Sensorimotor Training Research Articles

Physical activity in cancer - effectiveness of exercise therapy approaches

The positive effects of oncological exercise therapy are sufficiently proven according to scientific studies. International evidence-based guidelines confirm this importance and recommend physical exercise as part of the standard therapy for cancer. The effects of physical activity on cancer-specific deficits are versatile ranging from positive impact on fatigue syndrome, mortality, incontinence, lymphoedema, CIPN, anxiety, depression to reduction of pain. According to current knowledge, sensorimotor training is recommended for the treatment of polyneuropathy. The actual effectiveness of vibration training in reducing symptom burden is undetermined. There are more than 100 randomized, controlled studies with the highest evidence rating for the management of CrF available. In this regard, exercise therapy is more effective than drug therapy in alleviating the symptomatology of CrF. In addition to the movement-therapeutic approach, a coordinated diet is necessary to avoid nutrition shortages.The evidence on physical activity in oncology must be considered not only in theory, but also in practice and be accepted as a general recommendation for oncology patients. The personalized OTT treatment concept represents a practical implementation and offers a targeted treatment option with low side effects.

Effects of Ankle Sensorimotor Training Program Combined with Hip Strengthening Exercise on Muscle Strength, Static Balance, and Dynamic Balance in Individual with Functional Ankle Instability

Effects of Ankle Sensorimotor Training Program Combined with Hip Strengthening Exercise on Muscle Strength, Static Balance, and Dynamic Balance in Individual with Functional Ankle Instability

The type of exercise most beneficial for quality of life in people with multiple sclerosis: A network meta-analysis.

There is overwhelming evidence regarding the beneficial effects of exercise on the management of symptoms, functionality and health-related quality of life (HRQoL) of people with multiple sclerosis (MS). However, few analyze have compared different types of exercise. The aim of this network meta-analysis (NMA) was to assess which type of physical exercise has the greatest positive effect on HRQoL in people with MS. MEDLINE, Cochrane Library, Embase, Web of Science, Physiotherapy Evidence Database and SPORTDiscus databases were searched from inception to June 2021 to identify randomized controlled trials (RCTs) examining the effect of physical exercise on HRQoL in people with MS. The NMA included pairwise and indirect comparisons. We ranked the effect of interventions calculating the surface under the cumulative ranking (SUCRA). We included 45 RCTs in this NMA (2428 participants; 76% women; mean age 45 years). Five types of physical exercises were ranked. Sensorimotor training had the highest effect size (0.87, 95% confidence interval [CI] 0.60; 1.15) and the highest SUCRA (87%) for total HRQoL. The highest effect size and SUCRA for physical and mental HRQoL were for aerobic exercise (0.85, 95% CI 0.28; 1.42) (89%) and mind-body exercises (0.54, 95% CI 0.03; 1.06) (89%). Sensorimotor training was the best exercise for mild disease and aerobic exercise for severe disease for total HRQoL. Sensorimotor training seems the most effective exercise to improve HRQoL and aerobic and mind-body exercises to improve physical and mental HRQoL, respectively.

Five-week sensorimotor training efficacy in postural control of amateur college athletes with chronic ankle instability: controlled clinical trial

Five-week sensorimotor training efficacy in postural control of amateur college athletes with chronic ankle instability: controlled clinical trial

Analysis of the Existing Treatment Methods for Ballet Dancers with Ankle Joints Injuries. Literature Review

In a study by American scientists, it was noted that most of the injuries of ballet dancers occur on the lower limbs, as they are subjected to increased loads. Ankle joints injury with ligament injuries is the most frequent and complication-prone type of injury. Insufficient attention is paid to the accidents prevention and replenishment of the sensorimotor deficit in the process of recovering from this injury. According to a focused literature review by Mackenzie M.H. et al. on the epidemiology of acute sprain of the ankle ligaments, chronic instability of the ankle joint develops in 40% of patients who have experienced such an injury for the first time, characterized by repeated sprains and sensations of instability of the ankle joint. Aim. To analyze the process of rehabilitation of ballet dancers with the ankle joint injury, identify the shortcomings of rehabilitation programs, to study the effect of proprioceptive training programs in reducing the incidence of repetitive ankle sprains in athletes and ballet dancers with a history of ankle injuries. Conclusion. Suspension systems exercises can provide training not only for individual muscle groups, but also for proprioceptive sensitivity training, correction of postural disorders due to trauma, and most importantly, sensorimotor training under controlled conditions, which reduces the risk of possible re-traumatization.

Examining Sensory-motor Training Versus Impairment-based Training on Pain and Function in Subjects With Knee Osteoarthritis

Purpose: Osteoarthritis is a degenerative joint disease affecting synovial joints and damages joints due to stresses caused by an abnormality in any of the synovial joint tissues, including articular cartilage and subchondral bone, ligaments, menisci, periarticular muscles, peripheral nerves, and synovium. To compare the effect of sensory-motor training versus impairment-based training on pain and physical function in subjects with knee osteoarthritis. Methods: Simple random sampling was used to divide 30 subjects aged 50 and 70 years who met the inclusion and exclusion criteria into two groups (n=15). Group A received sensory-motor training, while Group B received impairment-based training. Before the treatment, the subjects walked for 10 minutes to warm up. For three weeks, each group was treated three times per week. Pre-test; post-test outcomes are noted, the visual analog scale (VAS) was used to assess pain, and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) was used to assess physical function. Results: Comparing the post-test pain (VAS) scores between groups showed that the mean±SD of posttest pain (VAS) score in the sensory-motor training group was 2.707±1.01. The mean±SD in the impairment-based training group was almost the same, at 2.29±1.13. It was statistically significant at the 5% level. Similarly, the mean±SD of the posttest function (WOMAC) score in the sensory-motor training group was 16.55±6.92. Conclusion: Sensory-motor training is superior to impairment-based training on pain and physical function in subjects with knee osteoarthritis.

The Effect of Sensorimotor Training on the Plantar Pressure Distribution Symmetry in Healthy Elderly: A Field Trial Study

Purpose: Sensorimotor impairment in the elderly leads to increased postural sway and plantar pressure distribution asymmetric. The plantar pressure distribution asymmetrical can cause secondary problems, such as forefoot pain, neuropathic plantar ulcers, and metatarsal stress fractures. Therefore, this study aims to examine the effect of sensorimotor training on the plantar pressure distribution symmetry in healthy elderly women. Methods: Forty healthy elderly women participated in this study and were randomly assigned to two experimental and control groups (20 people in each group). Pressure distribution was evaluated during standing with double-legs and eyes closed. The experimental group performed sensorimotor training for eight weeks, and the control group did not receive any intervention during this period. The statistical method of analysis of covariance (ANCOVA) was used to compare the results between the two groups. Results: Analysis of covariance (ANCOVA) test showed that after eight weeks of sensorimotor training, the plantar pressure distribution in the forward and backward of the right (P=0.000) and left (P=0.000) foot was balanced with a high effect size. In addition, the plantar pressure distribution symmetry of the inter-limb was balanced after eight weeks of sensorimotor training with a high effect size (P=0.015). Conclusion: Sensorimotor training by adjusting balance strategies and increasing the impulse sent from mechanical receptors cause sensorimotor integration and facilitates muscle activity. As a result, posture sway is reduced and plantar pressure distribution symmetrical.

The Effect of Sensorimotor Exercises on Hand Mobility in Patients with Cerebral Palsy Hemiplegia Half of the Body

Background and Aim: Cerebral palsy is a very common sensory-motor disorders that can lead to functional hand disabilities and reduced participation; therefore, the aim of the present study was to investigate the effect of sensorimotor training on the motor ability of patients with cerebral palsy. Methods: In the present quasi-experimental study, the statistical population included all patients with cerebral palsy in Tabriz rehabilitation centers. 30 male and female hemiplegia patients aged 45 to 70 years were selected as the available sample and randomly divided into two groups of 15 test and control. Box and block tests were used to measure gross motor ability. The training program included the sensory and motor part, which was done for eight weeks and 3 sessions per week and 60 minutes per session. Statistical analysis of data was performed using SPSS software version 26. Independent and paired t-tests were used at a significance level of 0.05. Results: The results of the present study showed that after the application of simultaneous sensorimotor exercises, the motor function of the upper limb was significantly improved (p = 0.000). The mean change was observed in the experimental group from 9.12 ± 1.16 to 13.05 ± 2.56 and in the control group from 8.92± 1.27 to 9.02 ± 0.94. Conclusion: Using simultaneous sensorimotor exercises can lead to improved hand mobility if sensory-motor experiences are created. Therefore, this type of exercise can be used in the rehabilitation program of patients with cerebral palsy according to their needs. 53% of the changes in depression and 57% of the changes in anxiety were due to neurofeedback; but neurofeedback had no effect on stress. Neurofeedback was able to reduce depression and anxiety in women with abdominal pain but had no effect on their stress level. Keywords: Sensory motor exercises, motor ability, cerebral palsy, hemiplegia

Effectiveness of action observation therapy based on virtual reality technology in the motor rehabilitation of paretic stroke patients: a randomized clinical trial

BackgroundThe rehabilitation of paretic stroke patients uses a wide range of intervention programs to improve the function of impaired upper limb. A new rehabilitative approach, called action observation therapy (AOT) is based on the discovery of mirror neurons and has been used to improve the motor functions of adult stroke patients and children with cerebral palsy. Recently, virtual reality (VR) has provided the potential to increase the frequency and effectiveness of rehabilitation treatment by offering challenging and motivating tasks. MethodsThe purpose of the present project is to design a randomized controlled six-month follow-up trial (RCT) to evaluate whether action observation (AO) added to standard VR (AO + VR) is effective in improving upper limb function in patients with stroke, compared with a control treatment consisting of observation of naturalistic scenes (CO) without any action content, followed by VR training (CO + VR).DiscussionAO + VR treatment may provide an addition to the rehabilitative interventions currently available for recovery after stroke and could be utilized within standard sensorimotor training or in individualized tele-rehabilitation.Trial registrationThe trial has been prospectively registered on ClinicalTrials.gov. NCT05163210. 17 December 2021.

Effect of Six-Week Resistance and Sensorimotor Training on Trunk Strength and Stability in Elite Adolescent Athletes: A Randomized Controlled Pilot Trial.

Intervention in the form of core-specific stability exercises is evident to improve trunk stability. The purpose was to assess the effect of an additional 6 weeks sensorimotor or resistance training on maximum isokinetic trunk strength and response to sudden dynamic trunk loading (STL) in highly trained adolescent athletes. The study was conducted as a single-blind, 3-armed randomized controlled trial. Twenty-four adolescent athletes (14f/10 m, 16 ± 1 yrs.;178 ± 10 cm; 67 ± 11 kg; training sessions/week 15 ± 5; training h/week 22 ± 8) were randomized into resistance training (RT; n = 7), sensorimotor training (SMT; n = 10), and control group (CG; n = 7). Athletes were instructed to perform standardized, center-based training for 6 weeks, two times per week, with a duration of 1 h each session. SMT consisted of four different core-specific sensorimotor exercises using instable surfaces. RT consisted of four trunk strength exercises using strength training machines, as well as an isokinetic dynamometer. All participants in the CG received an unspecific heart frequency controlled, ergometer-based endurance training (50 min at max. heart frequency of 130HF). For each athlete, each training session was documented in an individual training diary (e.g., level of SMT exercise; 1RM for strength exercise, pain). At baseline (M1) and after 6 weeks of intervention (M2), participants’ maximum strength in trunk rotation (ROM:63°) and flexion/extension (ROM:55°) was tested on an isokinetic dynamometer (concentric/eccentric 30°/s). STL was assessed in eccentric (30°/s) mode with additional dynamometer-induced perturbation as a marker of core stability. Peak torque [Nm] was calculated as the main outcome. The primary outcome measurements (trunk rotation/extension peak torque: con, ecc, STL) were statistically analyzed by means of the two-factor repeated measures analysis of variance (α = 0.05). Out of 12 possible sessions, athletes participated between 8 and 9 sessions (SMT: 9 ± 3; RT: 8 ± 3; CG: 8 ± 4). Regarding main outcomes of trunk performance, experimental groups showed no significant pre–post difference for maximum trunk strength testing as well as for perturbation compensation (p > 0.05). It is concluded, that future interventions should exceed 6 weeks duration with at least 2 sessions per week to induce enhanced trunk strength or compensatory response to sudden, high-intensity trunk loading in already highly trained adolescent athletes, regardless of training regime.

Effect of Integrated sensory-motor Training on muscular strength in Educable Mental Retardation Students

Today, in all human societies, exceptional people, especially people with intellectual disability are regarded. Students and children mentally retarded in physical skills such as strength have serious shortcomings. This study aimed town to investigate the effect of sensory-motor training on muscle strength in children with educable mental retardation. A quasi-experimental study was conducted. Thirty mentally retarded girls from primary school were selected through purposive sampling. Then, they were homogenized based on their pretest scores and were divided into two groups: fifteen experimental & fifteen control. That because of the evaluating reduction, the number of the control group reached ten. In this research, A Dynamometer and vertical jump test- was used to test physical strength. Sensory stimulation and physical exercises were practiced by the experimental group during twenty-four sessions. Each session was forty-five minutes long and was held three times a week. The control group performed the class programs. After twenty-four sessions both groups were tested. To investigate the research hypothesis Paired T-test and ANOVA2 × 2 and by SPSS software (version 21) were used. There were no significant differences between the two groups with regard to improving the muscle strength (p>0.05). Statistical results showed no significant differences between the two groups with regard to improving the muscle strength. Although applying the integrated sensory- motor is common among occupational therapists, it does not yield satisfactory results for muscle strength, according to the results of this study. Simultaneous utilization of other reference frames beside the sensory-motor Integration may result in better outcomes.

EFFECT OF SENSORIMOTOR INTEGRATION TRAINING ON BALANCE, NEUROMUSCULAR CONTROL AND REACTION TIME IN ELDERLY.

Background: SMT (sensorimotor training) is a form of exercise aiming to decrease the muscle imbalance by maximizing the sensory input coming from three sites in the body where there is a large number of propioception(the foot, sacroiliac joint ,cervical spine).The purpose of study is to check the effect of SMT on neuromuscular control, balance and reaction time using three levels i.e. stable surface , unstable surface and sand in elderly population. Method:The study was an experimental study with a sample size of 30 elderly subjects of age group 60-80 years. They had performed exercises in st three levels 1 in stable then foam then sand. They were assessed using SOT test, test for neuromuscular control and reaction time. Conclusion: The study shows that the sensorimotor training which is given in three levels i.e., in stable surface , foam and sand are effective in improving balance, increasing neuromuscular control and decreasing reaction time in elderly for decreasing risk of fall and improving quality of life in elderly.

Rehabilitation, exercise, and related non-pharmacological interventions for chemotherapy-induced peripheral neurotoxicity: Systematic review and evidence-based recommendations.

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are very limited. We systematically reviewed data on rehabilitation, exercise, physical therapy, and other physical non-pharmacological interventions and offered evidence-based recommendations for the prevention and treatment of CIPN. A literature search using PubMed, Web of Science and CINAHL was conducted from database inception until May 31st, 2021. 2791 records were title-abstract screened, 71 papers were full-text screened, 41 studies were included, 21 on prevention and 20 on treatment of CIPN. Treatment type, cancer type, chemotherapy compounds were heterogeneous, sample size was small (median: N = 34) and intention-to-treat analysis was lacking in 26/41 reports. Because of the methodological issues of included studies, the reviewed evidence should be considered as preliminary. Exercise, endurance, strength, balance, and sensorimotor training have been studied in low-to-moderate quality studies, while the evidence for other treatments is preliminary/inconclusive. We offer recommendation for the design of future trials on CIPN.

Chronic Ankle Instability - Mechanical vs. Functional.

Chronic ankle instability arises from three interacting contributing factors: mechanical ankle instability, functional ankle instability, and perceived ankle instability. To decide on the most appropriate individual recommendation for therapeutic options, it is necessary to assess which of the two main aetiologies - functional vs. mechanical - is dominant in causing the perceived impairment. It is essential to perform a thorough analysis and diagnosis, even though quantifying mechanical ankle instability is still a challenge in the clinical approach to this common pathology. When diagnosing mechanical instability, the most established procedure is physical examination, although this unfortunately does not allow the deficit to be quantified. Additional options include stress-ultrasound, 3D stress-MRI (3SAM), ankle arthrometry, marker-based 3D motion analysis, and diagnostic ankle arthroscopy. Of these the latter is considered the gold standard, even though it is an invasive procedure, it may not be performed for diagnostic reasons only, and it also does not allow the mechanical instability to be quantified. For diagnosing functional instability there are non-instrumented tests such as the Star Excursion Balance Test or Y-Balance Test, posturography/stabilometry, and gait and running analysis, possibly combined with EMG acquisition and isokinetic strength testing.To date, the standard of care is conservative management of ankle instability, and the therapy should include sensorimotor training, strength training of the periarticular muscles, balance training, and gait and running exercises on different surfaces. However, it is increasingly clear that a certain degree of mechanical instability cannot be compensated for by functional training. Thus, it is the goal of differential diagnostics to identify those patients and guide them to mechanical therapy, including ankle bracing, taping, and surgical ligament reconstruction.

Effect of multimodal sensorimotor training on the stereotypical behavior in children with autism spectrum disorder

OBJECTIVE: To analyze the effect of multimodal sensorimotor training on the stereotypical behavior in children with autism spectrum disorder (ASD).MATERIALS AND METHODS: A group of 60 children with autism were taken in the study who met the inclusion and exclusion criteria and were grouped into two groups using simple random sampling. Group 1 was the interventional group with 30 participants and Group 2 was control group with 30 participants. A 12-week multi-modal sensorimotor training program was given to Group 1. The control group (Group 2) was also given a 12-week conventional physiotherapy intervention. The outcome measure used was the Indian Scale for Autism Assessment (ISAA). Pretest and posttest findings on ISAA were noted for both groups.RESULTS: Multimodal sensorimotor training program has good results compared to the control group in improving the stereotypical behavior in children with ASD. Children who were given conventional physiotherapy programs also showed improvement in their posttest results. On comparing the two groups, multimodal sensorimotor training was found to be more effective in children with ASD.CONCLUSION: There is a significant improvement in stereotype behavior, such as head banging, hand flapping, and repetitive behavior. Multimodal sensorimotor training helps to improve the stereotypic behavior in children with ASD. The present study gives a promising intervention program for children with ASD.

Exercise and Neuropathy: Systematic Review with Meta-Analysis.

Peripheral neuropathies are a prevalent, heterogeneous group of diseases of the peripheral nervous system. Symptoms are often debilitating, difficult to treat, and usually become chronic. Not only do they diminish patients' quality of life, but they can also affect medical therapy and lead to complications. To date, for most conditions there are no evidence-based causal treatment options available. Research has increased considerably since the last review in 2014 regarding the therapeutic potential of exercise interventions for patients with polyneuropathy. Our objective in this systematic review with meta-analysis was to analyze exercise interventions for neuropathic patients in order to update a systematic review from 2014 and to evaluate the potential benefits of exercise on neuropathies of different origin that can then be translated into practice. Two independent reviewers performed a systematic review with meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Inclusion criteria according to the PICOS approach were: neuropathic patients, exercise interventions only, an inactive or non-exercising control group, and solely randomized controlled trials with the following outcome parameters: neuropathic symptoms, balance parameters, functional mobility, gait, health-related quality of life, and HbA1c (glycated hemoglobin). A total of 41 randomized, controlled trials met all inclusion criteria, 20 of which could be included in the quantitative analysis. Study quality varied from moderate to high. Current data further support the hypothesis that exercise is beneficial for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN) (27 studies) as well as for chemotherapy-induced peripheral neuropathy (CIPN) (nine studies), while there are only few studies (five) on all other causes of neuropathy. We found standardized mean differences in favor of the exercise group of 0.27-2.00 for static balance, Berg Balance Scale, Timed-up-and-go-test, nerve conduction velocity of peroneal and sural nerve as well as for HbA1c in patients with DPN, and standardized mean differences of 0.43-0.75 for static balance, quality of life, and neuropathy-induced symptoms in patients with CIPN. For DPN, evidence-based recommendations can now be made, suggesting a combination of endurance and sensorimotor training to be most beneficial. For patients with CIPN, sensorimotor training remains the most crucial component. For all other neuropathies, more high-quality research is needed to derive evidence-based recommendations. Overall, it seems that sensorimotor training has great potential to target most neuropathies and combined with endurance training is therefore currently the best treatment option for neuropathies. (PROSPERO 2019 CRD42019124583)/16.04.2019.

Differential effects of skilled reaching training on the temporal and spatial organization of somatosensory input to cortical and striatal motor circuits

It has been hypothesized that to perform sensorimotor transformations efficiently, somatosensory information being fed back to a particular motor circuit is organized in accordance with the mechanical loading patterns of the skin that result from the motor activity generated by that circuit. Rearrangements of sensory information to different motor circuits could in this respect constitute a key component of sensorimotor learning. We here explored whether the organization of tactile input from the plantar forepaw of the rat to cortical and striatal circuits is affected by a period of extensive sensorimotor training in a skilled reaching and grasping task. Our data show that the representation of tactile stimuli in terms of both temporal and spatial response patterns changes as a consequence of the training and that spatial changes particularly involve the primary motor cortex. Based on the observed reorganization, we propose that reshaping of the spatiotemporal representation of the tactile afference to motor circuits is an integral component of the learning process that underlies skill acquisition in reaching and grasping.NEW & NOTEWORTHY Sensorimotor transformations are fundamental to the function of the nervous system and determine how patterns of sensory input are converted into appropriate movements. We here investigated the extent to which experience-dependent processes can reshape the organization of somatosensory input feeding into cortico-basal ganglia motor structures. Our data point to a particularly important role for the primary motor cortex in the functional adaptions associated with skilled motor learning.

Greater Cortical Activation and Motor Recovery Following Mirror Therapy Immediately after Peripheral Nerve Repair of the Forearm

Cortical reorganization occurs immediately after peripheral nerve injury, and early sensorimotor training is suggested during nerve regeneration. The effect of mirror therapy and classical sensory relearning on cortical activation immediately after peripheral nerve repair of the forearm is unknown. Six participants were randomly assigned to the mirror-therapy group or the sensory-relearning group. Sensorimotor training was conducted in a mirror box for 12 weeks. The mirror-therapy group used mirror reflection of the unaffected hand in order to train the affected hand, and the sensory-relearning group trained without mirror reflection. Semmes-Weinstein Monofilaments (SWM) test, static 2-point discrimination test (S-2PD), grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were measured at baseline, the end of the intervention (T1), and 3 months after the intervention (T2). Finger and manual dexterity were measured at T1 and T2, and a functional MRI (fMRI) was conducted at T1. All participants showed improvement in the SWM, S-2PD tests, upper extremity function, and grip strength after the intervention at T1, except for the participant who injured both the median and ulnar nerves in the sensory-relearning group. In addition, the mirror-therapy group had better outcomes in finger dexterity and manual dexterity, and fMRIs showed greater activation in the multimodal association cortices and ipsilateral brain areas during motor tasks. This study provides evidence-based results confirming the benefits of early sensorimotor relearning for cortical activation in peripheral nerve injury of the forearm and different neuroplasticity patterns between mirror therapy and classical sensor relearning.

Back to feedback: aberrant sensorimotor control in music performance under pressure

Precisely timed production of dexterous actions is often destabilized in anxiogenic situations. Previous studies demonstrated that cognitive functions such as attention and working memory as well as autonomic nervous functions are susceptible to psychological stress in skillful performance while playing sports or musical instruments. However, it is not known whether the degradation of sensorimotor functions underlies such a compromise of skillful performance due to psychophysiological distress. Here, we addressed this issue through a set of behavioral experiments. After artificially delaying the timing of tone production while playing the piano, the local tempo was abnormally disrupted only under pressure. The results suggest that psychological stress degraded the temporal stability of movement control due to an abnormal increase in feedback gain. A learning experiment further demonstrated that the temporal instability of auditory-motor control under pressure was alleviated after practicing piano while ignoring delayed auditory feedback but not after practicing while compensating for the delayed feedback. Together, these findings suggest an abnormal transition from feedforward to feedback control in expert piano performance with psychological stress, which can be mitigated through specialized sensorimotor training that involves piano practice while volitionally ignoring the artificially delayed provision of auditory feedback.

Development and Validity of a Serious Game (VirtualTer) for Postural Balance Rehabilitation in Older Adults

Background Physiological changes resulting from aging can impair postural balance. Exergames have been used to treat balance disorders, enabling sensory-motor training due to their content, and with targeted goals and purposes beyond entertainment. Aim The aim of this investigation was to describe the development of a serious game, VirtualTer, and to test content validity. Methods A Brazilian group from the Federal University of Rio Grande do Norte developed a serious game called VirtualTer for postural balance rehabilitation in older adults. In game navigation, the avatar needed to save the environment from catching harmful energy that destroys nature. The avatar performs stationary walking, lateral reaching, and climbing up and down steps to capture the energies. Content validity was determined using content matter experts by the Delphi method. Eleven content matter experts played the game and expressed their opinions using the assessment instruments: VirtualTer Dimensions (VD) and System Usability Scale (SUS). Results VirtualTer was designed with regard to variability in practice, since the game was constructed under three levels and offers continuous and terminal feedback. The participants needed to achieve at least 70% of the total score to advance to the next phase. The limits of stability for lateral reach test were right 23.2 ± 4.77 cm and left 22.9 ± 4.86 cm, which was applied in the game. The content validity index of the VD was 0.8, and Cronbach’s alpha coefficient was 0.924. The content matter experts reported the game as having a 67.73 satisfaction with the SUS. Conclusion This game has good usability, low-cost investment, and supports access to innovative and valid technology for rehabilitation in countries with little investment in technology for health.