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Background The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. Objective To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. Materials and methods The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. Results We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95 % CI: -0.90, -0.21; p = 0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95 %: -1.70, -0.35; P = 0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. Conclusions Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.

Objective The purpose of this research was to evaluate the predictive capacity of five Early Warning Scores in relation to the clinical evolution of adult patients with different types of trauma. Research Methodology We conducted a longitudinal, prospective, observational study, calculating the Early Warning Scores [Modified Early Warning Score (MEWS), National Early Warning Score 2 (NEWS-2), VitalPAC Early Warning Score (ViEWS), Modified Rapid Emergency Medicine Score (MREMS), and Rapid Acute Physiology Score (RAPS)] upon arrival of patients to the emergency department. Setting In total, 445 cases of traumatic injuries were included in the study. Main Outcome Measures The predictive capacity was verified with the data on admission to intensive care units (ICU) and mortality at two, seven and 30 days. Results 201 patients were hospitalized and 244 were discharged after being attended in the emergency department. 91 cases (20.4%) required ICU care and 4.7% of patients died (21 patients) within two days, 6.5% (29 patients) within seven days and 9.7% (43 patients) within 30 days. The highest area under the curve for predicting the need for ICU care was obtained by the National Early Warning Score 2 and the VitalPAC Early Warning Score. For predicting mortality, the Modified Rapid Emergency Medicine Score obtained the best scores for two-day mortality, seven-day mortality and 30-day mortality. Conclusions Every Early Warning Score analyzed in this study obtained good results in predicting adverse effects in adult patients with traumatic injuries, creating an opportunity for new clinical applications in the emergency department.

ResumenObjetivoEvaluar la efectividad de un programa de juego basado en la realidad virtual para la mejora de los dominios cognitivos en pacientes con esquizofrenia.MétodoEnsayo clínico aleatorizado con 40 pacientes con esquizofrenia, 20 en el grupo experimental y 20 en el grupo control. El grupo experimental recibió 10 sesiones con Nintendo Wii® durante 5 semanas, 50 minutos/sesión, 2 días/semana, además del tratamiento convencional. El grupo control sólo recibió tratamiento convencional.ResultadosSe encontraron diferencias estadísticamente significativas de las puntuaciones T-Score entre la preevaluación y la postevaluación en el grupo experimental en cinco de los seis dominios cognitivos evaluados: velocidad de procesamiento (F=12,04, p=0,001), atención/vigilancia (F=12,75, p=0,001), memoria de trabajo (F=18,86, p