Title Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report (Preprint)

BACKGROUND Background: Dizziness and imbalance are common and disabling symptoms in multiple sclerosis (MS) patients caused by a central, peripheral or mixed vestibulopathy. Central vestibular disorder is the most frequent report in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and its repercussions in quality of life. However, immersive virtual reality (VRi) is a growing tool in this fieldwork, but no previous research has been performed studying its effects in MS. OBJECTIVE Objective: To apply a VRi vestibular training protocol in a patient with MS and assess the effects induced by the experimental intervention. METHODS Methods: Case study of a 54-year-old woman with relapsing remitting multiple sclerosis (RRMS). We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold standard vestibular training of Cawthorne-Cooksey. The 20 session intervention is formed of 10 initial sessions and 10 advanced sessions. Each 50 minute session will be performed 3 times per week for 8 weeks. Four evaluations were carried out over the study period: at baseline (T0), between the two intervention phases (T1), at the end of the intervention and at the one month follow-up (T3). The outcomes of the research were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone and usability of HMD. RESULTS Results: The patient improved DHI (T0=62 points/T2=4), BBS (T0=47/T2=54), iTUG (T0=8.35 sec/T2=5.57 sec), muscular tone of the erector spinae, rectus femoris and soleus, MFIS (T0=61/T2=37) and MSQoL-54 (T2 physical area=67.16%; T2 mental area= 33.56%) after receiving the VRi vestibular protocol. System Usability Scale reached 90% of usability and A grade. CONCLUSIONS Conclusions: This research provided evidence of the first VRi vestibular protocol in the MS population to improve dizziness, balance, gait, impact of fatigue and quality of life and muscular tone through an exergame intervention. This study may help to set a standardized VRi protocol for vestibular rehabilitation.

Bisalbuminémia: Uma Variante Rara da Albumina

Introduction: Bisalbuminemia is a qualitative disorder of albumin and it is defined by the coexistence in the same individual of two types of serum albumin with different electrophoretic mobility. There are two forms: hereditary and permanent, or acquired and transient.Case Report: Girl, 17-years-old, referenced to the hospital consult after incidental finding of bisalbuminemia detected in plasma protein electrophoresis performed within the investigation of diminished muscular tone in the lower limbs. Physical examination was normal. Secondary causes of bisalbuminemia were excluded. Later, it was confirmed the same disorder in plasma protein electrophoresis performed to her 14-years-old brother and mother.Discussion: We describe a rare case of hereditary bisalbuminemia in a portuguese family. In general, this condition shows no pathological significance, however it is of interest to the clinicians the knowledge of this analytic change for better orientation of their patients.

Bending, Flirting, Floating, Flying: A Critical Analysis of Female Figures in 1970s Gymnastics Photographs

During the 1970s, a new corporal and aesthetic standard emerged in women’s artistic gymnastics. No longer was grace and elegance the main feature, but acrobatic and somewhat robotic performances. These exercises were increasingly performed by highly trained and sexually immature girls. The Western audience was fascinated by the athletic and innocent-looking gymnasts. The emerging corporality and performance trend combined youthfulness und slimness with physical fitness and muscular tone, a combination that reflected the idealized woman of the 1970s. Sports photographs played a key role in distributing the “new” ideal of femininity. In this article, we consider how gymnasts’ performances of the 1970s were visualized by examining a sample of professional sports photographs. We demonstrate how sports photographs construct and establish gender and body standards through their visual construction of gendered and de-gendered gymnastics performances.