer-reviewed journals, and with adult age samples only (e.g., women, patients, or survivors, diagnosed with BC in any stage). We included observational studies and randomized trials. Detailed heart rate variability analysis (instruments, data collection protocol, and analysis methods) was required. Search terms included autonomic nervous system, heart rate variability, sympathetic and parasympathetic nervous system, autonomic dysfunction, vagal nervous and breast neoplasms, breast cancer and breast tumor. RESULTS Twelve studies were included in this review. The clinical importance of cardiac autonomic modulation assessed by heart rate variability analysis in BC patients and survivors is demonstrated by association with effects of BC surgery, and treatments, and the adverse effects of surgery and treatments on survivors (e.g., cardiotoxicity, fatigue, and stress). LIMITATIONS The strength of evidence of included studies is low: small samples size and heterogeneity, presence of confounders, and observational studies design. CONCLUSIONS The heart rate variability analysis could be used as a complementary non-invasive tool for the early diagnosis and better prognosis of autonomic dysfunction, and survival in BC patients. There are many potential clinical applications of heart rate variability analysis in BC patients, and the employment of such approaches could lead to lower impairment of autonomic function in this individuals.

Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

Abstract Purpose: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. Method: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. Results: Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. Conclusions: The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

Total Reaction Time Performance of Individuals with Autism after a Virtual Reality Task

Evidence suggests that people with autism perform simple reaction time (RT) tasks differently than typically developing (TD) individuals. The current study examines this possibility by investigating the simple total reaction time (TRT) performance and examined effects of practice on a virtual reality motor task (VRMT) in participants with autism. Twenty-seven participants diagnosed with autism spectrum disorder (ASD) and twenty-seven TD participants completed a TRT test alternated with a VRMT. Significant increases in TRT measures were found postpractice with the VRMT only in the female autistic group. These findings suggest that the VRMT is a promising tool for improving visual RT functioning in autistic individuals.

Virtual and augmented reality technologies in Human Performance: a review

Introduction : Todays society is influenced by Information and Communication Technologies. Toys that were once built by hand have been reinterpreted and have become highly commercialized products. In this context, games using Augmented Reality (AR) and Virtual Reality (VR) technologies are present in the everyday lives of children, youth and adults. Objective : To investigate how Physical Education professionals in Brazil have been making use of AR and VR games to benefit their work. Materials and methods : We only included studies that addressed exercise or physical activity using AR or VR games. We searched the databases of Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO), using the words augmented reality, virtual reality, exergames, Wii and serious games. Results : Nineteen articles were included in the systematic review. The most frequently used device was the Nintendo(r) Wii, with over 25 different kinds of games. With regard to the subjects of the studies, four studies were conducted with healthy individuals (mean = 65.7), three with patients with Parkinsons disease (mean = 18.0), three with elderly women (mean = 7.7) and two with patients with stroke injury (mean = 6.0). Conclusion : Many physical therapists and occupational therapists use serious games with AR or VR technologies as another work tool, especially for rehabilitation practices. The fact that these technologies are also used in Physical Education classes in Brazil indicates that electronic games are available and can be a tool that can contribute to the widespread adoption of exercise as an enjoyable form of recreation.

Heart Rate Variability and Cardiopulmonary Dysfunction in Patients with Duchenne Muscular Dystrophy: A Systematic Review

Duchenne muscular dystrophy (DMD) is a genetic recessive disorder with progressive muscle weakness. Despite the general muscle wasting, degeneration and necrosis of cardiomyocytes have been the main causes of morbidity and death in individuals with DMD. Cardiac failure is generally preceded by disturbances in heart rate variability (HRV), and non-invasive measurement of the autonomic nervous system has been an important tool to predict adverse cardiovascular events. Hence, the application of HRV to study autonomic modulation in DMD individuals, and the establishment of correlations between HRV and heart/lung diseases, age, and mortality will have the potential to improve quality of life and life expectancy of individuals with DMD. In order to evaluate the state of the art in this field, we conducted a systematic search in Medline/PubMed and BVS (virtual library in health) databases. We selected 8 studies using pre-defined criteria and meta-analysis revealed decreased parasympathetic activity and increased sympathetic predominance in individuals with DMD as major observations. Moreover, there is a strong association between diminished HRV and myocardial fibrosis with DMD. These patterns are evident in patients at early-stage DMD and become more prominent as disease severity and age increase. Thus, data minning clearly indicates that HRV assessment can be used as a predictor for sudden death in individuals with DMD. The use of the HRV, which is inexpensive, ubiquitously available in clinics and hospitals, and a non-invasive analysis tool, can save lives and decrease the morbity in DMD by alerting care givers to consider autonomic nervous system intervention.

Test–Retest Reliability and Clinical Feasibility of a Motion-Controlled Game to Enhance the Literacy and Numeracy Skills of Young Individuals with Intellectual Disability

Games using motion capture from web cameras have become increasingly popular. However, there are no games specifically designed to teach literacy to individuals with intellectual disabilities (ID). The aim of this study was to investigate the feasibility of introducing young individuals with ID to a new augmented reality game, the MoviLetrando, and establish its test-retest reliability to determine its usefulness in teaching the alphabet and motor control skills. The performance of a sample of 88 ID participants (52 males, 36 females, mean ± standard deviation age, 11.2 ± 2.6 years) was measured on two different testing sessions. Five dependent variables (total points, number of correct vowels/numbers, number of mistakes, number of omissions, and average time to reach symbols) were used for data analysis. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), Cronbachs alpha, and Bland-Altman plots were used to estimate the test-retest reliability and measurement precision. Feasibility was assessed by examining recruitment, adherence, and acceptability in both phases of the game. The dependent variables identified in the MoviLetrando demonstrated an ICC of 0.44 to 0.82, suggesting acceptable/good test-retest reliability, respectively. The internal consistency was satisfactory. The small SEM, as well as the narrow width of the 95 percent limits of agreement in the Bland-Altman plots, implied that measurements of these dependent variables were precise and accurate on both the occasions. Excellent test-retest reliability for performance measurement was demonstrated in the ID participants, indicating that the MoviLetrando could be used as an outcome measure for this population.

Breast disease in men in metropolitan São Paulo - Brazil

Although rare, breast cancer in males represents 1% of all cancer in men, and has shown increasing incidence in 25 years. To analyze age, gender, type of procedure performed and diagnosis of all cases of breast diseases in a public hospital in Sao Paulo, Brazil, with special focus on men. Cross‐sectional study of breast surgery in 2010‐2014 at Hospital Municipal Universitario de Sao Bernardo do Campo, Brazil. In the period 999 breast surgery were carried out. Patients with benign diseases were about 30 years old and patients with malignant diseases were over 50. Most surgical procedures performed on men were on the benign condition of gynaecomastia (n=21). The prevalence of breast cancer in the male population attending the public health system in Sao Bernardo was 0.27 (per 100,000). There was a single record of malignant disease in men, a 65 years old man, with histological diagnosis of ductal carcinoma. Surgical pathology of the breast in men is a rare event, and accounts for about 2.4% of mammary surgery in the municipality of São Bernardo do Campo. Awareness is necessary for health professionals and the media, regarding breast pathologies in the male population, to reduce the prejudice in the search for an early diagnosis of a condition so strongly linked to the female for the majority of people.

Augmentative and alternative communication in children with Down’s syndrome: a systematic review

BackgroundThe use of technology to assist in the communication, socialization, language, and motor skills of children with Down’s syndrome (DS) is required. The aim of this study was to analyse research findings regarding the different instruments of ‘augmentative and alternative communication’ used in children with Down’s syndrome.MethodsThis is a systematic review of published articles available on PubMed, Web of Science, PsycInfo, and BVS using the following descriptors: assistive technology AND syndrome, assistive technology AND down syndrome, down syndrome AND augmentative and alternative communication. Studies published in English were selected if they met the following inclusion criteria: (1) study of children with a diagnosis of DS, and (2) assistive technology and/or augmentative and alternative communication analysis in this population.ResultsA total of 1087 articles were identified. Thirteen articles met the inclusion criteria. The instruments most used by the studies were speech-generating devices (SGDs) and the Picture Exchange Communication System (PECS).ConclusionTwelve instruments that provided significant aid to the process of communication and socialization of children with DS were identified. These instruments increase the interaction between individuals among this population and their peers, contributing to their quality of life and self-esteem.

EXPLORANDO O POTENCIAL DE TAREFAS DE TEMPO DE REAÇÃO SIMPLES VISUAL PARA A EDUCAÇÃO FÍSICA: REVISÃO SISTEMÁTICA

Este estudo teve como objetivo rever criticamente a literatura cientifica publicada na ultima decada (2003 a 2012) sobre o uso de testes de tempo de reacao simples com estimulo visual relacionada a Educacao Fisica, mais especificamente objetiva apresentar uma sintese da evidencia empirica disponivel sobre a eficacia do uso deste tipo de teste no esporte, exercicio e atividade fisica, buscando na base de dados eletronica Thomson Reuters Web of KnowledgeSM. A partir das combinacoes de palavras “simple reaction time e athlete”, “simple reaction time e sport”, “simple reaction time e exercise” e “simple reaction time e physical activity”, 36 artigos foram selecionados para o estudo. As categorias investigadas foram: periodico, numero de participantes, sexo e idade, populacao investigada, software utilizado, tema e resultados. As publicacoes se concentraram nas revistas Medicine and science in sports and exercise e Psychology of sport and exercise, ambas com n=3. Predominaram pesquisas com o uso de testes de tempo de reacao simples com estimulo visual (TRSimples) para avaliacao do efeito do exercicio fisico sobre o desempenho no TRSimples (n=13) com uma media de 93 participantes (11 a 551 sujeitos). As populacoes de atletas investigadas foram variadas, com predominância do futebol e atletismo (ambas com n=5). A maioria dos estudos utilizou o software ANAM (Automated Neuropsychological Assessment Metrics) como instrumento de coleta de dados do TRSimples. Os artigos foram identificados e apresentados quanto ao seu tema de pesquisa: a) Uso do TRSimples para avaliacao da concussao cerebral causado por traumatismo na cabeca (n=8); b) Efeito do exercicio fisico sobre o desempenho no TRSimples (n=13); c) Niveis de pratica e comparacoes do TRSimples de atletas e nao atletas (n=8) e d) Fatores que influenciam o TRSimples (n=7). Os resultados dos artigos apontaram associacoes positivas entre o uso de testes de TRSimples e a concussao cerebral originada pelo esporte alem do efeito positivo do exercicio fisico sobre o desempenho cognitivo. O TRSimples contribuiu para analise dos niveis de pratica de atletas de mesma modalidade, de modalidades distintas e de nao atletas, alem de ser um indicador sensivel a diversos fatores que podem influenciar o desempenho cognitivo.