Abstract Aim: This systematic review aimed to investigate the acute effects of cardiovascular exercise on motor learning of non-disabled individuals. Methods: Forty studies were identified through database searching (PsycINFO, CENTRAL, Google Scholar, Scielo, and PUBMED). The studies demonstrated heterogeneity and were classified into two categories to guide the analyses: (1) – studies that investigated the effects of exercise-induced fatigue during practice on the performance in the retention test; (2) – studies that verified the acute impact of the cardiovascular exercise in close temporal proximity to the task practice on motor learning. Results: The studies demonstrated that (1) - the practice under fatigue conditions did not impair motor learning and that (2) – the cardiovascular exercise bout performed in close temporal proximity to task practice enhances the motor learning processes. Conclusion: Cardiovascular exercise enhances motor learning processes; however, these priming effects are dependents on the timing between practice and exercise, type of exercise, and task characteristics.

ABSTRACT Parkinson's disease causes a progressive decline of motor and cognitive functions, often affecting postural control. Training through virtual reality has been shown to be effective in improving this condition. This study aims to analyse the effects of the Kinect Adventures! games in postural control of people with Parkinson's disease. Ten individuals diagnosed with idiopathic Parkinson's disease, in stages I to III of the Hoehn & Yahr scale, aged between 48 and 73 years, were selected. Fourteen training sessions of one hour each, twice a week, were performed. Individuals were evaluated pre, post-intervention and 30 days after the last session of intervention by a force platform that measured the oscillation area and velocity of the centre of pressure in ten different sensory conditions and the Limits of Stability. Limits of Stability showed a statistically significant increase immediately after the training the 14 sessions, as were observed and there were no significant changes in oscillation area and velocity immediately after the intervention or 30 days after the end of training. The results of this study indicate that the training with Kinect Adventures! Games improve the postural control of people with Parkinson's disease, by increasing the Limits of Stability.

ABSTRACT This study investigated the effects of transition command related to caller location (front, back, right and left side of the take-off board) and type of caller communication (voice and clap hands) on the long jump performance by visually impaired athletes. Eight long jumpers with visual impairment (T11 class), both male and female, with an average age of 26.35 years (± 6.29), and their respective callers (n = 5) took part in this experiment. Two conditions were experimentally manipulated: (i) caller location and (ii) type of communication. Two long jumps were performed in each location under each type of communication, totalizing 16 long jumps per athlete. Results showed that type of command, as well as the callers’ locations, affected similarly the performance of the long jump by visually impaired athletes. They also showed that athletes and callers’ preferences for the type of transition command and positioning location had the same effects.

Resumo Introdução: Os transtornos depressivos e de ansiedade são considerados a principal causa de sofrimento emocional e diminuição da qualidade de vida de idosos. Foi sugerido que a prática de exercício físico pode ser um tratamento para depressão. Abordagens alternativas, como jogos interativos, podem reduzir sintomas depressivos. Objetivo: Comparar o efeito da realidade virtual, na forma de videogames interativos Kinect Adventures disponíveis comercialmente, em comparação com um programa de exercícios físicos padrão sobre sintomas depressivos de idosos. Método: Trata-se de um estudo piloto, grupos paralelos, experimental, controlado, randomizado, cego através de dois grupos de intervenção: Interactive Video Game Kinect Adventures (IVG, n = 8) versus programa de exercício físico (PEF, n = 6). Os dois grupos completaram um programa de sete semanas com um total de 14 sessões de 60 minutos divididas em duas sessões por semana. O IVG concluiu sessões de treinamento individuais usando os jogos Microsoft Xbox Kinect Adventures e o PEF realizou um programa de exercícios em grupo. Os sintomas de depressão foram mensurados através da Escala de Depressão Geriátrica (GDS-15). Essas medidas foram avaliadas pré-intervenção, pós-intervenção e no seguimento de 30 dias. Resultados: Houve um efeito significativo da avaliação sem efeito grupo ou interação entre fatores, no GDS-15 (RM-ANOVA, P <0,0001). Ambos os grupos apresentaram melhora na avaliação pós-intervenção GDS-15, que foi mantida após 30 dias de acompanhamento (teste post hoc de Bonferroni, P <0,05). Conclusão: Os resultados deste estudo sugerem que os jogos interativos Kinect Adventures e o exercício físico proporcionam efeitos positivos nos sintomas depressivos de idosos.

Abstract Introduction: Depressive and anxiety disorders are considered the main cause of emotional suffering and decrease of quality of life among older adults. It has been suggested that the practice of physical exercise can be a treatment option for anxiety and depression. Alternative approaches such serious games show promise for reducing depression symptoms. Objective: To compare the effect of virtual reality, in the form of commercially available interactive Kinect Adventures video games, compared to a standard physical exercise program on depressive symptoms of older adults. Method: This is a pilot study, parallel group, single-blind randomized controlled pilot trial that recruited two intervention groups: Interactive Video Game Kinect Adventures (IVG, n=8) versus usual physical exercise program (PEP, n=6). The two groups completed a seven week program with a total of fourteen 60-minute sessions divided into two sessions a week. The IVG completed individual training sessions using the Microsoft Xbox Kinect Adventures games and the PEP performed a group exercise program. Depression symptoms were measured using the Geriatric Depression Scale (GDS-15). This measure was assessed pre-intervention, post intervention and at 30-day follow-up. Results: There was a significant effect of assessment without group effect or interaction between factors, in the GDS-15 (RM-ANOVA, P < 0.0001). Both groups showed improvement in the GDS-15 post intervention assessment that was maintained after 30-day follow-up (Bonferroni post hoc test, P < 0.05). Conclusion: The results of this study suggest that both Interactive Kinect Adventures video games and physical exercise provide beneficial effects on depressive symptoms of older adults.

Practicing tasks in Virtual Reality (VR) environment has shown to be effective for gain in cognitive and motor functions in post stroke individuals. However, there are few information about how the motor learning process of tasks with different demands occurs in this population, and if there are differences when compared with healthy individuals. The aim of the present study was to investigate the motor learning process of eight VR’s tasks with different cognitive and motor demands, in post stroke individuals (Experimental Group-EG), and compare it with healthy individuals (Control Group-CG). Eighteen individuals participated in the study performing eight sessions of practice, four for each task. The study involved: pre-test (1 session), acquisition phase (4 sessions for each task), post-test (1 session), and retention test (1 session after thirty days since the end of acquisition phase). The statistical analysis was run by a 2 x 3 ANOVA (groups x learning tests) with Tukey post hoc. At the end, EG group was able to learn three tasks, while CG learned four, one more than the ones learned by the post-stroke individuals. Task’s complexity affected, in more intensely the motor learning process in post-stroke individuals that with eight sessions were able to learn only low-complexity tasks.

Abstract Aim: The aim of this study was to investigate the effects of adding a cognitive task on the performance of three different motor tasks with different demands, discrete skills, serial skills and continuous skills, by individuals with mild, moderate, and severe idiopathic Parkinson’ disease (PD). We also investigate the effect of the cognitive task in the secondary task and the cost of the dual-task. Method: This is a cross-sectional study. Individuals with idiopathic PD were divided in three groups with respect to motor severity (mild, moderate and severe groups). Participants’ performances were assessed in single and DT conditions including Sit-to-Stand test (SST), Timed Up and Go (TUG), and 10-meter Walk test (T10W). Cognitive task used was verbal fluency Results: The results show that dual task impact the performance of all primary tasks. DT negatively affects the performance of the motor tasks. And there is a different impact according the severity of the disease, severe ones are more affected than mild and moderate. Conclusion: In conclusion, adding a concurrent cognitive task negatively affected the performance of discrete, serial and continuous motor tasks, and this effect is more noticeable in severe than in mild patients. Under dual-task conditions, patients improved their cognitive task performance for gait and TUG, suggesting a prioritization of the secondary task for these tasks. There was no difference between the costs of the three tasks.

Abstract Aim: This study aims to investigate the effects of the type of extrinsic feedback provided equally in terms of timing and frequency of delivery on the motor learning after stroke. Methods: Twenty post-stroke individuals were distributed randomly into two groups according to the type of feedback provided: knowledge of performance experimental group (KPEG) and knowledge of results experimental group (KREG). Additionally, a control group (CG) was consisted of 20 healthy individuals age- and feedback-matched with the experimental groups. The task was a pointing skill performed in a virtual reality system. The acquisition phase consisted of 3 days/ 75 trials per day. Two retention tests (ret1 and ret2) were run after four days from the acquisition phase. Dependent variable measures were defined by motor performance and movement pattern. Results: The statistical analysis showed interaction effect F(3,108 = 49.13, p = 0.01) among KPEG and KREG. Based on the motor performance parameters (score) the KPEG improved performance significantly from pre to post (p = 0.001), and maintain it from pre to ret1 (p = 0.002), and from the pre to ret2 (p = 0.001). However, the KREG only showed a difference in motor performance from the pre to post (p = 0.003). Compared to the KREG, the KPEG showed improvement on the movement pattern based on the smoothness (p = 0.004), which suggests that the KPEG performed more corrections of movements in relation to the CG and KREG groups. Conclusion: These findings suggest that KP allowed better motor learning in individuals after stroke.

Resumo Introdução: A doença de Parkinson provoca declínio progressivo das funções motoras e cognitivas, levando a uma diminuição da independência e da qualidade de vida das pessoas acometidas. O treinamento por meio de realidade virtual tem se mostrando eficaz, pois promove estímulos cognitivos e motores, o que pode ser benéfico para estes indivíduos, melhorando sua qualidade de vida. Objetivo: Analisar os efeitos da realidade virtual na cognição e qualidade de vida de pacientes com Doença de Parkinson. Métodos: Tratou-se de uma série de casos. Participaram deste estudo onze indivíduos com média de idade de 65 (9,6) anos classificados nos estádios 1 a 3 da Escala Hoehn e Yahr. Os indivíduos participaram de quatorze sessões com duração de uma hora, duas vezes por semana durante sete semanas no qual praticaram quatro jogos do Kinect Adventures!. Eles foram avaliados antes, imediatamente após a intervenção e 30 dias após a intervenção. A cognição foi avaliada por meio da Escala Cognitiva de Montreal (MoCA) e a qualidade de vida foi avaliada por meio do Questionário de Doença de Parkinson (PDQ-39). Resultados: Somente as atividades do PDQ-39 do domínio da vida diária demonstraram melhoria estatisticamente significante. Os escores da MoCA, em geral, permaneceram os mesmos. Conclusão: Embora o treinamento da realidade virtual tenha promovido melhoria nas atividades do PDQ-39 no domínio de vida diária, não foi efetivo nos outros domínios avaliados quanto à qualidade de vida e cognição.

Abstract Introduction: Parkinson’s disease causes progressive decline of motor and cognitive functions leading to a decrease in the independence and quality of life of people affected. Training through virtual reality is proving effective, as it promotes cognitive and motor stimuli, which can be beneficial for these individuals, improving their quality of life. Objective: To analyze the effects of virtual reality on the cognition and quality of life of patients with Parkinson’s disease. Methods: A total of 11 individuals with a mean age of 65 (9.6) years classified in stages 1 to 3 of the Hoehn and Yahr Scale participated in this study. The subjects participated in fourteen sessions lasting one hour, twice a week for seven weeks in which they practiced four games of Kinect Adventures!. They were evaluated before, immediately after the intervention and 30 days after the intervention. Cognition was assessed using the Montreal Cognitive Scale (MoCA) and quality of life was assessed using the Parkinson’s Disease Questionnaire (PDQ-39). Results: Only PDQ-39 activities from the domain of daily living demonstrated a statistically significant improvement. The MoCA scores, in general, remained the same. Conclusion: Although virtual reality training promoted improvement in PDQ-39 activities in the daily life domain, it was not effective in the other domains assessed for quality of life and cognition.

Resumen Introducción: La enfermedad de Parkinson provoca una disminución progresiva de las funciones motoras y cognitivas, llevando a una disminución de la independencia y de la calidad de vida de las personas afectadas. El entrenamiento por medio de la realidad virtual se ha demostrado eficaz, pues promueve estímulos cognitivos y motores, lo que puede ser beneficioso para estos individuos, mejorando su calidad de vida. Objetivo: Analizar los efectos de la realidad virtual en la cognición y calidad de vida de pacientes con enfermedad de Parkinson. Métodos: Se trata de una serie de casos, participaron de este estudio once individuos con una media de edad de 65 (9,6) años clasificados en los estadios 1 a 3 de la escala Hoehn y Yahr. Los individuos participaron en catorce sesiones de una hora, dos veces a la semana durante siete semanas en las que practicaron cuatro juegos de Kinect Adventures!. Se evaluaron antes, inmediatamente después de la intervención y 30 días después de la intervención. La cognición fue evaluada por medio de la Escala Cognitiva de Montreal (MoCA) y la calidad de vida fue evaluada a través del Cuestionario de Enfermedad de Parkinson (PDQ-39). Resultados: Sólo las actividades del PDQ-39 del dominio de la vida diaria demostraron una mejora estadísticamente significativa. Los escores de la MoCA, en general, permanecieron iguales. Conclusión: Aunque el entrenamiento de la realidad virtual ha promovido una mejora en las actividades del PDQ-39 en el ámbito de la vida diaria, no fue efectivo en los otros ámbitos evaluados en cuanto a la calidad de vida y cognición.

Abstract AIMS The aim of this study was to investigate the effects of practice schedule on the motor learning of a synchronization timing task in post-stroke subjects. Subjects and METHODS Seventeen post-stroke individuals were assigned to the experimental group and for the control group were selected seventeen healthy individuals. At the acquisition phase, all participants performed 30 trials of a coincident timing task. Nine individuals from each group practiced constantly and eight from each group practiced randomly, with speed changes in the task. Subsequent phases included: 1) immediate transfer test and 2) long term transfer test after 3 days. Data were analyzed in relation to absolute, variable, and constant errors to assess the performance concerning accuracy, consistence, and direction of responses, respectively. RESULTS All groups increased their accuracy through the practice and were able to adapt it in different speeds. The stroke subjects were more variable in their motor responses. There was no effect of the practice schedule on motor learning, regardless the presence or absence of the neurologic damage. CONCLUSION Post stroke individuals were able to learn a synchronizing task and the capacity of adapt their performance after speed perturbation was preserved. There was no effect of the practice schedule on motor learning.

The virtual reality has been frequently required in rehabilitation settings. However, it still lacks specificity, making it necessary to establish specific criteria to classify the most relevant aspects of electronic games to allow interventions based on virtual reality. Therefore, the purpose of this study is to develop a “Perceptual and motor demands assessment protocol for virtual reality systems” and to investigate its content validity and intra and inter observer agreement. The protocol was created through a literature review including classical studies as well as a review of recent articles about motor behavior, physical training, cognitive neuroscience and virtual reality. The previous versions were presented in study group meetings and congresses, and modified accordingly to suggestions of experts. Three examiners used the final version to analyze twice the total of 20 videos of individuals in a virtual environment and answered a questionnaire about its content validity. Most of the obtained values were classified as “good” (concordance from 80% to 89%) or “excellent” (concordance from 90% to 100%) by the three examiners and the protocol’s content validity was adequate. The protocol is valid, applicable and practical for analyzing different requirements of electronic games in a virtual environment.

With the present study, we aimed to investigate the task complexity effects on the performance of a coincidence timing task in individuals with Down syndrome. The experimental group was consisted by 26 subjects with Down syndrome, 20 years old (± 5), and classified as mild or moderate in International Classification of Functioning and Health. Each participant in the experimental group was matched by in function of gender and age with a participant in a control group without Down syndrome. Both groups performed a coincident timing task, in which the participant had different levels of structural and functional complexity. Performance measure was derived from the consistency (absolute error), accuracy (variable error) and direction of response (constant error). Individuals with Down syndrome presented spatiotemporal organization impairments related to the difficulty in dealing with motor demand in order to interact with the perceptive demand. They also experienced difficulty in adapt to task complexity, causing performance error in the task. Individuals with Down syndrome have deficits in perceptive and space-time organization, and this phenomenon may be explained by the difficulty in integrating perceptive stimulus to motor actions with a high number of elements involved.

O objetivo deste estudo foi comparar o processo de aprendizagem de uma tarefa de controle postural entre indivíduos pós-Acidente Vascular Cerebral (AVC) e indivíduos saudáveis. Participaram do estudo 20 indivíduos pós- AVC (Grupo Experimental) e 20 indivíduos saudáveis pareados por idade (Grupo Controle). Os participantes praticaram uma tarefa de controle postural em ambiente virtual com incremento de complexidade. O delineamento foi constituído de quatro fases: pré-teste (cinco tentativas), fase de aquisição (quatro blocos de trinta minutos), pós-teste (cinco tentativas) e teste de retenção (cinco tentativas após uma semana sem prática). Para a análise estatística foi realizada uma ANOVA 2 x 3 (grupos x testes de aprendizagem). Resultados: Não houve diferença na aprendizagem motora entre os grupos (F= 41.22; p=0.88), o Grupo Controle conseguiu desempenhar a tarefa em níveis mais altos de complexidade que o Grupo Experimental (F = 4.77; p = 0.01), e ambos os grupos incrementaram o número de erros ao longo dos blocos de prática (F = 0.53; p = 0.00) por causa do aumento de complexidade. Conclusão: Pode-se verificar que indivíduos pós-AVC possuem a mesma capacidade de aprender uma tarefa de controle postural que indivíduos saudáveis, e que a complexidade aparenta ser um aspecto crucial para diferenciar o processo de aprendizagem motora destas diferentes populações.

The aim of this study was to compare the learning process of a postural control task between post-stroke patients and healthy subjects. The sample was composed of 20 post-stroke individuals (Experimental Group) and 20 aged matched healthy individuals (Control Group). Participants practiced a postural control task in a virtual environment with increasing of complexity. The study design involved four phases: pre-test (five trials), acquisition phase (four blocks of thirty minutes), post-test (five trials), and retention test (five trials after a week without practice). The statistical analysis was run by a 2 x 3 ANOVA (groups x learning tests). Results: There was no difference in motor learning between Experimental Group and Control Group (F= 41.22; p=0.88). In addition, it was founded that the Control Group could learn the task in a higher-level complexity than Experimental Group (F = 4.77; p = 0.01), and both groups increased the error during the trials of practice (F = 0.53; p = 0.00) because of task complexity. Conclusion: Therefore has been found that post-stroke individuals have the ability to learn a postural control task similar to healthy subjects, and the task complexity seems to be a key-factor in order to differentiate stroke from healthy subject's motor learning process.

Este estudo investigou os efeitos de diferentes quantidades estruturas de prática variada, após a prática constante, no processo adaptativo de aprendizagem motora. Os participantes foram 107 crianças com idade média de 11.1 ± 0.9 anos. Três experimentos foram realizados usando uma tarefa de timing antecipatório complexo manipulando os seguintes componentes na prática variada: velocidade visuais estímulo (experimento 1); padrão de resposta sequencial (experimento 2), e velocidade de estímulo visual mais padrão de resposta sequencial (experimento 3). Em todos os experimentos, o design envolveu três quantidades (18, 36 e 63 ensaios), e dois regimes (aleatória e por blocos) da prática variada. Os experimentos também envolveram duas fases de aprendizagem: estabilização e adaptação. As variáveis dependentes foram os erros absoluto, variável e constante relacionados ao objetivo da tarefa, e o timing relativo para avaliar o padrão de resposta. Os resultados mostraram que todos os grupos pioraram os desempenhos na fase de adaptação, e nenhuma diferença entre eles foi observada. No seu conjunto, os resultados dos três experimentos permitem concluir que as quantidades de tentativas manipuladas nas práticas aleatória e por blocos não promoveram a diversificação da habilidade desde que não foi observada nenhuma adaptação.

This study investigated the effects of different amounts and schedules of varied practice, after constant practice, on the adaptive process of motor learning. Participants were one hundred and seven children with a mean age of 11.1 ± 0.9 years. Three experiments were carried out using a complex anticipatory timing task manipulating the following components in the varied practice: visual stimulus speed (experiment 1); sequential response pattern (experiment 2); and visual stimulus speed plus sequential response pattern (experiment 3). In all experiments the design involved three amounts (18, 36, and 63 trials), and two schedules (random and blocked) of varied practice. The experiments also involved two learning phases: stabilization and adaptation. The dependent variables were the absolute, variable, and constant errors related to the task goal, and the relative timing of the sequential response. Results showed that all groups worsened the performances in the adaptation phase, and no difference was observed between them. Altogether, the results of the three experiments allow the conclusion that the amounts of trials manipulated in the random and blocked practices did not promote the diversification of the skill since no adaptation was observed.

Este estudo propôs-se a realizar uma revisão sistemática da literatura a fim de verificar os efeitos da realidade virtual (RV) sobre a reabilitação de pacientes que sofreram acidente vascular encefálico (AVE). Foi realizada uma busca nas bases de dados eletrónicas Medline, Lilacs, Scielo e Pubmed, no período de 2004 a 2012. As palavras-chave utilizadas foram: realidade virtual, vídeo game, AVC, fisioterapia, reabilitação, virtual reality, stroke, rehabilitation e physiotherapy. Foram localizados 893 artigos e, ao final da seleção foram analisados nove estudos. Os resultados obtidos mostraram que o treino com RV pode contribuir para a reabilitação de pacientes que sofreram AVE. Os estudos selecionados utilizaram sete sistemas de RV para o treino das seguintes funções: marcha, equilíbrio, membro superior, cognição e perceção. Além disso, dependendo da função treinada, os autores utilizaram diferentes métodos de avaliação. Entretanto, mesmo os estudos que avaliaram funções similares utilizaram instrumentos de avaliação diferentes o que dificulta a comparação dos resultados. Conclui-se que a RV pode promover efeitos positivos na reabilitação de pacientes pós-AVE. Apesar dos resultados promissores, ainda são necessários novos estudos com maior número de sujeitos e melhor qualidade metodológica.

This study aimed to perform a systematic review to verify the effects of virtual reality (VR) on the rehabilitation of stroke patients. The search was conducted in the electronic databases Medline, Lilacs, Scielo and PubMed, from 2004 to 2012. The keywords selected for the search were: virtual reality, video game, stroke, physiotherapy, rehabilitation. It was found 893 articles, and at the end of selection, nine studies were included. The results showed that training with VR may contribute to the rehabilitation of stroke patients. The selected studies involved the use of seven different VR systems for training of functions: gait, balance, upper limb function, cognition and perception. Furthermore, depending on the function trained, the authors selected different assessment methods. However, even in the studies with similar functions assessed it was found different measurement techniques. The conclusion was that VR can promote positive effects on rehabilitation of post stroke patients. Despite promising results, further studies are needed with larger numbers of subjects and better methodological quality.

Este estudo investigou a tomada de decisão de virar do nadador a partir de variáveis informativas espaciotemporais. Para este fim, provas de 50 metros dos nados crawl e costas para homens e mulheres foram selecionados de uma competição de natação, e analisadas através do software Tacto. Os participantes foram 120 adultos de ambos os sexos com idades entre 20 e 70 anos. As distâncias da parede da piscina em que os nadadores iniciaram a viragem foram analisadas em relação à velocidade e à variabilidade de deslocamento, as quais foram divididas em quatro grupos adotando-se quartis como os pontos de corte. Os resultados mostraram que para todas as condições, os nadadores que apresentaram maior velocidade e menor variabilidade de deslocamento decidiram iniciar a viragem a uma distância maior da parede da piscina, e vice-versa. Além disso, a maior distância pareceu estar relacionada ao desempenho bem-sucedido. Estes resultados sugerem que os nadadores devem estar em sintonia com a informação espaciotemporal e espacial a fim de maximizar o seu desempenho.

This study investigated the swimmer’s decision-making process for turning, based on spatiotemporal informational variables. The men and women 50-metre front crawl and backstroke events were selected and analyzed using TACTO software. Participants included 120 adults of both genders aged between 20 and 70 years. The distance to the pool wall at which the swimmers initiated the turn was analyzed with regards to velocity and variability of previous displacement. These factors were split into four groups adopting, quartiles as the cut-off points. Results showed that for all conditions, the swimmers who showed a higher velocity and a lower variability of displacement decided to initiate the turn at a greater distance to the pool wall. Furthermore, the greater distance seemed to be associated with a more successful performance. These results suggest that swimmers should be attuned to spatiotemporal and spatial information in order to maximize their performance.