Abstract According to a biopsychosocial framework, personal and environmental factors might be mediators or facilitators/barriers, respectively, to functioning. However, it is not known how these factors can impact independence in household chores in children/adolescents with Down syndrome (DS). This study explored whether and how personal/environmental factors are associated with the independence level in household chores of children/adolescents with DS in Brazil. Caregivers of twenty-eight children/adolescents with DS were interviewed using the CHORES and a standardized questionnaire about personal (child’s age and sex) and environmental (socioeconomic level and maternal schooling) factors. Multiple linear regression analysis identified if/how these factors are associated with level of independence. For CHORES self-care and CHORES total, sex was a significant variable explaining 21.8% and 15.8%, respectively, of the variation in the outcomes. For the outcome CHORES family care none of the variables was significant. Female sex was associated with a lower need for assistance. We conclude that only the personal factor assessed related to female sex in children with DS was associated with the independence level in household chores. This finding highlights the importance of health care providers and families to encourage the independence in chores regardless of sex and promote opportunities for both boys and girls. framework facilitatorsbarriers facilitators barriers facilitators/barriers respectively functioning However childrenadolescents adolescents DS. . (DS) personalenvironmental Brazil twentyeight twenty eight childs child s socioeconomic schooling ifhow if selfcare self total 218 21 8 21.8 158 15 15.8% outcomes assistance girls (DS 2 21. 1 15.8 15.

OBJETIVO: O estudo buscou verificar o efeito de um protocolo terapêutico baseado em realidade virtual (RV) sobre o desempenho motor e o equilíbrio funcional de uma criança com paralisia cerebral (PC).DESCRIÇÃO DO CASO: Uma criança com PC hemiplégica espástica de 7 anos, nível de GMFCS I, foi submetida a um protocolo de intervenção fisioterapêutica de 12 sessões de 45 minutos, numa frequência de duas vezes semanais, com o uso de terapia baseada em RV. Utilizou-se um console comercialmente disponível (XBOX(r)360Kinect(r)) capaz de rastrear a movimentação corporal, reproduzindo-a em uma tela. Anteriormente à intervenção, foram realizadas avaliações de seu desenvolvimento motor e equilíbrio por meio dos instrumentos: Escala de desenvolvimento Motor (EDM) e Pediatric Balance Scale (PBS), respectivamente. Foram realizadas duas avaliações com espaço de uma semana como linha de base e uma reavaliação após as 12 sessões. Não foram observadas diferenças nos escores dos instrumentos nas duas avaliações iniciais. Depois do protocolo de intervenção, o paciente aumentou o escore do instrumento PBS em três pontos, atingindo o teto da escala e, no instrumento EDM, passou de um desempenho motor muito inferior para apenas inferior.COMENTÁRIOS: As evidências apresentadas pelo presente relato apoiam o uso da RV como uma promissora ferramenta a ser incorporada no processo de reabilitação de paciente com disfunções neuromotoras.

OBJECTIVE: To verify the effect of an intervention protocol using virtual reality (VR) on the motor performance and balance of a child with cerebral palsy (CP).CASE DESCRIPTION: To comply with the proposed objectives, a 7-year old child with spastic hemiplegic cerebral palsy (CP), GMFCS level I, was submitted to a physiotherapy intervention protocol of 12 45-minute sessions, twice a week, using virtual reality-based therapy. The protocol used a commercially-available console (XBOX(r)360Kinect(r)) able to track and reproduce body movements on a screen. Prior to the intervention protocol, the child was evaluated using the Motor Development Scale (MDS) and the Pediatric Balance Scale (PBS) in order to assess motor development and balance, respectively. Two baseline assessments with a 2-week interval between each other were carried out for each tool. Then, the child was re-evaluated after the twelfth session. The results showed no changes in the two baseline scores. After the intervention protocol, the child improved his scores in both tools used: the PBS score increased by 3 points, reaching the maximal score, and the MDS increased from a much inferior motor performance to just an inferior motor performance.COMMENTS: The evidence presented in this case supports the use of virtual reality as a promising tool to be incorporated into the rehabilitation process of patients with neuromotor dysfunction.

INTRODUÇÃO: O acidente vascular encefálico (AVE) é um quadro neurológico agudo de repercussões amplas, que exige de suas vítimas programas de reabilitação desafiadores na promoção da função. Nesse contexto, a Realidade Virtual (RV) é uma ferramenta de interface na reabilitação que pode gerar altos índices de motivação do paciente e permitir adaptação da terapia ao seu nível de função. OBJETIVO: Verificar o efeito da RV por meio de videogame sobre o controle postural de um indivíduo pós-AVE. MATERIAIS E MÉTODOS: Um indivíduo pós-AVE com um ano de lesão foi submetido a um protocolo de reabilitação física com videogame numa frequência de três vezes por semana por um período de 12 semanas. Anteriormente e após o programa foi realizada dinamometria por plataforma de força para análise de variáveis relacionadas ao centro de pressão (COP). RESULTADOS: Na reavaliação, observou-se que a amplitude de deslocamento médio-lateral (x) aumentou 67% na condição de olhos abertos (OA) e fechados (OF); amplitude anteroposterior (y) aumentou 25 e 44% em OA e OF, respectivamente; área aumentou 109 e 141% em OA e OF; velocidade diminuiu 26 e 0,27% em OA e OF. CONCLUSÃO: A RV como interface na reabilitação possivelmente ampliou a exploração da base de suporte para manutenção da estabilidade, constituindo recurso adicional no tratamento desses indivíduos.

INTRODUCTION: The impaired postural control is one of the main problems for stroke survivors. Its consequences require the development of effective and challenging rehabilitation strategies for promotion of function. In this context, studies focusing on Virtual Environment (VE) suggest that Virtual Reality (VR) is an interface device which allows creating high levels of motivation and adaptation of the patient to the therapy. OBJECTIVE: The aim of this study was to investigate the role of VR using video game to the improvement of postural control in a chronic stroke survivor. MATERIALS AND METHODS: Only one subject participated in this study and was submitted to a rehabilitation protocol of 12 weeks, three times a week, using videogame. Measures of the center of pressure were obtained previously and latter to the protocol using a force plate. RESULTS: The protocol resulted in higher amplitude of sway in x and y for both eyes open and eyes closed condition, and a higher area of sway in both conditions too. However, the velocity of sway was reduced for both conditions. CONCLUSION: The VR as an interface device in rehabilitation could be responsible for improve the exploration of the support base and thus might be an additional device in clinical rehabilitation.