Background Serious games have been increasingly used for motor rehabilitation. However, it is not well known how different game features can be used to impact specific skills properly. Here, we study how the mode (competitive, co-active, collaborative) in which a multi-user game is presented impacts engagement and social involvement. Methods We collected data from 20 pairs of community-dwelling older adults (71.5 ± 8.7 years) in a study following a within-persons design. The participants performed a two-player upper limb rehabilitation game with three conditions (Competitive, Co-active, and Collaborative modes). Engagement and social involvement were assessed through the Core Module and Social Presence Module, respectively, from the Game Experience Questionnaire. To infer the impact of personality and cognitive function, users answered the International Personality Item Pool (short version) and the Montreal Cognitive Assessment, respectively. Results Results show that the Collaborative game mode promotes more social involvement when compared to Competitive and Co-active modes. This result is mostly explained by those participants with higher cognitive skills, and those that are more extrovert. Extrovert participants feel more empathy and are behaviorally more involved when playing the Collaborative mode. Also, the Collaborative mode is shown to be appropriate to promote interaction with participants that previously had a distant relationship, while the Competitive mode seems to be more beneficial to promote empathy between players with a closer relationship. Conclusions The Collaborative game mode elicited significantly higher social involvement in terms of Empathy, Positive Affect, and Behavioral Involvement. Hence, this game mode seems to be the most adequate choice to be used in multiplayer rehabilitation settings, where social interaction is intended.

RESUMO O objetivo desta pesquisa foi comparar a força funcional dos membros inferiores e superiores entre idosas fisicamente ativas e sedentárias. A amostra foi constituída de 540 voluntárias, divididas em: Grupo Fisicamente Ativo (GFA) e Grupo Sedentário (GS), que se subdividiram em: GFA1 (n=107 com 61,6±1,5 anos e IMC=27,1±3,9), GFA2 (n=94, com 66,7±1,3 anos e IMC=27,5±3,6), GFA3 (n=82, com 72,2±1,4 anos e IMC=27,5±3,8), GFA4 (n=75, com 77,2±1,3 anos e IMC=28,1±3,9), GS1 (n=36, com 62,9±1,2 anos e IMC=27,7±4,4), GS2 (n=39, com 67,7±1,3 anos e IMC=28,1±3,1), GS3 (n=49, com 72,5±1,3 anos e IMC=28,3±2,9) e GS4 (n=58, com 77,6±1,1 anos e IMC=28,3±3,8). Para mensurar a variável em questão, utilizaram-se os testes Chair stand e Arm curl. A estatística foi realizada através dos programas Office Excel 2007 e SPSS16, adotando-se como nível de significância U<0,05. Quanto à força funcional de membros inferiores (MMII), todos GFA apresentaram diferenças significativas sobre seus respectivos GS. Para a força funcional de membros superiores (MMSS), apenas os GFA1 e GFA2 apresentaram diferenças significativas sobre os GS1 e GS2. Conclui-se que os programas de atividade física foram capazes de manter, ainda que limitadamente, os níveis de força funcional de MMII e MMSS das idosas fisicamente ativas.

Introduction:The aging will inevitably bring some kind of functional decline in elderly, sarcopenia in this sense stands out because it damages the muscle function and extend also to the respiratory muscles. Objective: Systematically review studies that have sought to compare the strength of respiratory muscles between sedentary and physically active elderly in training programs nonspecific respiratory musculature. Materials and methods: From the descriptors motor activity, respiratory muscles and elderly, the databases LILACS, MedLine, Cochrane, PEDro, Scirus and Redalyc were consulted. Results: Of 1.263 experiments available in said databases, 12 were recovered and 6 were selected due they meet all the inclusion Fisioter Mov. 2014 jan/mar;27(1):129-39 Pereira FD, Batista WO, Fuly PSC, Alves-Junior ED, da Silva EB. 130 criteria and selection requirements. Conclusion: Physical activity programs offered by the selected studies led physically active elderly to have respiratory muscle strength statistically higher than the sedentary. However, this condition did not expressed itself as security to these elderly to present strength levels above of the minimum predictive of normality. [P] Resumo Introdução: O envelhecimento inevitavelmente trará algum tipo de declínio funcional ao idoso. Nesse sentido, a sarcopenia se destaca por acometer a função muscular e se estender também à musculatura respiratória. Objetivo: Revisar sistematicamente os estudos que buscaram comparar a força dos músculos respiratórios entre idosos sedentários e fisicamente ativos em programas de treinamento inespecíficos à musculatura respiratória. Materiais e métodos: A partir dos descritores atividade física, músculos respiratórios e idoso, foram consultadas as bases de dados LILACS, MedLine, Cochrane, PEDro, Scirus e Redalyc. Resultados: Dos 1.263 experimentos disponíveis nas referidas bases, 12 foram recuperados e 6 selecionados por atenderem totalmente aos critérios de inclusão e seleção estabelecidos. Conclusão: Os programas de atividade física propostos pelos estudos selecionados levaram os idosos fisicamente ativos a apresentarem força dos músculos respiratórios estatisticamente superior à dos sedentários. Ainda assim, essa força não foi necessariamente superior ao valor mínimo preditivo de normalidade. [K] Palavras-chave: Atividade física. Músculos respiratórios. Idoso.Fisioter Mov.

Background Serious games are promising for stroke rehabilitation, with studies showing a positive impact on reducing motor and cognitive deficits. However, most of the evidence is in the context of single-user rehabilitation, and little is known concerning the impact in multi-user settings. This study evaluates the impact that different game modes can have on engagement and social involvement during a two-user game. Specifically, we want to understand the benefits of game modalities based on competition, co-activation, and collaboration and analyze the influence of different motor and cognitive deficits and personality traits. Methods We developed a two-player setup—using tangible objects and a large screen interactive table—for upper limb rehabilitation purposes. We implemented a game that, while keeping the same basic mechanics, can be played in the three different modes (Competitive, Co-active, and Collaborative). We ran a within-person randomized study with 21 stroke survivors that were paired and played the game in its three versions. We used the Game Experience Questionnaire—Core Module to assess engagement and the Social Presence Module to assess Social Involvement. For personality, motor, and cognitive function, users answered the International Personality Item Pool (short version), Fugl-Meyer Assessment—Upper Extremity, Modified Ashworth Scale, and Montreal Cognitive Assessment, respectively. Results The Collaborative mode promoted significantly more Behavioral Involvement. The Competitive mode promoted more Flow and Challenge than the Co-active mode with participants with better cognitive performance, with low extraversion, or with higher motor skills. Participants with higher cognitive deficits reported more Competence with the Co-active mode. Conclusions Our results indicate that, for multi-user motor rehabilitation settings, the collaborative mode is the more appropriate gaming approach to promote social involvement, showing a high potential for increasing adherence and effectiveness of therapy. Additionally, we show that a player's motor and cognitive ability and personality should be considered when designing personalized tasks for multiplayer settings.

PurposeTo compare functional fitness (FF) levels among independent-living (IL) and day care (DC) elderly women of different age groups and to analyze changes in FF after 8 months of participation in an exercise program intervention for the IL elderly women.Materials and methodsA total of 674 elderly women were divided into four IL groups with age in the range of 60–64 years (IL60–64, n=149), 65–69 years (IL65–69, n=138), 70–74 years (IL70–74, n=135), and 75–79 years (IL75–79, n=83), and four DC groups with age in the range of 60–64 years (DC60–64, n=35), 65–69 years (DC65–69, n=34), 70–74 years (DC70–74, n=47), and 75–79 years (DC75–79, n=53). The intervention consisted of a multimodal exercise training, 3 days per week for 8 months. Senior Fitness Test battery performances were obtained at baseline and after 8-month intervention.ResultsSignificant differences were identified between all IL groups and DC groups in all FF tests (P<0.001), except between IL70–74 and DC70–74 in the chair sit-and-reach. Analysis of covariance (ANCOVA) identified significant improvements in all FF tests between pre- and posttests in the IL groups (P<0.001), except in the chair sit-and-reach for the IL70–74. ANCOVA also showed a significant declining performance in all FF tests for DC groups (P<0.001), except in the chair sit-and-reach for the DC70–74 and DC75–79.ConclusionIL women are more fit than institutionalized DC elderly women. The multimodal training was effective in improving all FF components related to daily living activities, in all age groups. In contrast, institutionalized elderly showed a clear tendency to worsen their FF over the time.

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OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls. METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05) were used. RESULTS: there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups. CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.

Introduction Action observation neurorehabilitation systems are usually based on the observation of a virtual limb performing different kinds of actions. In this way, the activity in the frontoparietal Mirror Neuron System is enhanced, which can be helpful to rehabilitate stroke patients. However, the presence of limbs in such systems might not be necessary to produce mirror activity, for example, frontoparietal mirror activity can be produced just by the observation of virtual tool movements. The objective of this work was to explore to what point the presence of a virtual limb impacts the Mirror Neuron System activity in neurorehabilitation systems. Methods The study was conducted by using an action observation neurorehabilitation task during a functional magnetic resonance imaging (fMRI) experiment with healthy volunteers and comparing two action observation conditions that: 1 – included or 2 – did not include a virtual limb. Results It was found that activity in the Mirror Neuron System was similar during both conditions (i.e. virtual limb present or absent). Conclusions These results open up the possibility of using new tasks that do not include virtual limbs in action observation neurorehabilitation environments, which can give more freedom to develop such systems.