IJCS | Volume 31, Nº6, November / December 2018

559 1. Cattadori G, Segurini C, Picozzi A, Padeletti L, Anzà C. Exercise and heart failure: an update. ESC Heart Fail. 2018; 5(2):222-232. 2. Berra K. Computers inmedicine. Virtual rehabilitation: dreamor reality? Clin Invest Med. 2006; 29(4):187-92. 3. Vieira Á, Melo C, Machado J, Gabriel J. Virtual reality exercise on a home-based phase III cardiac rehabilitation program effect on executive function, quality of life and depression, anxiety and stress: a randomized controlled trial. Disabil Rehabil Assist Technol. 2018; 13(2): 112-23. 4. Silva JPLN, Novaes LFM, Santos LCR, Galindo BP, Cavalcante MA, Araújo BCG, et al. Effects of Conventional and Virtual Reality Cardiovascular Rehabilitation in Body Composition and Functional Capacity of Patients with Heart Diseases: Randomized Clinical Trial. Int J Cardiovasc Sci. 2018; 31(6): 619-629. 5. Mezzani A, Hamm LF, Jones AM, McBride PE, Moholdt T, Stone JÁ, et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. Eur J Prev Cardiol. 2013; 20(3):442-67. 6. Herdy AH, López-Jiménez F, Terzic CP, Milani M, Stein R, Carvalho T, et al. Diretriz Sul Americana de Prevenção e Reabilitação Cardiovascular. Arq Bras Cardiol. 2014; 103(2 supl.1): 1-31. 7. Ades PA, Savage PD, Harvey-Berino J. The treatment of obesity in cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2010, 30(5): 289-98. 8. Miller FL, O’Connor DP, HerringMP, Sailors MH, Jackson AS, Dishman RK, et al. Exercise dose, exercise adherence, and associated health outcomes in the TIGER study. Med Sci Sports Exerc. 2014, 46(1): 69-75. 9. Rock CL, Flatt SW, Byers TE, Colditz GA, Demark-Wahnefriend W, Ganz PA, et al. Results of the exercise and nutrition to enhance recovery and good health for you (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors. J Clin Oncol. 2015, 33(28):3169-76. 10. Myers J, PrakashM, Froelicher V, DoD, Partington S, Atwood, E. Exercise Capacity and Mortality among Men Referred for Exercise Testing. N Engl J Med. 2002; 346(11):793-801. References Stein & Franzoni Digital tools and cardiovascular rehabilitation Int J Cardiovasc Sci. 2018;31(6)558-559 Editorial to conventional rehabilitation. 8 Another strategy to control exercise intensity would be to quantify METS in the rehabilitation sessions. It should also be noted that the increase in fat percentage and fat weight may be related to the absence of nutritional counseling (food control was only performed through a reminder). Through nutritional counseling, the individuals participating in the experiment would have received proper guidance so they could change their eating habits rather than simply record their food intake. 9 Despite some major biases and limitations, we believe the study has some merits. In a nutshell, the researchers entered in a field that mixes the present with the future, by showing in this RCT the effectiveness that a strategy of rehabilitation through VR has the potential of inducing similar gains to conventional CR on variables such as functional capacity and capillary blood glucose. In this regard, functional capacity is a powerful measure and is directly related to death by cardiovascular outcomes. 10 Improving the functional capacity of individuals with heart diseases can qualify the protocol that uses VR as a tool to be used in CR. Now, it is evident that studies with a more robust sample size, longer intervention period and with well-structured protocols are necessary to answer some questions about the real role of VR in the CR scenario. This is an open-access article distributed under the terms of the Creative Commons Attribution License