Purpose: The objective of this paper is to carry out a systematic review about the information about the application of of virtual reality (VR) and videogames in cardiac rehabilitation (CR).Methods: A systematic review was conducted. Jadad scale was applied to evaluate the methodological quality of the articles included and the degree of evidence and the level of recommendation were determined through the Oxford Center for Evidence-Based Medicine.PRISMA guidelines statement for systematic reviews were followed. Results:The total number of articles included in the present review was 10, with heterogeneity in the study populations, CR phases, technology used and protocols. Most of the studies showed an increase in heart rate, less pain, a greater ability to walk, higher energy levels, an increase in physical activity and improvements of motivation and adherence. The methodological quality of the studies was between acceptable and poor.Conclusions: The use of VR and videogames could be considered as complementary tools of physical training in patients with CVD in the different phases of CR. However, it is also necessary to carry out studies with adequate methodological quality to determine the ideal technological systems, target populations and clearly protocols to study their effects in the short, medium and long-term assessments.

Purpose The aim of the present study was to evaluate the efficacy and safety of non‐supervised home‐based exercise versus individualized and supervised programs delivered in clinic‐based settings for the functional recovery immediately after discharge from a primary TKA. Methods Medline, Embase, Cochrane, and PEDro databases were screened, from inception to April 2015, in search for randomized clinical trials (RCT) of home‐based exercise interventions versus individualized and supervised outpatient physical therapy after primary TKA. Target outcomes were: knee range of motion (ROM), patient‐reported pain and function, functional performance, and safety. Risk of bias was assessed with the PEDro scale. After assessing homogeneity, data were combined using random effects meta‐analysis and reported as standardized mean differences or mean differences. We set a non‐inferiority margin of four points in mean differences. Results The search and selection process identified 11 RCT of moderate quality and small sample sizes. ROM active extension data suitable for meta‐analysis was available from seven studies with 707 patients, and ROM active flexion from nine studies with 983 patients. Most studies showed no difference between groups. Pooled differences were within the non‐inferiority margin. Most meta‐analyses showed significant statistical heterogeneity. Conclusion Short‐term improvements in physical function and knee ROM do not clearly differ between outpatient physiotherapy and home‐based exercise regimes in patients after primary TKA; however, this conclusion is based on a meta‐analysis with high heterogeneity. Level of evidence I.

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(1) Background: The aim of the present study was to determine the effects of a virtual reality (VR) program, as a complementary tool to a conventional cardiac rehabilitation (CR) program in phase II of patients with ischemic heart disease compared to a conventional treatment group. (2) Methods: A single blinded randomized clinical trial was conducted. The patients were randomized to a control group (CG) or an experimental group (EG). The EG carried out a training based on VR of aerobic exercise using the XBOX ONE console and Kinect sensor. Ergometry, metabolic equivalents (METS), Functional Independence Measure, 6-min walk test (6MWT), the Short Form Health Survey-36 Questionnaire (SF-36), the Beck Depression Inventory-II, and the degree of satisfaction and adherence to treatment were used as outcome measures. (3) Results: Our results showed no statistically significant differences between the two groups. Statistical analysis within group for the EG showed statistically significant changes in the variables HR final ergometry, ergometry minutes, % ergometry, METS, final HR 6MWT, 6MWT distance, 6MWT number of laps, and for the SF-36 and Beck Depression Inventory-II. (4) Conclusion: A VR-based video game program, as an adjunct tool to a CR program, showed improvements in ergometry, METS, resistance to fatigue and health-related quality of life with excellent adherence and satisfaction perceived by patients with ischemic heart disease in phase II.

The local and referred pain elicited from widespread active MTrPs fully reproduced the overall spontaneous clinical pain area in patients with FMS. Widespread mechanical pain hypersensitivity was related to a greater number of active MTrPs. This study suggests that nociceptive inputs from active MTrPs may contribute to central sensitization in FMS.