Amanda Maria da Conceição Perez

Background: A cerebral vascular accident (CVA) is an event that compromises the central nervous system (CNS), leading to functional limitations. Virtual Reality (VR) has been proposed as a novel technological tool for rehabilitation, as it extends beyond treatment, providing motivation to patients. This study aims to evaluate the evidence of gait and balance rehabilitation using Virtual Reality (VR) in a population of adults and elderly individuals post-stroke in personalized virtual environments and commercially available gaming systems. Methods: The databases used in this study were selected as major research sources in the health and engineering fields. They include Pubmed, IEEE, PMC, Sciencedirect, Springer, and Bireme. Article searches were conducted, restricting the publication period to 2014-2024. The search descriptors followed the MESH/DECS terms: Stroke, Virtual Reality, Gait, Balance and Ecercise Therapy. Controlled trials comparing VR to conventional rehabilitation were included. Population criteria included adults and the elderly post-stroke, excluding children, cerebral palsy, and other neurological disorders associated with gait and balance disturbances. Results: The search in the established databases yielded 1,711 studies, of which 115 were excluded due to duplication, 1,403 after title and abstract screening, and 182 after full-text reading. Thus, 11 studies met the inclusion criteria. Conclusions: VR rehabilitation moderately improves outcomes compared to conventional rehabilitation in adults and the elderly post-stroke. However, current interventions have small sample sizes to precisely evaluate their overall benefits. Future research should analyze the activities performed, participation, and assessment measures, and investigate commercially available VR systems.

In 2019, the Coronavirus (SARS-CoV-2) virus was identified, also defined as novel coronavirus or severe acute respiratory syndrome coronavirus 2. The Corona VIrus Disease (COVID-19) pandemic generated several changes in society in 2020 as a result of its rapid spread in humans. The main symptoms are high fever (≥ 37.8 °C), dry cough, dyspnea, upper respiratory symptoms, myalgia, fatigue and diarrhea in the most uncommon cases. Considering the emergency situation caused by the COVID-19 pandemic and the effects attributed to it, rehabilitation professionals have a fundamental role in the functional recovery of patients, independence and improvement of quality of life. This is a systematic review of the literature, with the aim of discussing the main findings on physical therapy management in functional changes in post-COVID-19 patients. Pubmed, Scielo, Sciencedirect, BVS and PEDro databases were used. The terms MESH/DECs used for the searches were: Rehabilitation, Physical Therapy Modalities, Covid-19, Post-acute Syndromes COVID-19 and Physical Fitness, the keywords were also used: rehabilitation, physiotherapy, Covid-19, post- acute syndrome COVID-19 and functional capacity. To cross the terms, Boolean operators (AND and OR) were used. Randomized trials, recommendations, quasi-randomized or prospective controlled trials, reports, guidelines, and field updates were included. As for the selected population, studies were included in individuals of both sexes, with no age restriction, that evaluated physiotherapeutic interventions in patients who had COVID-19. Literature reviews, case studies, conferences, abstracts of articles published in conference proceedings and letters to the editor were excluded from the research. To measure methodological quality, the PEDro scale was used.Searches for articles were performed restricting the period of publication between the years 2019 to 2022. The electronic search strategy identified a total of 364 records from the selected databases. After screening for duplicates, 14 articles were excluded, followed by screening by titles and abstracts, another 298 articles were excluded, of these 47 potentially relevant records were submitted to full text review and of these 5 randomized clinical trials were included in this review. In view of the findings of this study, it can be concluded that physical therapy rehabilitation should continue after hospital discharge, with the aim of improving physical performance and activities of daily living (ADL) in post-COVID-19 patients.