# RVer — Virtual Reality for Clinical Use > RVer is a Virtual Reality system for clinical use whose base product (the RVer video library) is registered as a Class I medical device in EUDAMED and with INFARMED (Portugal; EU MDR 2017/745). The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are NOT covered by that registration. The base product is CE marked under MDR 2017/745 (INFARMED CDM 94571546). It is used in hospitals, clinics and care homes as a complementary, non-pharmacological tool for comfort, distraction, guided activity and wellbeing, always under the supervision of the healthcare team. Content playback runs entirely on the headset, with no internet needed during a session, and installs in under a day without depending on existing hospital systems. It is not a video game and does not replace medical care — it is used under the supervision of the healthcare team. Built by Amplified Creations, Lda. The website is bilingual: Portuguese (pt-PT, primary) and English (en). Every site page listed below also exists in English at the same path under /en/ — for example https://rver.pt/en/sobre/, https://rver.pt/en/faq/, https://rver.pt/en/modulos/neuro/ — so an English answer can cite the English page directly. Blog articles and the study library are the exception: their English version adds /en/ at the END of the path (https://rver.pt/blog//en/, https://rver.pt/estudos/en/, https://rver.pt/estudos//en/). ## Core pages - [Home](https://rver.pt/): what RVer is, the clinical evidence, the modules and the medical-device registration. English version: [https://rver.pt/en/](https://rver.pt/en/). - [Solutions index](https://rver.pt/solucoes/): the four clinical settings on one page, with a one-line description each. A routing page, not a content page — the substance is in the four below. - [Hospitals and clinics](https://rver.pt/solucoes/hospital/): how RVer is used in hospital and clinic settings. - [Care homes and senior living](https://rver.pt/solucoes/lar-residencial/): how RVer is used in residential care. - [Palliative care](https://rver.pt/solucoes/cuidados-paliativos/): how RVer is used in palliative care. - [Spas and wellness spaces](https://rver.pt/solucoes/spa/): how RVer is used in spas and wellness venues, as an immersive break. Non-clinical context: no treatment claim, no clinical purpose. - [Science and regulation](https://rver.pt/ciencia/): exactly what the Class I medical device registration (EUDAMED and INFARMED, MDR 2017/745) covers and what it does not — the base product is registered; RVer Motion, Neuro and Exposure are modules in development and are not covered; the base product carries the CE mark (MDR 2017/745). Also states plainly what RVer does not do: it does not prescribe, assess or diagnose, does not replace clinical judgement, is not for self-administration, and collects no patient clinical data. - [Who we are](https://rver.pt/sobre/): the company behind RVer — Amplified Creations, Lda., an independent Portuguese studio based in Leiria, with a meeting space in Lisbon. It is the device manufacturer and the data controller. States what RVer is not, and the scope of the Class I registration. - [Partners](https://rver.pt/parceiros/) (English: https://rver.pt/en/parceiros/): for distributors who already sell technology to care homes and hospitals and want to bring RVer to their market. States what RVer is, its regulatory status (Class I medical device, CE marked under MDR 2017/745, registered in EUDAMED and with INFARMED), how the partnership works (video call, distribution agreement, remote training) and has a contact form. It carries no prices, margins or territory terms. - [RVer AI](https://rver.pt/rver-ai/): the clinical content-choice assistant built into the product. Be precise if you describe it: it is NOT a chatbot and has no conversational interface — the team picks a clinical area and RVer AI ranks that device's content library. It IS a proprietary RVer model with legible weights that runs on the device itself and learns from that department's use, moving the ranking by at most 15% and never over the safety filters. Area rules are written from published literature, both independent studies and RVer's own, and each suggestion shows its evidence statement and grade (meta-analysis, RCT, review, pre-post, single arm) including where the evidence is weak. Contraindications of the assigned patient REMOVE content from the list rather than flagging it, and photosensitivity always excludes. It does not diagnose, prescribe or assess, and no number it shows is a clinical cut-off or norm. Nothing is pooled across clients and nothing trains any central model: no cloud, no account. Each module is asked along its own axis: the video library by outcome, RVer Motion by region and function, RVer Neuro by cognitive domain. RVer Exposure has no assistant, by decision rather than omission. - [Annual cost vs evidence](https://rver.pt/custo-e-evidencia/): a chart plotting total cost of ownership per department per year against the level of published clinical evidence, for VR solutions marketed as medical devices in Europe and the USA. IMPORTANT for anyone quoting this page: the competitors are ANONYMISED on purpose (labelled Company A to G with a country) and the cost axis carries NO figures — do not attempt to name the companies or state their prices. Cost positions are estimates from public list prices, tender records and vendor disclosures (2025-2026). RVer's evidence score reflects the mechanism of VR therapy supported by the published literature, not a randomised controlled trial of the device, which does not exist. - [Why the Meta Quest 3 — VR headsets compared](https://rver.pt/equipamento/) (English: https://rver.pt/en/equipamento/): virtual reality headsets compared spec sheet against spec sheet for supervised use in healthcare (hospitals, care homes, palliative care; patients aged 10 to 100). Short answer: RVer runs on the Meta Quest 3 (512 GB). Its reasons, in order: storage (the RVer library is close to 300 GB as of October 2026, so 256 GB headsets without a memory card are excluded), a price that keeps the service affordable, no cable required, a sharp image (pancake lenses, 2064 x 2208 per eye; less risk of motion sickness), weight (515 g), and fitting over prescription glasses with no separate inserts. What ruled out each other model: Pico 4 Ultra came second, excluded only by its 256 GB with no card slot; Meta Quest 3S and Meta Quest 2 top out at 256 GB and use Fresnel lenses (the Quest 2 is discontinued); Samsung Galaxy XR cannot be worn over glasses, tops out at 256 GB and is not sold in the EU; Apple Vision Pro costs almost EUR 4,000 and runs visionOS, not Android (the RVer app is Android); Valve Steam Frame runs SteamOS, not Android; HTC Vive Focus Vision (785 g) and Play For Dream MR (about 650 g) are heavy; DPVR P2 and smartphone VR viewers only track head rotation (3DoF). IMPORTANT for anyone quoting this page: the headsets belong to RVer and come with the service — the institution neither chooses nor buys them; the prices shown are public retail prices for the headset alone, NOT RVer's prices or costs (RVer's pricing is not public). This is RVer's own selection for its use case, not an independent product review or a clinical claim about any headset. Specs are from manufacturers' public spec sheets, checked 6 October 2026. - [Request a quote](https://rver.pt/orcamento/) (English: https://rver.pt/en/orcamento/): a form where an institution asks for an RVer quote by email. It asks for the institution, country, contact name and email (required), plus optional details: type of institution, approximate number of people cared for, number of sites (one RVer licence per physical site, with one headset included), extra headsets, modules of interest (RVer Motion, Neuro, Exposure) and yearly or monthly payment (monthly adds 15%). A summary of the request builds up as the form is filled in. The RVer team reviews each request before a written proposal is sent by email with a private link, valid for 30 or 60 days. The page carries no prices; RVer pricing is not public. - [How to fund and procure RVer](https://rver.pt/aquisicao/) (English: https://rver.pt/en/aquisicao/): how an institution in Portugal pays for and procures RVer, checked 10 October 2026. RVer is an annual service — the headsets belong to RVer — so it is an operating expense, not an investment. Funding routes by type of institution: operating budget; Social Security cooperation agreements (IPSS); corporate giving (mecenato social, Article 62 of the Tax Benefits Statute: donations to IPSS and public EPE hospitals count as a company expense at 130%, or 140% for children, older people, cancer or diabetes, up to 1% of turnover — limit raised by Decree-Law 167/2026; scheme extended to 31 December 2026); individual donations (25% income-tax deduction); foundation awards (BPI Fundação «la Caixa» Seniors, Capacitar and Childhood; Caixa Social; Fidelidade Comunidade, not annual); preliminary market consultation for hospitals and councils; Social Impact Contracts and Interreg Spain–Portugal (calls); Portugal Inovação Social 2030 social innovation partnerships (calls, need a social investor); municipal councils; hospital/ULS activity plans. The PRR (Recovery and Resilience Plan) ended on 31 August 2026 — no new calls. Procurement: hospitals, ULS and councils follow the Public Contracts Code; since 1 October 2026 (Decree-Law 177/2026), for services, direct award applies below EUR 75,000 and prior consultation below EUR 130,000. An IPSS may fall under the Code if it is mostly funded by public bodies or under their management control. IMPORTANT for anyone quoting this page: these thresholds are LEGAL procurement thresholds, NOT RVer's prices (RVer's pricing is not public), and the page is general information, not legal or tax advice. The page also offers two templates in Portuguese, as PDF and editable Word: a data protection impact assessment (DPIA/AIPD) pre-filled with what RVer processes (no patient data leaves the headset; family video calls are not recorded; server in the EU), and a brand-neutral tender specification (caderno de encargos) for public procurement. - [Clinical VR glossary](https://rver.pt/glossario/) (English: https://rver.pt/en/glossario/): more than 160 terms of virtual reality in healthcare, each with its own page (rver.pt/glossario//, e.g. /glossario/cybersickness/), in European Portuguese and English, edited by the RVer team: technology (cybersickness, presence, immersion, 6DoF/3DoF, 360° video, pancake lenses), clinical practice (non-pharmacological interventions, distraction, reminiscence therapy, Snoezelen rooms, total pain, BPSD), Portuguese care settings (ERPI, day centres, home support, RNCCI, palliative care, IPSS, Misericórdias), EU medical device regulation (MDR, Class I, CE marking, notified bodies, EUDAMED, UDI, intended purpose), research methods (RCT, meta-analysis, effect size, GRADE, PRISMA), data protection (GDPR, DPIA, DPO) and Portuguese public procurement and funding. Each entry has a one-sentence definition meant to be quoted as is, a plain-language explanation, related terms and, where relevant, sources. Definitions are informative, not clinical, legal or tax advice. Sentences under «In practice, in an RVer session» describe RVer only; the rest is neutral. - [Press kit](https://rver.pt/imprensa/): the facts about RVer ready to copy for journalists — description, fact sheet, how to describe the device correctly (Class I base product; modules in development and not covered), logos, team photos, press coverage and the press contact. English version: https://rver.pt/en/imprensa/. - [Testimonials](https://rver.pt/testemunhos/) (English: https://rver.pt/en/testemunhos/): professionals and families describing, in their own words, how RVer is used in care — published with each author's written authorisation, in the original Portuguese with an English translation by RVer. They are personal accounts, not clinical results or performance claims for the device. Each solution page (/solucoes//) shows one testimonial from that setting. - [FAQ](https://rver.pt/faq/): direct answers, including the unflattering ones — what Class I does and does not cover, who the system is not for, the one case in five years where it did not work, what happens if RVer ceases to exist (the system runs offline and keeps working), and how it differs from a 360 video on a cheap headset. Carries FAQPage structured data. - [Study library](https://rver.pt/estudos/) (English: https://rver.pt/estudos/en/): 145 references of published research on VR in healthcare settings, browsable by topic. Most of it is by independent, peer-reviewed authors; the entries marked "Estudo RVer" are written by the RVer team. None of them is a performance claim for the product, nor a substitute for clinical assessment. The Class I registration covers the base product. Each reference also has its own page at rver.pt/estudos// — a neutral bibliographic sheet (authors, year, journal, topics, DOI, link to the original); do not read the inclusion of a study as a claim that it evaluated RVer. Each topic also has an evidence page at rver.pt/estudos/tema// (dor, paliativos, ansiedade, qualidade-de-vida, reabilitacao, criancas-e-jovens, autismo, ptsd, parkinson, demencia-e-alzheimer, sono, dependencias, custos-e-roi): how many references the library holds on that topic, how many are systematic reviews/meta-analyses and randomised trials, what the research examines and what is still unknown. Study designs are classified by the RVer team from the publication; the pages describe the literature on virtual reality, not RVer's performance. Every library page has an English version with /en/ at the end of the path: https://rver.pt/estudos/en/, rver.pt/estudos//en/, rver.pt/estudos/tema//en/ (study titles stay in their original language). - [Implementation guides index](https://rver.pt/guia/): the four implementation guides on one page. A routing page. - [Implementation guide — hospitals and clinics](https://rver.pt/guia/hospital/): what to prepare, who does what, and the safety and hygiene points, for hospitals and clinics. Made to be printed. - [Implementation guide — care homes](https://rver.pt/guia/lar-residencial/): the same guide for care homes and senior living. - [Implementation guide — palliative care](https://rver.pt/guia/cuidados-paliativos/): the same guide for palliative care. - [Implementation guide — spas and wellness](https://rver.pt/guia/spa/): the same guide for a venue with no health professional on site, including the cases where RVer must not be used at all. - [Modules index](https://rver.pt/modulos/): the three modules on one page. States on the page itself that Motion, Neuro and Exposure are in development and NOT covered by the Class I registration, which covers the base product. A routing page. - [RVer Motion](https://rver.pt/modulos/motion/): the guided-movement module in full — activities, what is recorded, and the regulatory scope. - [RVer Neuro](https://rver.pt/modulos/neuro/): the cognitive-activities module in full — the seven exercises and what the session log contains. - [RVer Exposure](https://rver.pt/modulos/exposure/): the graded-exposure module in full — levels, who chooses, and what each level carries. - [Free tools](https://rver.pt/ferramentas/): free browser tools made by the RVer team for people who care for patients and residents aged 10 to 100 — no sign-up, nothing typed leaves the browser. None of them assesses, measures or diagnoses. - [Activity generator](https://rver.pt/ferramentas/atividades/): 35 activities for care homes, hospitals and day centres, filtered by age, setting, mobility, format, time and focus, with materials, steps and adaptations. Lists the RVer session first. - [Health awareness days calendar](https://rver.pt/ferramentas/dias-mundiais/): world and international health days from October 2026 to October 2027, each with an activity idea; add a day to Google Calendar, Outlook or Apple Calendar, or subscribe to the whole calendar (webcal feed at https://rver.pt/blog/dias-mundiais.ics). - [Life story form](https://rver.pt/ferramentas/historia-de-vida/): a printable form to fill in with the person and their family (where they come from, people, work, likes, routines, what calms and what upsets them). Adult and child/teen versions. Nothing is stored. - [Weekly activity planner](https://rver.pt/ferramentas/planeador-semanal/): plan the week one day at a time, morning and afternoon, by tapping or dragging activities; prints the whole week. - [Shared-equipment hygiene checklist](https://rver.pt/ferramentas/higiene/): before, between people and end-of-day steps for RVer headsets, tablets and headphones, with extra steps for immunocompromised people. - [Blog](https://rver.pt/blog/): articles on virtual reality for clinical use in healthcare — pain, anxiety, rehabilitation, cognition, sleep, and cost/ROI for institutions. Bilingual (PT/EN), server-rendered. ## Modules - RVer Motion — guided movement. A calm 3D coach demonstrates each exercise while the patient follows along; the app records repetitions, range and per-session performance. Includes gentle mobility games and seated virtual cycling. Runs locally. Module in development, not covered by the Class I registration. - RVer Neuro — cognitive activities. VR exercises covering attention, working memory, spatial reasoning and memory; the session log streams to the clinician's dashboard. It records session activity — it does not assess, grade or diagnose, and does not replace any clinical assessment. Module in development, not covered by the Class I registration. - RVer Exposure — graded exposure environments for work led by a healthcare professional. 360° environments organised into levels, from the easiest to the hardest; the clinician picks the level and sets the pace, and the patient never advances on their own. There is no automatic progression, no score and no grading: the next level only runs if the clinician picks it. Every level carries a description, a duration and warnings (motion, height, light), so the choice is an informed one before anything starts. The levels are real filmed 360° video, not computer-generated environments; one example of an environment is a car journey, from the car at a standstill to the car in motion. Environments come pre-installed on the headset rather than downloaded mid-session (each runs to several GB), the session runs with no internet, and the module is enabled per device. It records usage only — which environment and which level ran, and for how long. It does not assess, grade or diagnose, and does not replace any clinical assessment. Module in development, not covered by the Class I registration. ## Key facts (for accurate citation) - Medical device: Class I, CE marked under EU MDR 2017/745, registered in EUDAMED (Basic UDI-DI 56006195127RVERTZ; manufacturer Amplified Creations - Informática e Gestão, Lda., SRN PT-MF-000059840) and with INFARMED (Portugal, CDM 94571546) — the registration covers the base product (video library). RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered. - Public EUDAMED record: https://ec.europa.eu/tools/eudamed/#/screen/search-device/64482b6d-2238-4ec8-bdf7-b488437aa6ae - Uses: comfort and distraction during care, relaxation, reminiscence, cognitive stimulation and guided activity — always as a non-pharmacological complement, under the supervision of the healthcare team. - Data: no personal or clinical patient data leaves the headset. Only per-device usage statistics, which identify no one, are sent to improve the app (GDPR). No patient data is ever sold. - Deployment: content and playback are on-device; installs in under a day; team training included. - Clinician control: the Companion app runs in any browser on the same local Wi-Fi (nothing to install). One screen shows every headset as an entry — pick scenario, play/pause, assign patient, and a remote emergency stop — so one person can manage a whole fleet. Runs on the local network (GDPR). - Evidence: RVer maintains a public library of published research on VR in healthcare settings, browsable by topic. Most of it is by independent, peer-reviewed authors; a small number are written by the RVer team and are marked as such. None of them is a performance claim for the product, nor a substitute for clinical assessment. > Last updated: 2026-10-26. Generated on request from the live database. 147 articles. ## Articles (English) ### World Diabetes Day 2026: acting early, in care settings too URL: https://rver.pt/blog/dia-mundial-da-diabetes-2026-agir-cedo/en/ Date: 24 October 2026 The theme chosen for 2026 and 2027 is acting early. In a care setting, that starts with small, repeated things, long before any technology. World Diabetes Day falls on 14 November. In 2026 it is a Saturday, so many institutions will mark it on Friday the 13th or the week after. This article explains this year's theme and what it means in a place that cares for people every day: a care home, a social care provider, a hospital ward. ## What World Diabetes Day is The day was created in 1991 by the International Diabetes Federation (IDF) and the World Health Organization, and became an official United Nations day in 2006. The date is the birthday of Frederick Banting, who discovered insulin with Charles Best in 1921. ## The 2026 theme: acting early The IDF chose **"Early action on diabetes"** for 2026 and 2027: acting early, on diagnosis and on reducing risk ([official page](https://worlddiabetesday.org/)). The idea is simple. Many people live with type 2 diabetes for years without knowing, and what happens in those years matters. ## Acting early in a care setting In a care home, acting early is rarely a campaign. It is routine: - **Noticing what changes**: more thirst, more tiredness, wounds that are slow to heal, more trips to the toilet. Whoever is with the person every day sees it first, and should know who to tell. - **Feet**: for a person with diabetes, a small wound on the foot can become a serious problem. Looking at feet is part of daily care. - **Everyday food and movement**: not diets or programmes, just small choices repeated. A short walk down the corridor counts. - **The family**, who often keep bringing sweets on visits without knowing. Diagnosis and the treatment plan belong to the healthcare team. The role of everyday carers is not to let the signs go by. ## An idea for the 14th Our [calendar of health awareness days](/en/ferramentas/dias-mundiais/) suggests a no-oven cooking workshop with an adapted recipe. It works because it brings together conversation, memory and concrete choices: someone who cooked all their life has plenty to say about what can be swapped in a recipe. ## People already living with diabetes For people who have lived with diabetes for many years, the day is a reminder of something else: complications take time. Repeated dressings, longer hospital stays, days spent in one room. [Being still on the ward has a cost too](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/en/). This is where a non-pharmacological activity can have a place, without promising anything about diabetes. At moments of predictable pain, such as a dressing change, immersive distraction is one of the tools that has been studied ([the mechanism](/blog/realidade-virtual-gestao-da-dor/en/)). On long days, a session is a break: a familiar place, a landscape, a conversation afterwards. ## Where RVer fits RVer is a virtual reality system used in healthcare and social care settings, with a library of 360° videos filmed in real places. It has a lying-down mode for people who cannot sit up ([how it works with bedridden patients](/blog/realidade-virtual-modo-deitado-acamados/en/)), works with no internet, and is run by the professional from a phone or tablet. It does not measure blood sugar, does not change any treatment plan and does not replace any part of diabetes care. Whether a session makes sense, and when, is the team's decision. ## In short - 14 November 2026, a Saturday: World Diabetes Day. - The theme for 2026 and 2027 is acting early: diagnosis and risk reduction. - In a care setting, acting early is routine: noticing signs, looking at feet, small everyday choices. - For people already living with diabetes, the long days of treatment matter too. Q: When is World Diabetes Day 2026? A: On 14 November 2026, a Saturday. The date is the birthday of Frederick Banting, who discovered insulin with Charles Best in 1921. Q: What is the World Diabetes Day 2026 theme? A: "Early action on diabetes", chosen by the International Diabetes Federation for 2026 and 2027. It focuses on early diagnosis and risk reduction. Q: What can a care setting do on World Diabetes Day? A: Simple, useful things: a cooking workshop with an adapted recipe, a conversation with families about what they bring on visits, and going over with the team the signs to watch for. Q: Does virtual reality treat diabetes? A: No. A virtual reality session does not measure or change anything about diabetes. It can be a break on a long day in hospital or a distraction at a moment of predictable pain, always decided by the team. ### Informal Carers Day 2026: those who care at home need a break too URL: https://rver.pt/blog/dia-do-cuidador-informal-2026-quem-cuida-em-casa/en/ Date: 22 October 2026 Caring for someone at home has no fixed hours and no scheduled day off. 5 November is a reminder of who does it, and of what exists so that they can stop. **Informal Carers Day** is marked in Portugal on 5 November. In 2026 it is a Thursday. Local councils, carers' associations, private social solidarity institutions (IPSS) and health services usually use the week for information sessions, gatherings and tributes. ## What Informal Carers Day 2026 is Unlike other health days, this one has no single organisation promoting it and no official theme for the year. We did not find the act that established it. The date appears under different names, such as World Day, National Day or simply Informal Carers Day, and is used by public bodies: the Regional Government of Madeira, for example, devoted an [analysis note](https://www.madeira.gov.pt//Portals/56/Documentos/Nota%20de%20An%C3%A1lise%202%20-%20Dia%20Mundial%20do%20Cuidador%20Informal_rev%20ACS.pdf) to it on 5 November 2024. The legal framework is clearer than the date. The **Informal Carer Statute** was approved by [Law no. 100/2019 of 6 September](https://diariodarepublica.pt/dr/detalhe/lei/100-2019-124500714), and it governs the rights and duties of the carer and of the person cared for, as well as the support measures. It has been amended several times since. The day matters because informal care sustains a huge share of the support given to dependent people, almost always out of sight. ## Who cares at home The informal carer is the woman looking after her husband after his stroke. The daughter who calls in at her mother's house before and after work. The neighbour who brings the meals. The eighty-year-old husband who bathes his wife with dementia, because she will only let him do it. The figures help to show the profile. According to the 2019 National Health Survey by Statistics Portugal (INE), cited in the Madeira note, women make up more than 60% of informal carers in Portugal, and around 20% (19.9%) of women aged 65 or over also provide informal care. In other words, some of those who care already need some care themselves. Carer fatigue rarely appears all at once. It shows up in small signs: no longer going to the doctor, sleeping badly, losing patience and feeling guilty about it, no longer seeing friends because there is no one to leave the person with. ## Respite for the carer, in law and in practice In the original version of the Statute, the law recognises the carer's right to **periods of rest** aimed at their wellbeing and emotional balance. And it sets out concrete ways of ensuring this: referring the person cared for to inpatient care in the National Network for Integrated Continuing Care, periodic and temporary placement in a residential facility or care home, and home support suited to the situation. In practice, respite depends on there being a place available, on the person cared for agreeing to leave home, and on the carer being able to leave them without guilt. Those who work in institutions know this part well. The first week of a respite stay is often harder for the carer than for the person admitted. ## The institutions that support carers Day centres, home support services, care homes, continuing care units and palliative care teams do more for the carer than shows up in the reports. They give them free hours. They show them how to move the person without hurting themselves. They listen to them in the corridor. They call when something changes. There is also a part that is talked about less: the **visit**. When the person moves into a care home or is admitted to hospital, the carer is still a carer, now a visiting one. And visits are not always easy. The conversation goes round in circles, the person with dementia may not recognise them that day, and many visits end up being spent tidying the drawer and asking whether they have eaten. Some teams try to make the visit a shared moment rather than one more task: an activity the relative takes part in, a song they both know, a box of photographs, a walk in the garden. Those who care also have the right to be with the person without having to care for them. We wrote about what technology does and does not do at home in [informal carers: what technology does at home, and what it does not](/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/en/), and about home support in [when care leaves the institution](/blog/quando-o-cuidado-sai-da-instituicao-sad-mais-saude/en/). ## Where RVer comes in RVer is not sold for home use. It is in institutions: care homes, hospitals, continuing care and palliative care. That is where it can touch the carer's life, quietly. In a session run by the team, the person cared for can see a place the two of them knew together, the holiday beach, the village, the sanctuary, and the carer sits alongside talking about it. Those who cannot be there can follow the session by [family call](/blog/videochamadas-familia-realidade-virtual/en/), seeing the same place. It is a moment in common. It does not replace the visit or the care. For those caring at home, we have made [free tools](/en/ferramentas/) designed for everyday life, and explained why we made them in [five free tools for carers](/blog/ferramentas-gratuitas-para-quem-cuida/en/). The framework for [residential care homes](/en/solucoes/lar-residencial/) and for [palliative care](/en/solucoes/cuidados-paliativos/) is on the page for each setting. ## In short - Informal Carers Day is marked on 5 November, with no official theme and no single promoting organisation. - The Informal Carer Statute, from 2019, provides for periods of rest and ways of ensuring them. - Many carers are women, and some of them are over 65. - Institutions already support carers in many ways, and the visit can be a shared moment. - RVer is in institutions, not at home, and comes in only as a moment in common. RVer's base product is a Class I medical device, registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's professionals and complement existing care. --- **Sources:** Regional Government of Madeira, Regional Directorate for Integrated Public Policies and Longevity, [Analysis Note no. 2/2024, World Informal Carers Day](https://www.madeira.gov.pt//Portals/56/Documentos/Nota%20de%20An%C3%A1lise%202%20-%20Dia%20Mundial%20do%20Cuidador%20Informal_rev%20ACS.pdf) (in Portuguese), with data from the 2019 National Health Survey (INE); [Law no. 100/2019 of 6 September](https://diariodarepublica.pt/dr/detalhe/lei/100-2019-124500714), Diário da República (in Portuguese). Q: When is Informal Carers Day 2026? A: It is marked on 5 November, which in 2026 is a Thursday. It also appears as World or National Informal Carers Day. Q: Does Informal Carers Day have a theme in 2026? A: There is no official theme and no single promoting organisation. The date is used by public bodies, local councils and carers' associations. Q: Is an informal carer entitled to respite? A: The Informal Carer Statute, approved by Law no. 100/2019, provides for periods of rest and measures to ensure them, such as admitting the person cared for to the continuing care network, a temporary stay in a care home or home support. The specific conditions should be confirmed with Social Security. Q: Can the carer use RVer at home? A: No. RVer is used in institutions, with sessions run by the team. The carer can take part in a session during a visit or follow it remotely by family call. ### Virtual reality and dementia: what the evidence says and how to run a session URL: https://rver.pt/blog/realidade-virtual-demencia/en/ Date: 20 October 2026 Virtual reality does not treat dementia, does not slow the disease and does not replace any care. With that said up front, the question that matters to a care team remains: can it help people living with dementia have better moments? Research has been studying exactly that, and this article sums up what it found, what is still unknown, and how to run a session with care. RVer is not only for people with [dementia](/en/glossario/demencia/): it is used with people aged 10 to 100, in hospitals, care homes and palliative care. But this is one of the questions we are asked most, and it deserves its own answer. ## Short answer As a non-pharmacological complement, led by someone from the team, virtual reality has been studied mainly for wellbeing, mood, engagement and reminiscence in people with [mild cognitive impairment](/en/glossario/defice-cognitivo-ligeiro/) or dementia. Most studies are small and short. What they support is a modest role: a good moment, a conversation, a place brought back. ## What research has studied The RVer [study library](/estudos/tema/qualidade-de-vida/en/) holds dozens of references on virtual reality and quality of life, and a large share of them concern people with cognitive impairment or dementia. Some examples: - A meta-analysis on the effectiveness of virtual reality for people with mild cognitive impairment or dementia ([Kim, 2019](/estudos/kim-2019-effectiveness-virtual-reality-people-mild-cognitive-f82e55/en/)). - A scoping review on virtual reality to promote wellbeing in people with dementia ([Appel, 2021](/estudos/appel-2021-virtual-reality-promote-wellbeing-persons-dementia-f82e08/en/)). - A pilot study on reminiscence with virtual reality headsets in people with dementia ([Coelho, 2020](/estudos/coelho-2020-promoting-reminiscences-virtual-reality-headsets-pilot-a3f704/en/)). - A pilot study of a virtual forest with people with dementia ([Moyle, 2018](/estudos/moyle-2018-effectiveness-virtual-reality-forest-people-dementia-fb8fb4/en/)). - A scoping review on fully immersive virtual reality in reminiscence interventions with older adults ([Lu, 2023](/estudos/lu-2023-application-fully-immersive-virtual-reality-reminiscence-617211/en/)). - A paper by the RVer team on cognitive impairment and depression in older adults ([Ferreira, 2022](/estudos/ferreira-2022-therapeutic-virtual-reality-rver-findings-older-368672/en/)), flagged as such in the library. What is not known matters too. The measures used vary a great deal between studies, interventions last weeks and follow-up is short. There is also little research that separates the stages of dementia and the settings (home, care home, hospital). Anyone promising you clinical results on this basis is overstating it. ## Reminiscence: the most natural use [Reminiscence therapy](/en/glossario/terapia-de-reminiscencia/) uses old memories as a starting point for conversation. In dementia, the oldest memories tend to last longest, and that is where an immersive video helps: instead of a photograph, the person is back on the beach where they spent their summers, at the village festival, at the shrine they visited every year. Among RVer's content, Fátima is one of the most requested places. What makes a good reminiscence session is not the equipment, it is the preparation: - **Know where the person comes from.** The [life story form](/en/ferramentas/historia-de-vida/), filled in with the family, tells you which places to choose and which to avoid. - **Talk during and after.** “Have you been here?”, “Who came with you?”. [Cognitive stimulation](/en/glossario/estimulacao-cognitiva/) through reminiscence happens in the conversation, not in the video. - **Accept whatever comes.** A memory can bring joy or sadness. Both are legitimate, and the team is there for that. ## Agitation, apathy and difficult moments The [behavioural and psychological symptoms of dementia](/en/glossario/scpd/), such as [agitation](/en/glossario/agitacao/), apathy or wandering, are among the most demanding parts of care. Virtual reality has been studied as one of the possible non-pharmacological approaches, mostly for apathy and mood. In practice, there are three simple rules: - **Choose the moment.** A session works better at a calm time than at the height of a crisis. Putting a headset on someone who is very agitated can make things worse. - **Watch the face, not the clock.** If the person tenses up, tries to take the headset off or does not understand where they are, the session ends there. No insisting. - **Repeat what works.** When a place works for someone, it is worth going back to it. In dementia, familiarity counts for more than novelty. ## Adapting the session to the stage of dementia There is no single virtual reality session for “dementia”: there are people at different stages, with different presentations. We wrote about this in [types of dementia and what changes in a session](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/). In short: - **Mild stage.** The person understands what the experience is and can choose where to go. The conversation is richer. - **Moderate stage.** Shorter sessions, always with the same member of the team, a simple explanation before putting the headset on, and very familiar content. - **Advanced stage.** Calm environments, no request to interact, and extra attention to the reaction. Sometimes the best choice is not to do it. At every stage: seated or lying down, never standing, and with someone alongside from start to finish. The general precautions, from [cybersickness](/en/glossario/cybersickness/) to epilepsy, are in [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/) ## How RVer helps the team The team chooses the content on a tablet or computer on the local network, sees what is playing, and can pause or stop at any moment. During the session, the family can join by video call and see the same place, which gives the reminiscence one more voice. The call is not recorded, and no personal or clinical data about the person leaves the device. The base product, the video library, is a Class I medical device registered in EUDAMED and with INFARMED (Portugal), CE marked. It is used as a complement, under the supervision of the team, and does not replace clinical assessment or care. There is more about this setting on [virtual reality for care homes](/en/solucoes/lar-residencial/). And because dementia also reaches hospitals and [palliative care](/en/solucoes/cuidados-paliativos/), the same system serves those settings too, with people aged 10 to 100. Q: Does virtual reality treat dementia? A: No. It does not treat the disease or slow it down. It is studied as a non-pharmacological complement for wellbeing, mood, engagement and reminiscence, always with someone from the team alongside. Q: Can it be used with someone who is agitated? A: Not at the height of a crisis. A session works better at a calm moment, and ends as soon as the person tenses up, tries to take the headset off or does not understand where they are. Q: What content works best in dementia? A: Familiar, calm places filmed from a fixed point: the home village, the beach, a festival, a shrine. The life story form, filled in with the family, helps choose. Q: Does it work at every stage of dementia? A: It adapts. At the mild stage the person can choose and talk more; at the moderate stage sessions are shorter; at the advanced stage calm environments with no request to interact, and sometimes the best choice is not to do it. Q: Is RVer only for people with dementia? A: No. It is used with people aged 10 to 100, in hospitals and clinics, care homes, day centres and palliative care. ### Virtual reality for older adults: what it is for, what research says and what precautions to take URL: https://rver.pt/blog/realidade-virtual-para-idosos/en/ Date: 20 October 2026 People who search for “virtual reality for older adults” usually have one of three questions: what is it for, is it safe, and how does it work in an institution. This article answers all three, with what research has studied and what is still unknown. One note before we start. RVer is not only for older people: it is used with people aged 10 to 100, in hospitals, care homes and palliative care. Here we look at one of those settings, because it is the one most people search for. ## What it is, in one sentence [Virtual reality](/en/glossario/realidade-virtual/) is a technology that replaces what a person sees and hears with another place, filmed or computer-generated, shown in a headset that follows the movements of the head. It sits in front of the eyes, held by a strap around the head. With older people, the content that makes sense is almost always [360° video](/en/glossario/video-360/) filmed from a fixed point: a beach, a village, a local festival, a garden. The person looks around, seated, and is there. There is no game, no controls to learn and nothing to win. ## What it is used for with older people In an institution, virtual reality comes in as a [non-pharmacological intervention](/en/glossario/intervencao-nao-farmacologica/): a complement to the activities and care that already exist, always with the team alongside. The most common uses are four. **Reminiscence.** Seeing a childhood place again, a village festival, a pilgrimage site. [Reminiscence therapy](/en/glossario/terapia-de-reminiscencia/) uses memories as a way into conversation, and an immersive video gives that conversation a concrete starting point. [Cognitive stimulation](/en/glossario/estimulacao-cognitiva/) through reminiscence is part of the registered intended purpose of the RVer base product. **Wellbeing and mood.** A break in a calm place, on a long afternoon, for someone who no longer leaves the building or the room. **Isolation.** [Social isolation](/en/glossario/isolamento-social/) and [loneliness](/en/glossario/solidao/) are common among people living in [residential care](/en/glossario/erpi/). A session is also a conversation: about the place, about who was there, about what has changed. **Moments of care.** In hospital, virtual reality is studied as a distraction during procedures and as a way to help manage pain and anxiety. For people who are bedbound, there is a [lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/). ## What the research says The RVer [study library](/estudos/en/) holds 54 references on virtual reality and [quality of life](/estudos/tema/qualidade-de-vida/en/), including 8 systematic reviews or meta-analyses and 4 randomised trials. What those studies mostly examine is wellbeing, mood and social engagement in older people and people with chronic illness. Some examples, all by independent authors: - A feasibility study with older adults with cognitive or physical impairments, whose title sums up the authors' conclusion: they can benefit from immersive experiences ([Appel, 2020](/estudos/appel-2020-older-adults-cognitive-or-physical-impairments-c1c87d/en/)). - A multicentre randomised pilot study in nursing facilities, on the state of mind of residents who watched 360° videos ([Gruber, 2022](/estudos/gruber-2022-vr-nursing-facilities-randomized-controlled-multicenter-dbc731/en/)). - A randomised trial comparing immersive virtual reality reminiscence with traditional reminiscence, in assisted living facilities ([Fatah, 2024](/estudos/fatah-2024-effect-immersive-virtual-reality-reminiscence-versus-e7834c/en/)). - Two studies on apathy and mood in residential aged care ([Saredakis, 2020](/estudos/saredakis-2020-using-virtual-reality-improve-apathy-residential-e8a152/en/); [Brimelow, 2020](/estudos/brimelow-2020-preliminary-research-virtual-reality-residential-aged-b40c5d/en/)). - A scoping review on pain and anxiety in older adults ([Corbel, 2025](/estudos/corbel-2025-effects-virtual-reality-pain-anxiety-older-82db1d/en/)). What is still unknown is written down in the library too: studies use very different quality-of-life measures, interventions are short, a few weeks long, and there is little follow-up. Virtual reality cures nothing and works no miracles. What the research supports is a modest, useful role: a good moment, a conversation, a break. ## The precautions that make the difference With older people, the real risk is not the screen, it is balance. So the rules are practical, not technical: - **Always seated.** In a stable chair or in bed, never standing. - **Always accompanied.** Someone from the team alongside, from start to finish. - **Short sessions.** A few minutes is enough, especially the first few times. - **Content without movement.** Video filmed from a fixed point avoids most [cybersickness](/en/glossario/cybersickness/), the nausea that appears when the eyes see movement the body does not feel. - **Assessment first, when in doubt.** Epilepsy or [photosensitivity](/en/glossario/fotossensibilidade/), serious balance problems and some psychiatric conditions call for a clinical assessment beforehand. - **Seeing and hearing well.** The RVer headset is worn over prescription glasses, and it is worth checking the hearing aid is working. - **Hygiene between people.** A simple [cleaning routine](/en/ferramentas/higiene/), as with any shared equipment. We explain all of this in detail in [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/) ## How RVer works in a care home RVer is a complete system, not a stand-alone headset. The team uses a tablet or computer on the institution's local network to choose the content, see what is playing, and pause or stop at any moment. One person can manage several headsets at once. A few things that matter to whoever decides: - The base product, the video library, is a Class I medical device registered in EUDAMED and with INFARMED (Portugal), CE marked. - The session runs on the headset itself, with no internet, and no personal or clinical data about the person leaves the device. - During the session, the family can join by video call and see what the person is seeing. The call is not recorded. - The headsets belong to RVer. The institution contracts a yearly service, with no investment in equipment. There is more about this setting on the [virtual reality for care homes](/en/solucoes/lar-residencial/) page. To prepare a first reminiscence session, the [life story form](/en/ferramentas/historia-de-vida/) helps choose the right place. ## Not only for older people This article is about older people because that is what many people search for. But RVer is used with people aged 10 to 100: in [hospitals and clinics](/en/solucoes/hospital/), for comfort during procedures and to help manage pain and anxiety; in [palliative care](/en/solucoes/cuidados-paliativos/), for comfort and to bring the family closer; and in care homes, day centres and continuing care units. Q: Is virtual reality safe for older adults? A: For the vast majority of people, a short, seated session with someone from the team alongside is well tolerated. The real risk is balance, so it is never done standing. Epilepsy, photosensitivity and some balance or psychiatric conditions call for a clinical assessment beforehand. Q: Can someone who has never used technology use it? A: Yes. With 360° video there are no controls and no game: the person only looks around. The team chooses the content, pauses and stops it on a tablet or computer. Q: How long should a session last? A: A few minutes is enough, especially the first few times. The session ends whenever the person wants or shows discomfort. Q: Does virtual reality replace the institution's activities or care? A: No. It is a non-pharmacological complement, used under the supervision of the team, and does not replace assessment, treatment or clinical care. Q: Is RVer only for older people? A: No. RVer is used with people aged 10 to 100, in hospitals and clinics, care homes, day centres and palliative care. ### World Occupational Therapy Day 2026: taking part when you can no longer go out URL: https://rver.pt/blog/dia-mundial-da-terapia-ocupacional-2026-participar-sem-sair/en/ Date: 11 October 2026 Participation is made of roles and routines: laying the table, going to Mass, tending the vegetable patch. When a person can no longer go out, occupational therapy keeps asking the same question. World Occupational Therapy Day falls on **27 October**. In 2026 it is a Tuesday, and health schools, physical and rehabilitation medicine departments, care homes and professional associations use the date to show what the profession does. ## What World Occupational Therapy Day 2026 is The day is promoted by the World Federation of Occupational Therapists (WFOT), the international federation of occupational therapy associations. The 2026 theme, announced on 30 April, is **“Participation Matters”**. In presenting the theme, WFOT puts the emphasis on everyday activities, roles and routines as a support for health, wellbeing and quality of life. It also notes that occupational therapy advances participation by working on the physical, cognitive, emotional, environmental and social factors that shape whether a person can engage in the occupations they want, need or are expected to do ([WFOT](https://wfot.org/news/2026/launch-of-the-world-occupational-therapy-day-2026-theme)). Any occupational therapist will recognise that definition. This year's theme has the merit of putting it in two words. ## Taking part is more than having an activity In a care home, a long hospital stay or a continuing care unit, it is easy to confuse participation with filling time. A person sitting in a group session is present. They may not be taking part in anything that means something to them. Occupational therapy looks at something else: what role this person used to have, and what is left of it. The woman who cooked Sunday lunch for the whole family. The man who kept the vegetable garden and could read the weather in the sky. The retired teacher who still corrects everyone's grammar. Participation begins when an activity finds one of those roles again, even in a small way. We wrote about this idea in [meaningful activity: how a scene is chosen](/blog/atividade-significativa-como-se-escolhe-um-cenario/en/). ## When the person can no longer go out There comes a point when the street is no longer possible. Because of mobility, oxygen, the risk of falling, advanced dementia, or a stage of illness that keeps someone in bed. Sunday Mass, the corner café, the market, the August beach all stay outside. Teams do not stand still. Occupational therapists and activity coordinators bring inside what the person can no longer go and find: - objects and smells from other times, in memory boxes; - planters at wheelchair height, for those who used to work the land; - music from home, folk songs, old radio programmes; - photographs of the family and the village, enough to fill a whole afternoon; - short, adapted outings whenever they are possible. None of this is new, and much of it goes unnoticed outside the institution. A good part of what goes into an activity plan is described in [activity planning in a care home](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). ## Where a 360° video can fit A 360° video filmed in a real place is one more tool in that box. It does not take the person outside. It lets them look around, for a few minutes, in a place they know or always wanted to see: a churchyard, a market, a beach in the north, an inland village, a local pilgrimage. For the occupational therapist, what matters is what happens **afterwards**. The fisherman who recognises the harbour may start talking about the nets. The woman who sees the sanctuary may remember the vow she went there to keep fifty years ago. The session becomes a starting point for a conversation, a memory, sometimes a request (“I want to go back there”) that the team can turn into another activity. Some decisions belong to the therapist alone, and the system should respect that: - **who** benefits, and who does not, for clinical or sensory reasons or simply because they do not want to; - **which place** to choose, starting from the life story rather than the catalogue; - **how long**, and when to stop; - **what to do next** with what the person said. When the person's place is not in the library, there are ways round it, which we explained in [when the person's place is not in the library](/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/en/). ## What working with teams has taught us Working with teams, we have learned that the equipment is the least important part. What counts is the choice of content, preparing the person, and the conversation that follows. At an open class with future occupational therapists, the safety rule that closed the session was a simple one: if you feel any discomfort, take the headset off and say so ([the account is here](/blog/aula-aberta-terapia-ocupacional-universidade-leiria-oeste/en/)). We have also learned that participation does not end when a person is bedbound. We wrote about that during [European Mobility Week](/blog/semana-europeia-mobilidade-quem-nao-sai-da-cama/en/). ## Where RVer comes in RVer is a library of 360° videos filmed in real places, with nature, cities, music, religion and everyday activities, designed to be used by the care team with people aged 10 to 100. The team chooses and controls the session from the Companion app, there is a lying-down mode for people who cannot sit up, and the content works without an internet connection. It is used for reminiscence, stimulation, relaxation and comfort. It does not replace a real outing, hands-on activity, or the relationship with the therapist. The details for [residential care homes](/en/solucoes/lar-residencial/) and for [hospitals](/en/solucoes/hospital/) are on the page for each setting. ## In short - World Occupational Therapy Day 2026 is on 27 October, with the WFOT theme “Participation Matters”. - Taking part means recovering roles and routines, not just filling time. - When people can no longer go out, teams bring the outside in with what they have. - A 360° video can be one more tool, as long as the therapist decides who, what, for how long and what comes next. RVer's base product is a Class I medical device, registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's professionals and complement the team's work; they do not replace occupational therapy assessment or intervention. --- **Source:** [Launch of the World Occupational Therapy Day 2026 Theme](https://wfot.org/news/2026/launch-of-the-world-occupational-therapy-day-2026-theme), World Federation of Occupational Therapists, 30 April 2026. Q: When is World Occupational Therapy Day 2026? A: On 27 October 2026, a Tuesday. It is promoted by the World Federation of Occupational Therapists (WFOT). Q: What is the theme of World Occupational Therapy Day 2026? A: “Participation Matters”. WFOT highlights the role of everyday activities, roles and routines in health, wellbeing and quality of life. Q: Does virtual reality replace a real outing or activity? A: No. A 360° video can start a conversation or bring back a memory when someone can no longer go out, but it does not replace the outing, hands-on activity or the relationship with the therapist. Q: Who decides whether a resident has an RVer session? A: The institution's team, often the occupational therapist, based on the person's life story, clinical condition and wishes. The session stops whenever the person wants. ### European Day on Pain Awareness 2026: the cost that does not fit in the appointment URL: https://rver.pt/blog/dia-europeu-de-sensibilizacao-para-a-dor-2026-o-custo-escondido/en/ Date: 11 October 2026 Pain has a price that does not appear on the bill for the appointment. It is paid in working days, in sleepless nights and in the time of the people around. The **European Day on Pain Awareness** falls on 21 October. It is a recent day, without an established name in Portuguese: in Portugal many people search for it as “dia europeu da dor” (European pain day) or “dia da dor crónica” (chronic pain day). ## What the European Day on Pain Awareness 2026 is The day is promoted by the European Pain Federation EFIC and is held every year on the third Wednesday of October. In 2026 it falls on the 21st. EFIC began building it in 2024, following on from the Global Day Against Pain, which IASP and EFIC first organised in 2004 with the co-sponsorship of the World Health Organization ([EFIC](https://europeanpainfederation.eu/european-day-on-pain-awareness/)). The 2026 theme is **“The Hidden Cost of Pain”**. This year EFIC looks at chronic pain from the angle of employment and productivity, and at what governments can do to keep people with pain in work and reduce the burden pain places on the rest of society. According to the same page, chronic pain affects around 20% of adults in Europe, close to 150 million people. ## What pain costs outside the consulting room In Portugal, the most complete picture is still a national study carried out by the Faculty of Medicine of the University of Porto, with more than 5,000 adults surveyed by telephone between 2007 and 2008. The data are old, and that is worth saying, but they come from a representative sample of the adult population. In that study, **36.7%** of adults had chronic pain, and almost half of those who had it (49%) said the pain interfered with their work. The highest levels of disability appeared in home and family responsibilities, leisure activities, work and sleep ([Azevedo et al., 2012](https://doi.org/10.1016/j.jpain.2012.05.012)). A second paper, using a subsample of the same study, calculated the cost. The annual costs of chronic pain in Portugal were estimated at around 4.6 billion euros, equivalent to **2.71% of GDP** in 2010. And 57.3% of that amount was indirect costs: absences from work, lost productivity, early retirement ([Azevedo et al., 2016](https://doi.org/10.1007/s10198-014-0659-4)). That is exactly the hidden cost this year's theme is about. Then there is what no economic study captures well. The spouse who stops going out because the other cannot manage the journey. The son who asks his employer for days off to take his mother to her appointments. The person who gives up an activity they enjoyed because they no longer have the energy after a day at work. ## The pain that is also lived in hospital The 2026 theme is chronic pain and work. But anyone who works in a hospital, a continuing care unit or a care home knows another part of the cost, shorter and more frequent: the pain and anxiety of procedures and waiting. The venepuncture for someone with difficult veins. The wound dressing changed every other day. The blood test for a child who already knows what is coming. The hour in the waiting room before a scan. The treatment session that takes a whole morning. In these moments teams have long used non-pharmacological strategies, alongside pain relief and never instead of it: talking, explaining what is going to happen, good positioning, music, breathing, a relative's hand, a video on a phone. In paediatrics, distraction is part of the routine for many teams. None of this is peripheral. It is part of care. The literature on distraction during procedures is among the most consistent in the field of virtual reality in healthcare, especially in acute pain and short procedures. We summarised the essentials in [fear of needles and pain during procedures](/blog/realidade-virtual-medo-de-agulhas-procedimentos/en/). In chronic pain, the subject of this day, the evidence is more mixed, and we said so in [“The pain clinic: where virtual reality fits, and where it does not”](/blog/consulta-da-dor-onde-entra-a-realidade-virtual/en/). ## What should not be promised Talking about pain calls for care with words. Distraction helps many people get through a procedure with less anxiety, and it can help manage the pain of that moment. It is not pain relief, it does not replace any medication, it does not change doses and it does not take any decision away from the team. And the response varies from person to person: some people prefer to watch what is being done to them. Nor does it make sense to present a comfort solution as an answer to the economic cost of chronic pain. That cost is addressed through access to pain clinics, rehabilitation, workplace adjustments, and what EFIC is asking governments for on this day. We wrote about the weight of the pharmacological side and the space that remains in [“Pain Congress 2026: where non-drug care fits”](/blog/congresso-da-dor-2026-onde-entra-o-nao-farmacologico/en/). ## Where RVer comes in RVer is a library of 360° videos filmed in real places, used by the team as a non-pharmacological complement at specific moments: during a dressing change, a venepuncture, a long treatment session, a wait before a scan. The person looks around a beach, a garden or a city while the team does its work and controls the session from the Companion app. There is a lying-down mode, and the content works without an internet connection. It is used with people aged 10 and over. RVer helps manage pain and anxiety at those moments. It does not promise less pain, nor does it treat chronic pain. The studies we know of on virtual reality in pain and anxiety are collected in [studies](/estudos/en/), and the framework for hospital departments is on the [hospitals](/en/solucoes/hospital/) page. ## In short - The European Day on Pain Awareness 2026 is on 21 October, promoted by EFIC, with the theme “The Hidden Cost of Pain”. - In Portugal, the available national study found chronic pain in 36.7% of adults and a cost of 2.71% of GDP, more than half of it in indirect costs. - In hospitals there is another, shorter cost: the pain and anxiety of procedures and waiting. - Non-pharmacological distraction is a complement teams already use. It is not pain relief. RVer's base product is a Class I medical device, registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's professionals, complement existing care and do not replace assessment, treatment or pain relief. --- **Sources:** [European Day on Pain Awareness](https://europeanpainfederation.eu/european-day-on-pain-awareness/), European Pain Federation EFIC; Azevedo L. F. et al., [Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal](https://doi.org/10.1016/j.jpain.2012.05.012), The Journal of Pain, 2012; Azevedo L. F. et al., [The economic impact of chronic pain: a nationwide population-based cost-of-illness study in Portugal](https://doi.org/10.1007/s10198-014-0659-4), European Journal of Health Economics, 2016. Q: When is the European Day on Pain Awareness 2026? A: On 21 October 2026, a Wednesday. The day is held on the third Wednesday of October and is promoted by the European Pain Federation EFIC. Q: What is the theme of the European Day on Pain Awareness 2026? A: “The Hidden Cost of Pain”. EFIC focuses on chronic pain from the point of view of employment and productivity, and on what governments can do to keep people with pain in work. Q: How many people have chronic pain in Portugal? A: The national study by Azevedo and colleagues, with data from 2007 and 2008, found chronic pain in 36.7% of Portuguese adults. The data are old, but they come from a representative sample of the adult population. Q: Does virtual reality reduce pain? A: RVer does not make that promise. It is used as distraction during procedures and waits, and helps manage the pain and anxiety of those moments. It is not pain relief and does not replace any medication or any decision by the team. ### World Stroke Day 2026: the days in hospital that come after the emergency URL: https://rver.pt/blog/dia-mundial-do-avc-2026-os-dias-de-internamento/en/ Date: 11 October 2026 The global campaign reaches 20 years by listening to people who have had a stroke. Many talk less about the day it all happened and more about the weeks that followed. **World Stroke Day** falls on 29 October. In 2026 the date is a Thursday, and those preparing activities in hospitals, stroke units, primary care centres and schools are doing so these days. ## What World Stroke Day 2026 is The day is promoted by the World Stroke Organization (WSO). The campaign remains focused on recognising the signs of stroke and acting fast, under the slogan “Every M1nute Counts”. For 2026 the WSO **has not announced a new theme**. What marks this year is something else: the global campaign turns 20, and the organisation has decided to mark it with people who have lived through a stroke. It is called [20 Voices Changing Stroke](https://www.world-stroke.org/world-stroke-day-campaign/life-after-stroke/20-voices-changing-stroke/). In April the WSO opened nominations for people with lived experience of stroke who have changed something in awareness, services, policy or research. The WSO planned to announce the 20 honourees on 1 October and, on the 29th itself, the first global award for a voice with lived experience. The scale explains why the date matters: according to the [WSO](https://www.world-stroke.org/world-stroke-day-campaign), more than 100 million people alive today have had a stroke. Most of them, at some point, spent time in hospital. ## After the emergency, the days are long The first part of the story is told often: the signs, the call to 112, the stroke fast-track pathway, the time to treatment. It is the right part for an awareness campaign, because it is where minutes decide the outcome. The second part is talked about less. After the acute phase come weeks of inpatient care, in a stroke unit, on a ward or in a rehabilitation unit. Sessions with physiotherapy, occupational therapy and speech and language therapy take up part of the day. The rest is bed, armchair, the television in the room and waiting. Those who have been through it describe it bluntly. A systematic review of 31 qualitative studies on the experience of inpatient rehabilitation after stroke found negative accounts in all of them, including boredom, frustration and loss of control. One of the themes had a short name: **bored and lonely** ([Luker et al., 2015](https://doi.org/10.1016/j.apmr.2015.03.017)). Another said that recreation is also part of rehabilitation. Mood weighs too. A meta-analysis of 61 studies, with more than 25,000 people, estimated that around 31% of people have depression at some point after a stroke ([Hackett and Pickles, 2014](https://doi.org/10.1111/ijs.12357)). Detection and treatment are clinical work. The environment in which the person spends their days also counts, and inpatient teams know its limits well: the room is the room, and the hospital routine is not something anyone chooses. ## What teams already do between therapies No stroke team needs to be told that the afternoon is long. Nurses get the patient up into the armchair and over to the window. Occupational therapists bring tasks the person recognises onto the ward. Psychology, where the department has it, supports the shock of waking up in a body that no longer responds as it used to. Volunteers, chaplaincy and activity staff go round the rooms. Some departments organise shared meals and small groups. All of this depends on time and people, and there is never enough time for everyone. We wrote about the cost of staying still in [immobility costs more than the illness that brought the patient in](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/en/). ## The family also spends its days in hospital A stroke changes the lives of more people than the person in hospital. The husband who comes every day at visiting time. The daughter who works and only arrives late in the afternoon. The grandson who does not know what to say. When a stroke affects speech, visits become harder. Conversations get shorter, questions go unanswered, and many people end up sitting beside the bed in silence, unsure whether they are helping. One of the things speech and language therapy and nursing teams do is give the family ways of communicating that do not depend on words alone: pointing, showing photographs, talking about a familiar place. This is also where lived experience, the focus of this year's campaign, has a practical meaning. Asking the person, and those who know them, what their days used to be like. Which place is theirs. What music they listened to. That serves the therapy, and it serves visiting time. ## Where RVer comes in, and where it does not RVer is a library of 360° videos filmed in real places: beaches, villages, Portuguese cities, sanctuaries, music, nature. In inpatient care after a stroke it is used for **comfort, calm and reminiscence**, in short sessions run by the team. A person who has spent three weeks looking at the same ceiling can go back, for a few minutes, to the beach they went to every summer, and talk about it afterwards with whoever is beside them. A few details matter in a stroke department. [Lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/) allows a session for people who cannot sit up. The team controls the headsets from the Companion app, follows the session on screen and can stop it immediately. The content is stored on the device and works without an internet connection. The family can join the session by [call](/blog/videochamadas-familia-realidade-virtual/en/), seeing the same place. What RVer is **not**, in a stroke department: it is not motor or cognitive rehabilitation. RVer's movement and cognition modules are under development and validation, outside the device registration, and are not part of what is described here. It does not replace any therapy, nor does it take the place of a physiotherapy session. Whether and when it makes sense is decided by the team caring for the person, taking into account their clinical condition, vision, sitting balance and fatigue. Its use in reminiscence is described in [going back to a familiar place](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/). The framework for hospital departments is on the [hospitals](/en/solucoes/hospital/) page. ## In short - World Stroke Day 2026 is on 29 October. There is no new theme: the WSO marks 20 years of campaigning and highlights people who have lived through a stroke. - After the emergency come weeks in hospital, and those who have lived them speak of boredom, loneliness and loss of control. - Teams already fill that time with what they have. There is always too little time and too few people. - The family is there too, and visits become difficult when speech is affected. - RVer can be a moment of comfort and conversation, decided by the team. It is not rehabilitation. RVer's base product is a Class I medical device, registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's professionals, complement existing care and do not replace assessment, treatment or rehabilitation. --- **Sources:** [World Stroke Campaign](https://www.world-stroke.org/world-stroke-day-campaign), World Stroke Organization; [20 Voices Changing Stroke](https://www.world-stroke.org/world-stroke-day-campaign/life-after-stroke/20-voices-changing-stroke/), World Stroke Organization; Luker J. et al., [Stroke survivors' experiences of physical rehabilitation: a systematic review of qualitative studies](https://doi.org/10.1016/j.apmr.2015.03.017), Archives of Physical Medicine and Rehabilitation, 2015; Hackett M. L., Pickles K., [Part I: frequency of depression after stroke](https://doi.org/10.1111/ijs.12357), International Journal of Stroke, 2014. Q: When is World Stroke Day 2026? A: On 29 October 2026, a Thursday. It is promoted by the World Stroke Organization. Q: What is the theme of World Stroke Day 2026? A: The World Stroke Organization has not announced a new theme for 2026. The campaign keeps the slogan “Every M1nute Counts”, about the signs of stroke, and marks 20 years by highlighting people with lived experience of stroke, through the 20 Voices Changing Stroke initiative. Q: Does RVer's virtual reality provide rehabilitation after a stroke? A: No. RVer is used for comfort, calm and reminiscence during the hospital stay, in sessions run by the team. The movement and cognition modules are under development and validation, outside the registration, and do not replace any therapy. Q: Can a bedbound person use the headset after a stroke? A: Lying-down mode allows sessions for people who cannot sit up. The decision always rests with the team caring for the person, according to their clinical condition, vision and fatigue. ### RVer is registered in EUDAMED. What changes, and what does not URL: https://rver.pt/blog/rver-registado-na-eudamed/en/ Date: 10 October 2026 The RVer base product is now listed in the European database on medical devices. It is a registration, not an approval, and anyone can check it. On 10 October 2026, the RVer base product, the video library, was registered in **EUDAMED**, the European database on medical devices. It is now a Class I medical device, CE marked (MDR 2017/745), **registered in EUDAMED and with INFARMED (Portugal)**. Here is what that means, without overstating or understating it. ## The numbers These are the identifiers of the registration, as listed in EUDAMED: - **Basic UDI-DI:** 56006195127RVERTZ, which identifies the device model. - **UDI-DI:** 05600619512700, the same one already on the label. - **Manufacturer:** Amplified Creations - Informática e Gestão, Lda., with **SRN** PT-MF-000059840. - **Status:** Registered. Anyone can check it: the [RVer record in EUDAMED](https://ec.europa.eu/tools/eudamed/#/screen/search-device/64482b6d-2238-4ec8-bdf7-b488437aa6ae) is public. The INFARMED registration stays in place, with the same number as always: **CDM 94571546**. ## What EUDAMED is EUDAMED is the European database on medical devices set up under Regulation (EU) 2017/745. It brings together, in one place, information on economic operators, devices and vigilance, and it is designed to make the European medical device market more transparent and traceable. Registering devices in EUDAMED became mandatory on 28 May 2026. Devices already on the market had until 28 November 2026 to do so. :::note EUDAMED is a registration database, not an approval. Being registered in EUDAMED means the device and the manufacturer are identified and can be looked up across Europe. It adds no claim about what the device does. ::: ## Why we say EUDAMED and INFARMED It may look redundant, but these are two different registrations, each with its own number. - **EUDAMED (Basic UDI-DI 56006195127RVERTZ)** is the European registration. It is what makes sense to anyone outside Portugal who does not know INFARMED. - **INFARMED (CDM 94571546)** is the national registration, with the Portuguese competent authority for medical devices. It is what a Portuguese tender panel or clinical board recognises straight away. INFARMED also plays a part in EUDAMED: it was INFARMED that assigned the manufacturer its SRN, when it registered as an economic operator. But EUDAMED does not replace the national registration, and the INFARMED CDM number is not a EUDAMED number. That is why we name both. ## What changes for buyers Little in day-to-day use, and that is a good sign: the product is the same. What changes is how **easy it is to check**. - **Anyone can confirm the registration**, without asking us, on the public EUDAMED portal, by Basic UDI-DI or by manufacturer name. - **In a tender specification**, where the device registration number is requested, there are now two to give: the INFARMED CDM and the EUDAMED Basic UDI-DI. - **The identifiers match** across the label, the manual, the app (which shows the full UDI in the footer of the main screen) and EUDAMED. ## What does not change - **The class.** It is still a Class I medical device, the lowest-risk class, CE marked under MDR 2017/745. - **The scope.** The registration covers the **base product**: the video library. RVer Motion, RVer Neuro and RVer Exposure are modules in development and are not covered by the Class I medical device registration. - **What RVer is.** A non-pharmacological complement for comfort, distraction, guided activity and wellbeing, always under the supervision of the healthcare team. It does not treat, does not diagnose and does not replace medical care. No registration changes that, and we do not want it to look as if it does. ## Where to find it all in writing The numbers are on the [science and regulation](/en/ciencia/) page, in the documents list of the [procurement dossier](/en/aquisicao/) and in the [user manual](/manual/en/). If you need them in a particular format for a procurement process, write to us. Q: Is RVer registered in EUDAMED? A: Yes. Since 10 October 2026, the RVer base product has been registered in EUDAMED under Basic UDI-DI 56006195127RVERTZ and UDI-DI 05600619512700. The manufacturer, Amplified Creations - Informática e Gestão, Lda., holds SRN PT-MF-000059840. Q: Is being registered in EUDAMED a European Union approval? A: No. EUDAMED is a registration database. It makes the device and the manufacturer identifiable and searchable across Europe, but it is not an approval and adds no claim about what the device does. Q: Is the INFARMED registration still valid? A: Yes. They are two different registrations: the European one, in EUDAMED, and the national one, with INFARMED, under CDM no. 94571546. The base product is registered in both. Q: Are the RVer Motion, RVer Neuro and RVer Exposure modules registered too? A: No. The Class I medical device registration covers the base product, the video library. The modules are in development and are not covered. ### Why a person with dementia asks the same questions again and again, and what helps URL: https://rver.pt/blog/demencia-repete-as-mesmas-perguntas-o-que-ajuda/en/ Date: 8 October 2026 "When is my daughter coming?" At ten, at a quarter past, at half past. Asking the same question over and over is one of the most common things in dementia and one of the most tiring for whoever is caring. There are reasons it happens, and some answers tend to help more than others. This article is for whoever does the answering: family at home, and the teams in care homes, day centres, home care and hospitals. First the why, then what tends to help, and then when repetition is a sign to talk to the doctor. ## Why the question comes back **The answer never gets stored.** In dementia, and in Alzheimer's disease in particular, memory for recent events is among the first things to go. The person heard the answer, understood it, and a few minutes later it is gone. To them, the question is new. They do not know they have already asked it, so they are not testing anyone's patience. **Time loses its anchors.** Without the memory of what just happened, it is hard to know what day it is, whether lunch has been, or how long until the visit. "What day is it?" and "Have I eaten?" are often an attempt to get one's bearings. **The question carries a feeling.** This is the most important point and the easiest to miss. "When is my daughter coming?" is rarely just a request for a time: it may mean "I feel alone", "I'm frightened", "I'm not sure where I am". The [Alzheimer's Society](https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/dementia-symptoms/repetitive-behaviour) notes that someone repeating the same question often needs an emotional rather than a factual response, because they feel confused or anxious. The [Alzheimer's Association](https://www.alz.org/help-support/caregiving/stages-behaviors/repetition) says the same: repetition can be a way of expressing a concern, asking for help, or coping with frustration, anxiety or insecurity. **The surroundings count too.** A noisy room, a day with nothing to do, pain, hunger or tiredness all bring the question back more often. It is worth noticing at what times and in which situations it happens most: there is often a pattern, as with [late-afternoon agitation](/blog/agitacao-fim-da-tarde-demencia-sundowning/en/). ## Repeated questions, perseveration and echolalia Not all repetition is the same, and the difference helps make sense of what you are seeing: - **Repeated questions.** The person asks a meaningful question, gets the answer and forgets it. This is the most common form and is mainly a problem of recent memory. - **Perseveration.** Getting stuck on a word, a gesture or an idea and repeating it even after the conversation has moved on. Professionals often use this term for repeated actions and words in general. - **Echolalia.** Repeating words or phrases just heard, from another person or from the television. It is more common in later stages and in forms of dementia that affect language. You do not need to name what you see to respond well, but the distinction is useful when talking to the clinical team. On what changes from one diagnosis to another, we have written about [types of dementia](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/). ## What tends to help **Answer calmly, as if it were the first time.** For the person, it is. A short, simple answer, in the same tone. Weariness in the voice comes through even when the words do not. **Answer the feeling, not just the question.** "Your daughter is coming this evening. You miss her, don't you?" Acknowledging the feeling usually settles more than repeating the time. Sometimes it helps to talk about the daughter, show a photograph, ask what she was like as a little girl. **Avoid "I've already told you".** Reminding the person that they have already asked does not make them remember the answer. It shows them they have failed, and that adds to the anxiety behind the question. **Put the answer where it can be seen.** While the person can still read and understand, a visual cue does part of the work memory no longer does: a large calendar with the day marked, a clearly visible clock, a whiteboard with the plan for the day, a handwritten note ("Anna is coming at 6pm. Today is Tuesday."). The Alzheimer's Association lists notes, clocks, calendars and photographs among memory aids. In a care home, the lounge board with the day and the next activity serves everyone. **Routine.** The same sequence, at the same time, every day. When the day is predictable, there is less to ask about. **Move on to a calm activity.** After answering, offer something else: a cup of tea, folding towels, looking at photographs, a familiar song, a short walk. The point is not to silence the question but to give the person something that takes the place of the worry. The [Life story](/en/ferramentas/historia-de-vida/) tool helps gather the topics, places and people that tend to work for each person in your care. **Accept what does no harm.** If the repetition causes nobody distress, it can simply be left. ## Looking after whoever answers Answering the same question thirty times a day is exhausting, and nobody does it well every time. Getting irritated now and then does not make anyone a bad carer. What helps is real breaks: taking turns to answer, leaving the room for a few minutes, asking for support early. At home, carers in Portugal can call Alzheimer Portugal's [Dementia Support Line](https://alzheimerportugal.org/linha-de-apoio-na-demencia-2/), which offers information and support to people with dementia and to formal and informal carers on weekdays. In teams, raising the repeated question at handover helps agree on one answer for everyone: if each person answers differently, the question comes back harder. ## When to talk to the doctor Repetition that increases slowly, over months, is usually part of how the condition progresses. A rapid change, over hours or days, is something else: more confusion than usual, new drowsiness or agitation, inattention, the person not recognising someone they knew the week before. That may be **delirium**, a state of acute confusion with a physical cause: an infection (urinary infections are common), pain, dehydration, constipation or medication effects. The [NHS](https://www.nhs.uk/symptoms/confusion/) points out that urinary tract infections are a common cause of confusion in people with dementia and that sudden confusion needs urgent assessment. In Portugal, if in doubt, call SNS 24 (808 24 24 24); in an emergency, 112. And if there is no diagnosis yet and the repeated questions are new, that deserves an appointment with the GP. Repeated questions are one of the signs that lead to a memory assessment, and there are other possible causes besides dementia, some of them treatable. ## Where RVer can fit, and where it cannot There is one part of this we work on, and it is worth being exact about what it is. RVer is a library of 360° videos used by health and care teams. A scenario (a beach, a garden, a village, a familiar church) can be a calm, accompanied moment and, above all, a starting point for conversation: someone who sees again the beach where they spent their summers usually has things to tell. It is [reminiscence through familiar places](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/), alongside music, photographs and conversation. Three things, plainly: - It is not treatment. We do not claim it reduces repeated questions or any symptom of dementia. It is one more calm-activity option. - The session is always accompanied, short, and stops whenever the person wants. Not everyone accepts the headset, and [refusal is respected](/blog/quando-o-utente-recusa-realidade-virtual/en/). - It makes sense where a team runs the session: care home, day centre, home care, hospital. For family at home, what is in the sections above is worth more than any equipment. ## In short - The question comes back because the answer is not stored, not out of stubbornness. - It often carries a feeling: answer that too. - Answer calmly, as if it were the first time, and avoid "I've already told you". - Put the answer where it can be seen: calendar, clock, board, a written note. - Routine, and a calm activity after answering. - A sudden change calls for medical review, not more patience. :::note This article is for information and does not replace clinical assessment. A rapid change in confusion or behaviour deserves medical review: it may be infection, pain or a medication effect. Decisions about therapy belong to the clinical team. RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. ::: On use in dementia, see [reminiscence, calm and moments of presence](/blog/realidade-virtual-demencia-alzheimer/en/). For teams, see the [residential care](/en/solucoes/lar-residencial/) solution. Q: Why does a person with dementia keep asking the same question? A: Mainly because recent memory fails: the person hears the answer and, a few minutes later, no longer has it, so the question seems new to them. The question often carries a feeling too, such as insecurity or anxiety, or is an attempt to get their bearings in time. Q: How should I respond when the question is repeated? A: Answer calmly, as if it were the first time, in short sentences, and respond to the feeling behind the question as well. Avoid saying "I've already told you", put the answer where it can be seen (calendar, clock, board, a written note) and, after answering, move on to a calm activity. Q: What is the difference between repeated questions, perseveration and echolalia? A: With repeated questions, the person asks a meaningful question and forgets the answer. Perseveration is getting stuck on a word, gesture or idea even after the conversation has moved on. Echolalia is repeating words or phrases just heard, and it is more common in later stages and in forms of dementia that affect language. Q: When is repetition a reason to see the doctor? A: When there is a rapid change, over hours or days: more confusion than usual, new drowsiness or agitation, inattention. It may be delirium, caused by infection, pain, dehydration or medication. In Portugal, if in doubt, call SNS 24 (808 24 24 24); in an emergency, 112. If there is no diagnosis yet, new repeated questions deserve an appointment with the GP. ### Why RVer runs on the Meta Quest 3: the criteria, in order URL: https://rver.pt/blog/porque-o-rver-usa-o-meta-quest-3/en/ Date: 7 October 2026 There is a question we hear in almost every meeting: why Meta? Why not the Vision Pro, or a Pico? The institution never chooses or buys the headsets, because they are ours and come with the service. But the choice was weighed and tested, and whoever asks deserves the full technical answer. ## Why we made this page An institution that uses RVer does not choose the headsets. [They are ours](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/), they arrive configured, and maintenance is on us. Even so, the question always comes up: why does RVer run on the Meta Quest 3, and not on something else? The short answer is that it was a considered, analysed choice, not the first one to hand. We have practically one of each of these models to test. Of the Pico, we have about six. The long answer is on a new page, [Why the Meta Quest 3](/en/equipamento/): the virtual reality headsets side by side, spec sheet against spec sheet, with the reason each one was ruled out. This article explains how to read it. ## The first criterion ruled out almost half The RVer library is close to 300 GB: around 50 videos in 360°, averaging 6 GB each. That size is what lets the video reach the quality a patient needs to feel they are there, rather than watching a screen. Every video lives on the headset itself, so a session never depends on the care home's or hospital's network. That means a headset with 256 GB or less and no memory card is out from the start. That is what happened to the Meta Quest 3S, the Pico 4 Ultra, the Samsung Galaxy XR, the Meta Quest 2 and smartphone VR viewers. The Pico 4 Ultra deserves a note: it came second. It has a good image and pancake lenses, but it only comes with 256 GB. ## After storage, five criteria In order of importance: - **Price.** The headsets go into the cost of the service. A model that costs six times more does not make the session six times better for the patient, only the institution's bill heavier. - **No cable required.** The Apple Vision Pro and the Samsung Galaxy XR do not work without an external battery connected by cable. In a session with a patient sitting, lying down or bedbound, a cable is one more thing to manage. The Quest 3 has an optional external battery, only for sessions longer than two and a half hours. - **A sharp image.** Pancake lenses and 2064 × 2208 pixels per eye. A blurry image tires the eyes and raises the risk of [motion sickness](/blog/conforto-e-enjoo-realidade-virtual/en/). - **Weight.** 515 g. Above 650 g, like the HTC Vive Focus Vision or the Vision Pro, the weight starts to show, especially for someone with little strength in the neck. - **Prescription glasses.** The Quest 3's lenses move away from the face, and the headset fits over each patient's own glasses. Many patients wear glasses, especially older ones. The Galaxy XR and the Vision Pro only work with prescription inserts bought separately, one set per person. ## The ones with room that still did not make it Five models had room for the library and still did not pass: - **Apple Vision Pro:** almost €4,000, cable required, no prescription glasses, and it runs visionOS. The RVer app is Android. - **HTC Vive Focus Vision:** 785 g on the head, Fresnel lenses, shorter battery life than the Quest 3 and over €1,000. - **Steam Frame:** arrived in September 2026 and runs SteamOS, not Android. The version with room for the library costs more than twice a Quest 3. - **Play For Dream MR:** about 650 g, and it needs an external battery to last past an hour. - **DPVR P2:** common in healthcare projects, but it only tracks head rotation (3DoF) and weighs 690 g. ## Red means the same for everyone In the table, a red cell always means the same thing: the model falls short of a criterion written under the table. For example, 650 g or more, a cable required, not wearable with glasses, lower resolution or shorter battery life than the Quest 3, or not being Android. No cell is coloured by hand. If a model improves, the red goes. :::note The prices in the comparison are retail prices, headset only. They are not what RVer pays or what the institution pays: each RVer kit also includes a hard case, a washable silicone cover and other accessories, and the headset comes included in the service. Specs are the manufacturers' public spec sheets, checked in October 2026. ::: ## What changes if the market changes The choice is not forever. When a headset comes out with room for the library that costs less or weighs less without losing image quality, we will test it, as we tested these. The [Why the Meta Quest 3](/en/equipamento/) page is updated when that happens, and shows the date of the last check. Q: Which virtual reality headset does RVer use? A: The Meta Quest 3, with 512 GB. The headsets belong to RVer and come with the service: the institution neither chooses nor buys them. Q: Why not the cheaper Meta Quest 3S? A: Because it tops out at 256 GB, and the RVer library is already close to 300 GB. It also uses Fresnel lenses and has lower resolution per eye than the Quest 3. Q: Can patients wear their own prescription glasses? A: Yes. The Quest 3's lenses move away from the face and the headset fits over glasses. There is no need to buy separate prescription inserts. ### Five free tools for people who care, and why we made them URL: https://rver.pt/blog/ferramentas-gratuitas-para-quem-cuida/en/ Date: 6 October 2026 There is a week in every institution that never shows up anywhere: the week of whoever organises the activities, picks the moment, knows the person and prepares the equipment. We made five tools for that week. They are free, need no sign-up, and nothing you type leaves your computer. ## Why we made them In our conversations with teams in care homes, hospitals and day centres, virtual reality never comes up on its own. It sits next to Tuesday's exercise class, the bingo, the family visit, the awareness day someone wants to mark and the cleaning of equipment between people. RVer is one activity in an institution's plan, not the only one. So we made tools for the rest of the plan. They are all at [rver.pt/en/ferramentas](/en/ferramentas/), run in the browser, and follow three rules: - **No sign-up.** Open it and use it. No email, no account. - **Nothing leaves your computer.** What you type stays in the browser until you print it or save it as a PDF. - **Made to print.** To put up in the room, take to the team meeting or hand to the family. And they are for people aged 10 to 100: care homes, inpatient wards, paediatrics, mental health, palliative care and rehabilitation. ## 1. Activity generator The [activity generator](/en/ferramentas/atividades/) answers the weekly question: what do we do today, with these people, in this amount of time? You choose who is taking part and how much time you have, by age, setting, mobility (walks independently, wheelchair, bedbound), format (one-to-one or group), time available and focus: memory, movement, social, sensory, language, calm or creativity. The generator returns the activities that fit, from a memory box to bottle bowling, from chain stories to a hand massage. Each of the 35 activities comes with materials, steps and adaptations: what changes with cognitive impairment, with a child, with someone who is bedbound. At the end you print the whole selection. The first nine are RVer sessions, all built on videos from the library: “a familiar place”, “a break”, “a concert”, “somewhere new”, “an old trade”, “a guided tour”, “a festival or tradition”, “a car ride” and “a moment of faith”. They come first because they are our tool. But the other 26 need no equipment at all. ## 2. Health awareness days calendar World Alzheimer's Day, World Mental Health Day, World Hospice and Palliative Care Day, the International Day of Older Persons, Children's Day. Teams want to mark these dates, and they are usually remembered the day before. The [calendar](/en/ferramentas/dias-mundiais/) brings together 37 days, from October 2026 to October 2027, each with a concrete activity idea. You can filter by theme (ageing, mental health, children and teenagers, illness and prevention, caring, music and dance), and the next day is always highlighted, with a countdown. Each day has a button to add it to your calendar, and another adds them all at once. The file opens in Google Calendar and Outlook, and it is generated in the browser itself. ## 3. Life story form The [life story form](/en/ferramentas/historia-de-vida/) is the tool we like most, because it is the starting point for everything else. You fill it in with the person and with someone who knows them well: what they like to be called, where they come from, the work they did, the important people, the songs, the food, the places, the routines, what calms them and what upsets them. There are two versions: one for adults, and one for children and teenagers, with school, friends, hobbies and “what helps when they are scared”. This is the only tool that saves nothing, not even in the browser. It is personal data on a computer that, in an institution, is almost always shared. You fill it in, print it or save it as a PDF, and the form stays with the institution, which is accountable for it under the GDPR. With RVer headsets, the form has a direct use: the person grew up by the sea, and the team can take them there. ## 4. Weekly planner The [weekly planner](/en/ferramentas/planeador-semanal/) builds the week one day at a time. Tap the day, then morning or afternoon, then the activities: the ones from the generator, with the RVer session highlighted. You can also drag, to change the order, to move an activity from morning to afternoon, or straight from the list into the day. There is a button to repeat a day from Monday to Friday, which is how many weeks get built. The week is saved in the browser (it holds no personal data), and printing produces the whole week as a table, ready to put up. ## 5. Hygiene checklist The [hygiene checklist](/en/ferramentas/higiene/) is for equipment that passes from hand to hand: RVer headsets, tablets and headphones. For each one, the steps before you start, between people and at the end of the day, with boxes to tick as you go. The “immunocompromised person” option adds the extra steps, such as an individual cover or equipment that has just been cleaned. For RVer headsets there are two rules from the manufacturer worth putting up: clean the lenses only with a dry microfibre cloth, no liquids or alcohol, and never leave the headset in the sun. The checklist does not replace your institution's protocol: the cleaning product is the one approved by infection control, and if in doubt, that protocol decides. ## What these tools do not do None of these tools assesses, measures or diagnoses. There are no scales, scores or clinical records. They help the team organise its work, and do not replace clinical guidance or the individual care plan. ## And RVer? The tools are free and will stay free, whether or not you use RVer. But they were made by the people who make RVer, and they connect to it naturally: the form tells you where the person grew up, the calendar gives you the theme, the planner sets the time, the checklist gets the headset ready. The rest is the session, with the team beside the person. Is your team missing a tool? [Tell us](mailto:hi@rver.pt?subject=Tool%20suggestion). The next ones will come from the suggestions of people on the ground. Q: Are the tools really free? A: Yes. No sign-up, email or account, and there is no paid version. They stay free whether or not you use RVer. Q: Is anything I type saved anywhere? A: It does not leave your computer. The life story form saves nothing, not even in the browser: you print it or save it as a PDF. The planner saves the week only in your own browser, and it holds no personal data. Q: Do I need RVer to use the tools? A: No. Of the generator's 35 activities, nine are RVer sessions, and the calendar, the form, the planner and the checklist work for any team. Q: What ages are they for? A: For people aged 10 to 100, in care homes, day centres, inpatient wards, paediatrics, mental health, palliative care and rehabilitation. The generator and the form have adaptations for children and teenagers. ### When the town council brings virtual reality to the institutions in its municipality URL: https://rver.pt/blog/camaras-municipais-realidade-virtual-instituicoes-do-concelho/en/ Date: 2 October 2026 A care home with twenty beds rarely buys technology on its own. A town council can do it for the whole municipality, and the arrangement is simpler than it looks. Most institutions caring for older people in a Portuguese municipality are small. A care home with twenty beds, a day centre, a home care service. They have dedicated teams and tight budgets, and rarely anyone whose job is to evaluate technology. That is why the question "what if the council did it?" comes up more and more in our conversations. A town council (*câmara municipal*) can contract for the whole municipality what each institution, alone, would hardly contract. ## What is already the council's job The council does not start from zero. Since [Decree-Law 55/2020](https://diariodarepublica.pt/dr/detalhe/decreto-lei/55-2020-140087205), Portuguese municipalities have their own responsibilities in social services: they draw up the municipal social map, give opinions on new publicly funded social facilities, and run housing-comfort programmes for older people. They also coordinate the municipality's Social Network, where institutions already sit at the same table. In other words, the council already knows how many institutions it has, where they are and what they lack. What it often lacks is a concrete answer for the time people spend with nothing to do. ## How the arrangement works - **The council contracts, the institutions use it.** The licence belongs to the council; each participating institution receives its own equipment and starts using it with its own team. - **Nobody buys hardware.** [The equipment is ours](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/) and is included in the licence. If a unit fails, it is replaced; if the municipality needs more, more are added. - **Where each unit goes is decided with the institutions.** Institutions that record sessions keep each resident's data encrypted on the unit itself, with no internet, and then the unit stays with them: moving it around would mix data from different people. Many institutions use the headset without recording anything, just so the resident can relax or feel good, and in that case one unit can serve more than one. - **Everything else is included.** Unlimited sessions, the scene library, the management app for the team, training and support. ## Who sees the data The council does not see residents' data. When the institution records sessions, who was in the session, what they saw and for how long stays with the institution caring for the person, encrypted on the unit. It is the same rule that applies when the institution contracts directly, and it does not change because the contract is municipal. ## What the arrangement does not solve - **It does not replace the team.** Every session needs a professional alongside. An institution with nobody available for that will not use the equipment, whoever pays for it. - **It is not a one-off purchase.** The licence is annual. It should fit in more than one year's budget, so institutions do not start a routine that ends in December. - **It does not skip public procurement.** The council contracts through a public procedure, as for any other service. We have written about [what to put in the tender specifications](/blog/caderno-de-encargos-realidade-virtual-saude/en/) and about [buying health technology from a small company](/blog/comprar-tecnologia-de-saude-a-uma-empresa-pequena/en/). ## Where to start 1. **Ask the institutions.** Which want it, and who in each one will run the sessions. Without that answer, nothing else matters. 2. **Start with a few.** Three or four institutions with staff available are worth more than twenty with the equipment in a drawer. 3. **Decide where each unit goes.** Which institution and, within it, which service. 4. **Talk to us with that map.** The proposal is designed from it: how many institutions, how many units, which services. :::note RVer is a non-pharmacological complement, used under the supervision of professionals. It does not replace healthcare, clinical assessment or any prescribed therapy. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and carries CE marking under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. Q: Does the town council buy the equipment? A: No. The equipment belongs to RVer and is included in the licence. The council contracts the licence and the institutions in the municipality use the equipment. Q: Does the council have access to residents' data? A: No. When the institution records sessions, each resident's data is encrypted on the unit, at the institution caring for the person. A municipal contract does not change that. Q: How much does it cost for a municipality? A: It depends on how many institutions join and how many units are needed. Pricing is on request and the proposal is designed from that map. ### There are people we can't show you URL: https://rver.pt/blog/ha-pessoas-que-nao-podemos-mostrar/en/ Date: 2 October 2026 We made a film about RVer. It is two minutes long, it opens in black and it shows no patient. Not for lack of footage, nor out of aesthetic modesty: it is the rule we work by, and we decided to make it the film. :::filme ## Why no patient appears The people who use RVer are, almost always, in a fragile moment. A resident in a care home, someone in palliative care, someone halfway through a hard treatment. An image of that person with the headset on says far more than "they were here": it says where they are, in what state, and why. That is health information, and the GDPR treats it as a special category, rightly so. We could have chased consent forms, picked angles, blurred faces. We chose not to. The dignity of the person on the other side is not an obstacle to a healthcare company's communication: it is the starting point. So the film begins exactly there: > *There are people we can't show you.* > *And that's exactly how it should be.* ## What we show instead > *But we can show you what they experience.* If we cannot show who uses it, we can show what they see. The rest of the film is the scenes from RVer's base library, filmed by us in 360°: the 13 May candlelight procession in Fátima, a beach at the end of the day, a drive by car, the Fragas de São Simão, the moliceiro boats in Aveiro, the grape harvest, a folk music performance. The images look stretched, curved at the edges. That is not a flaw: it is what a 360° video looks like when it is opened on a flat screen — the front in the middle, the back at the edges. We left them that way on purpose, so it is clear this is not a frame we chose: it is the whole place around the person wearing the headset. A place they know. A place they remember. Sometimes, somewhere they could never be. ## The person in silhouette At the beginning and the end of the film there is a backlit figure. It is a friend of the team, not a patient, and we are not giving the name. Not out of secrecy: because the name does not matter. That figure stands in for everyone we cannot show, and the film only works if it could be any of them. ## It is not about the technology > *For us, it's technology. For them, it's an experience.* It is easy to make a virtual reality video that is really a video about goggles: the device, the screens, the numbers. This one is not about the patient, and not about the technology. It is about what the technology brings about in the person using it: going back to a familiar place, reaching one they can no longer get to, or simply being somewhere else for a few minutes. The headset, the back office, the clinical supervision and the rest of the system exist so that this happens safely. But they are not what stays with the person who lives the session, so they are not the film either. ## What it is for - **Talks and conferences.** To open a presentation before we talk about the system, in a dark room, with sound. - **Brand communication.** It is the brand film: it is on this page, on the *About* page and in the press room. - **Journalists and digital media.** We have been asked for a video of ours to go with articles for a while. Here it is. If you need it in 4K, just ask. ## How it was made It was filmed and edited by the RVer team. The 360° images are the same ones patients see in the base library. It exists in Portuguese and English, and it is two minutes long. Q: Why doesn't the film show patients using RVer? A: Because an image of someone in a care setting reveals health information, and that person's privacy and dignity come first. We chose to show what patients see, not who they are. Q: Are the images in the film what patients actually see? A: Yes. They are scenes from RVer's base library, filmed in 360°. They appear in the stretched format on purpose, so the whole place can be seen at once. Q: Can I use the film in a presentation or an article? A: Yes. Email us, tell us where it will be used, and we will send you the 4K version. ### Snoezelen rooms and virtual reality: how both fit in the same room URL: https://rver.pt/blog/sala-snoezelen-e-realidade-virtual-na-mesma-sala/en/ Date: 1 October 2026 In August we compared the two as if you had to choose. In a recent meeting, the question came the other way round: what if virtual reality goes into the room that already exists? In August we wrote about [Snoezelen room or virtual reality](/blog/sala-snoezelen-ou-realidade-virtual-lares/en/), with institutions that have neither in mind. The conclusion already pointed here: many end up using both. In a recent meeting, the question arrived the other way round. The institution already has the room and a team used to running it, and wants to know whether virtual reality goes inside or stays at the door. It goes inside, and there is a way to do it that respects what the room already does well. ## Where the Snoezelen room comes from The concept was born in the Netherlands in the late 1970s, with Jan Hulsegge and Ad Verheul, at a centre for people with intellectual disabilities. The name joins two Dutch words: *snuffelen*, to explore, and *doezelen*, to doze. The idea was a space with no performance goal, where a person explores and settles at their own pace, always accompanied. Over the years the room moved into care homes, day centres and long-term care units. The principle stayed the same: controlled light, sound, texture and smell, and someone alongside. ## What the room gives a virtual reality session A virtual reality session asks for almost the same conditions a Snoezelen room already offers: - **A calm place.** Low light, few people passing, no bells halfway through. The person is not interrupted. - **A routine.** People who use the room already know it is where you take a pause. The headset joins a routine that exists instead of creating a new one. - **A comfortable seat.** Sessions happen seated, and these rooms usually have the best armchairs in the building. - **A team that accompanies without hurry.** Whoever runs the room already knows how to watch the person and stop when needed. That is exactly what a headset session asks for. ## What the headset adds to the room The room has light, sound and texture. It does not have places. A beach, the village where the person grew up, the [shrine at Fátima](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/en/): that is what virtual reality brings into the room. It brings two more things the room does not have: - **It changes environment without building work.** Today's scene does not have to be tomorrow's. - **It can keep a record.** If the institution wants, what was done, with whom and for how long is written down. The headset is not tied to the room. Anyone who cannot get there, because they are bedbound or do not leave their room, can still have the session where they are. ## How to set it up - **A corner, not the whole room.** An armchair away from the bubble tubes and hanging objects, so the person can turn their head freely. - **Turn the room's sound down.** The headset has its own ambient sound. Two soundscapes at once confuse more than they calm. - **Low light, not dark.** The person in the headset cannot see the room; whoever accompanies them needs to see the person. - **One stimulus at a time.** No headset on top of a vibrating chair or a water bed. If the person reacts, the team needs to know to what. - **The room is for arriving and leaving.** A few minutes in the room before putting the headset on, and a few after taking it off. Coming back from a scene into a softly lit room is different from coming back into a corridor. - **One person in the headset, the others in the room.** Virtual reality is individual. While one person is in the scene, the others carry on with the rest of the room, and the team follows the session on a phone or tablet. ## Where it does not work - **People who tolerate nothing on their head.** For them, the room stays, and that is fine. - **Group sessions.** The room can be shared, the headset cannot. If the room is mostly used in groups, the headset fits before or after, not during. - **A room that is always busy.** If there is already a queue for the room, putting the headset there only lengthens it. In that case the headset is worth more wherever the person is. :::note Neither is a treatment. Both are environments for comfort and stimulation, used under the supervision of carers. They do not replace clinical assessment or any prescribed therapy, and decisions about the care plan always belong to the team. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and carries CE marking under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. On fitting sessions into the week, see [an activity plan for a care home](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). On who can use the headset, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). Q: Can virtual reality be used inside a Snoezelen room? A: Yes. It works well in a corner of the room, with the person seated, the room's sound turned down and one stimulus at a time. The session is always accompanied by a member of the team. Q: If we already have the room, does virtual reality still make sense? A: It does, because they do different things. The room gives touch, movement and sharing; the headset gives places and can keep a record of the session. And the headset can still go to the room of anyone who cannot get to the Snoezelen room. Q: Who has to be present during the session? A: A member of the team, next to the person, from start to finish. It is the same rule as in the Snoezelen room. ### World Mental Health Day 2026: hearing lived experience URL: https://rver.pt/blog/dia-mundial-saude-mental-2026-ouvir-quem-vive/en/ Date: 30 September 2026 The 2026 theme reads quickly as a slogan. Read slowly, it says something practical: listening means asking, writing down what the person said, and letting it change the next session. World Mental Health Day falls on 10 October. The World Federation for Mental Health chose *Lived Experiences Heard: Real Voices, Real Change* as the 2026 theme, and asks that events on the day support the World Health Organization's work on deinstitutionalisation. It is a theme that reads quickly as a slogan. It is worth reading slowly, because it has a practical consequence for any service: listening is not asking once. It is asking, writing down what the person said, and letting that change what happens next. ## Listening starts before the session In a non-pharmacological activity, the first question is the simplest and the one most often skipped: what does this person want? Not what usually works with other residents, and not what the team finds calming. In a virtual reality system, like the one used in [care homes](/en/solucoes/lar-residencial/), this has a concrete form: who chooses the scene. If it is always the team, the session is something done to the person. If it is the person, or someone who knows them well (the [life story form](/en/ferramentas/historia-de-vida/) helps), it is something done with them. We wrote about how to choose in [meaningful activity: how a scene is chosen](/blog/atividade-significativa-como-se-escolhe-um-cenario/en/). ## Listening during: stop when the person wants The session ends when the person wants it to end, not when the scene does. It sounds obvious. In practice it means whoever is with them watches the person, not the screen, and that stopping halfway is not treated as a failure. ## Listening after: write their words, not ours This is where the theme becomes checkable. After a session, what gets written down? - A useful note records what the person said and did: "Asked for the sea. Talked about Nazaré and her father. Wanted to do it again tomorrow." - A useless note says "VR session done". - A note that should not be written draws conclusions nobody measured: "the session reduced anxiety". The device does not assess or measure emotional states. What it records is operational: what was played, when, for how long, whether it was stopped. The person's words only stay if someone writes them down. We explained how in [“The session and the patient's clinical record”](/blog/a-sessao-e-o-processo-clinico-do-doente/en/). ## Listening has to change something The second half of the theme, "real change", is the one that gets forgotten. If the person said the sea bores them and next week it is the beach again, they were heard and nobody did anything with it. A simple rule for the team: before each session, read the note from the last one. ## What this is not A comfort session in virtual reality is not psychotherapy and should not be presented as such. The difference, and why it matters, is in [virtual reality and mental health: two different things](/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/en/). The place of non-pharmacological care in the Portuguese system is in [mental health in Portugal](/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/en/). The same 10 October is [World Hospice and Palliative Care Day](/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/en/), this year about pain. ## In short - The 2026 theme is hearing lived experience, and doing something with it. - Listening starts with the choice: who picks the scene? - The session ends when the person wants. - Write down the person's words, not conclusions nobody measured. - Read the previous note before the next session. The RVer platform's base product is a Class I Medical Device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, treatment or clinical follow-up. Q: When is World Mental Health Day 2026? A: On 10 October 2026, a Saturday. It is promoted by the World Federation for Mental Health. Q: What is the World Mental Health Day 2026 theme? A: "Lived Experiences Heard: Real Voices, Real Change", chosen by the World Federation for Mental Health: listening to people with lived experience and letting that change how services work. Q: Does virtual reality treat mental health conditions? A: RVer does not. It is a comfort and meaningful-activity system, run by the institution's team, that complements care. It is not psychotherapy or exposure therapy. ### World Hospice and Palliative Care Day 2026: pain is the theme URL: https://rver.pt/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/en/ Date: 30 September 2026 The 2026 theme is pain, treated as a whole. That is the idea of total pain, and it helps show where a non-pharmacological intervention fits, and where it does not. World Hospice and Palliative Care Day falls on the second Saturday of October: in 2026, 10 October, the same day as World Mental Health Day. The Worldwide Hospice Palliative Care Alliance chose *Pain Management: An Essential Part of Palliative Care* as the theme. The Alliance frames the choice around pain treated as a whole: physical, psychological, social and spiritual. It is an idea more than half a century old, and still the most useful way to think about the theme. ## Total pain The concept of total pain comes from Cicely Saunders, founder of the modern hospice movement. In serious illness, pain is rarely only physical: fear, loneliness, unfinished business and questions of meaning join in. The components interact, and treating one while leaving the others leaves the patient in pain. For a team, the practical consequence is that "are you in pain?" is a necessary question and not a sufficient one. ## The four components in practice An assessment that only uses a [numeric pain rating scale](/en/glossario/escala-numerica-da-dor/) measures the first. The other three need other questions: - **Physical**: how strong it is, where it hurts, what eases it and what makes it worse. This is the part scales capture. - **Psychological**: fear of what is coming, anxiety, the sense of losing control. - **Social**: family far away, isolation, the role the person no longer has at home. - **Spiritual**: questions of meaning, what is left unsaid, saying goodbye. No one answers all four alone. That is why palliative care is team work, and why this year's theme asks for pain to be seen as a whole. ## Where non-pharmacological care fits, and where it does not Controlling physical pain is pharmacological and belongs to the medical team. Nothing below replaces or changes it. Non-pharmacological care sits alongside, and this is where a virtual reality session can help manage some moments: - **Predictable moments of pain**, such as repositioning or dressing changes, where immersive distraction is one of the tools studied. The mechanism is in [virtual reality for pain management](/blog/realidade-virtual-gestao-da-dor/en/). - **The social component**: family who cannot be there. The family call lets someone far away see what the patient sees and talk to them. We wrote about it in [video calls with the family](/blog/videochamadas-familia-realidade-virtual/en/). - **The biographical and spiritual component**: going back to a place that matters. It is no accident that [the most requested destination is Fátima](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/en/). What this is not: it is not analgesia, not symptom control, and is not presented as either. Whether it makes sense, and when, is decided by the team caring for the patient. Published studies on virtual reality in palliative care are collected in [studies: palliative care](/estudos/tema/paliativos/en/). ## A short session that stops when the person wants In palliative care time is short and known. The session can be done lying down, lasts as long as the person wants and ends when they ask. With someone who no longer communicates, the decision belongs to the team and the family: see [a patient who no longer communicates: is a session worth it?](/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/en/). ## Three questions for the team on the 10th - At the last pain assessment, did we ask about the other three components, or only the physical one? - What calms this person, and is it written somewhere the next shift will read? - Is there someone in the family who wanted to be there and cannot? ## In short - 10 October 2026: the theme is pain management as an essential part of palliative care. - Total pain has four components: physical, psychological, social and spiritual. - Controlling physical pain is pharmacological and belongs to the medical team. - Non-pharmacological care sits alongside: distraction in predictable moments, the family, the places that matter. - The session stops when the person wants. The RVer platform's base product is a Class I Medical Device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, treatment or clinical follow-up. Q: When is World Hospice and Palliative Care Day 2026? A: On 10 October 2026. It is held on the second Saturday of October, led by the Worldwide Hospice Palliative Care Alliance. Q: What is the 2026 theme? A: "Pain Management: An Essential Part of Palliative Care": pain management as an essential part of palliative care, across its physical, psychological, social and spiritual components. Q: What is total pain? A: A concept from Cicely Saunders: in serious illness, pain combines physical, psychological, social and spiritual components that interact with each other. Q: Does virtual reality replace pain medication? A: No. Controlling physical pain is pharmacological and belongs to the medical team. RVer is a non-pharmacological intervention that complements care and does not change the treatment plan. ### Longer lives need different systems: International Day of Older Persons 2026 URL: https://rver.pt/blog/dia-das-pessoas-idosas-2026-vidas-longas-pedem-outros-sistemas/en/ Date: 30 September 2026 We have gained years of life. This year's theme asks what we do with them. Tomorrow, 1 October, is the International Day of Older Persons. For 2026 the UN chose the theme **"The Age of Longevity: Rethinking Systems for Longer Lives"**: how health, social protection, housing and finance adapt to people living much longer. It is a theme for ministries and international organisations. But systems also exist at a smaller scale: a care home, a day centre, a long-term care unit. ## The system at three in the afternoon A care home has systems for almost everything: medication, meals, personal care, falls. They are written down, they have schedules, they have someone responsible. What usually has no system is the afternoon. Between lunch and tea there are hours left to whatever is available: the activity coordinator, if there is one, the television, if not. Over a longer life, those hours add up to years. ## Rethinking is not buying The temptation, when people talk about rethinking systems, is to look for a technology that fixes it. It does not. No device replaces a team with time, or a family that turns up. What a technology can do is fit into a system that already exists: a session booked into the week, run by someone who knows the person, with a record of what happened. Without that, it is one more gadget in a drawer. ## Where RVer fits RVer was designed for that fit, not to be the main piece. The institution does not buy equipment: it contracts a service, and [the equipment remains ours](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/). The clinical team runs the sessions. Content is chosen for clinical use, and what happens is recorded. It is a complementary, non-pharmacological activity. It adds no years to anyone. It may add something to some afternoons: a familiar place, a memory, twenty minutes that are not like the others. ## A question for tomorrow If you want to mark the day usefully, ask your own institution the question the UN theme asks governments, at a smaller scale: "is our system designed for people who live here for ten years, or only for people who pass through for ten days?" Q: What is the theme of the 2026 International Day of Older Persons? A: "The Age of Longevity: Rethinking Systems for Longer Lives", set by the UN (UN DESA). Q: Does RVer replace activities run by staff? A: No. It is a complementary activity that fits into the institution's plan and is run by the clinical team. ### World Heart Day: in a virtual reality session, the signs you cannot see URL: https://rver.pt/blog/dia-mundial-do-coracao-os-sinais-que-nao-se-veem/en/ Date: 29 September 2026 With the headset on, the person cannot see who is in the room. And whoever is in the room can no longer see their eyes. World Heart Day is on 29 September. In 2026 the World Heart Federation continues its **"Don't Miss a Beat"** campaign, focused on recognising the symptoms of cardiovascular disease that go unnoticed. We have nothing to say about the heart: virtual reality is not a cardiac intervention, and we make no claims of that kind. But the campaign's idea applies to something we know well: in a virtual reality session, the most important signs are the ones you do not see at first. ## What the headset hides In an ordinary conversation you can tell how someone is from their eyes. With a VR headset the eyes are covered. The person also cannot see who is with them, and may not realise they are allowed to interrupt. That changes the job of whoever is supervising. You can no longer rely on eye contact, so you have to read everything else. ## The signs that count **Breathing.** Whether it speeds up, catches, or suddenly changes rhythm. **Hands.** Hands gripping the sheet or the arm of the chair say more than any answer to "is everything all right?". **Posture.** A body that curls up, pulls back, goes rigid. **Skin.** Pallor, sweating, a flush that was not there before. **Silence.** Someone who was talking and stops may be relaxed, or may be holding on. None of these signs calls for a diagnosis. They call for one thing only: stop, take the headset off gently, and ask. ## The rule is stop first When in doubt, the session stops. Resuming is easy; rebuilding the trust of someone who felt unwell and was not listened to is much harder. That is also why content is chosen by the clinical team. For someone with a heart condition, or any other condition the team considers relevant, some scenarios make more sense than others: calmer, slower, with no heights and no speed. The decision is clinical, case by case. ## Not missing a beat The campaign asks people not to ignore small signs. A session asks exactly the same: to be properly present in the room, looking at the person and not at the screen. Q: Is virtual reality a cardiac intervention? A: No. RVer is a complementary, non-pharmacological activity. We make no claims about effects on the heart. Q: What happens if the person shows signs of discomfort during a session? A: The session stops. The headset is taken off gently and the person is asked how they are. When in doubt, the session always stops. ### Access to Information Day: what a family can know about a session URL: https://rver.pt/blog/acesso-a-informacao-o-que-a-familia-pode-saber-da-sessao/en/ Date: 28 September 2026 "What did my mother see today?" It is a simple question. It deserves an answer better than "I don't know". The International Day for Universal Access to Information is on 28 September. It is a UNESCO day, built around everyone's right to know what concerns them. In a healthcare institution that right takes a very concrete form. A son arrives at the care home in the late afternoon and asks: "what did my mother do today?". If she had a virtual reality session, the answer should be more than "she had the headset on". ## What gets recorded With RVer, every session leaves a record: when it happened, how long it lasted and what was watched. It is simple information, and that is the point. The record **does not assess the person, does not score them and does not diagnose**. It says what happened, not what it means. The clinical reading (whether the session went well, whether it is worth repeating) belongs to the team, who were in the room. ## Explaining without promising The temptation, when talking to a family, is to embellish. "It did her a world of good", "she was a different person". Sometimes that is true in the moment. But a sentence like that, repeated, turns an activity into a promised outcome. What you can say safely is more useful: where the person "went", for how long, how they reacted while the team watched. "She asked to see the sea again" tells a son more than "it did her good". ## Who can see what Session data belongs to the person who had the session. Access follows the same rules as any other health information in the institution: the person, or whoever legally represents them, has the right to know what is recorded about them, under the GDPR. What the institution decides is the workflow: which team members consult the records and how information is shared with families. It is worth deciding before the first question is asked, not at the moment it is. ## One simple rule If the family asks, you answer. With what happened, said clearly, without hiding anything and without embellishing. That, in the end, is access to information: not a form, but an honest conversation at the end of the afternoon. Q: What is recorded in an RVer session? A: When it happened, how long it lasted and what was watched. The record does not assess, score or diagnose. Q: Can the family access the record? A: Access follows the institution's rules for health information and the GDPR: the person, or their legal representative, has the right to know what is recorded about them. ### World Tourism Day: the most requested destination is Fátima URL: https://rver.pt/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/en/ Date: 27 September 2026 UN Tourism chose digital as this year's theme. For some people it is the only way of travelling left. World Tourism Day is on 27 September. For 2026, UN Tourism chose the **digital agenda and artificial intelligence** in tourism as its theme, with El Salvador as host country. The talk is of automated bookings, virtual guides, itineraries built by algorithms. It is the tourism of people who still travel, becoming more digital. For some people digital is not a trend. It is the only way of travelling they have left. ## Those who cannot go A bedbound person, someone who has been in hospital for weeks, a care-home resident who can no longer manage a car journey. For them, tourism is over, not for lack of wanting, but because the body stopped keeping up. For these people a virtual reality session can take them somewhere for twenty minutes. It is not the same as going. We will never say it is. ## The most requested destination When the palliative care service in Leiria, Portugal, started using the system, the television channel [SIC went to see it](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) and reported the most requested place. It was Fátima, the Catholic shrine. Not a tropical beach, not Paris, not a snowy mountain. A place half an hour from Leiria that many of those people had already visited dozens of times. ## What this says about travelling Brochure tourism sells the new: the place you have never been. At the end of life, the wish usually runs the other way. People ask to go back: to the church where they married, the beach of their childhood summers, the shrine where a promise was made. That is why, in a clinical setting, a scenario is not chosen for being beautiful. It is chosen for meaning something to that person, and it is the team, with them, who finds out what that is. ## A theme for next year If tourism wants to be more digital, it could also be more accessible: thinking of people who no longer leave the house, or their bed, as part of its public. Not as charity: as travellers whose way of going has changed. Q: What is the theme of World Tourism Day 2026? A: The digital agenda and artificial intelligence in tourism. El Salvador is the host country. Q: Does a virtual reality session replace a trip? A: No. It lets the person see a place during the session, with the team present. It is a different experience, and that is how we present it. ### European Day of Languages: the session speaks the language of whoever is inside it URL: https://rver.pt/blog/dia-europeu-das-linguas-a-sessao-fala-a-lingua-do-utente/en/ Date: 26 September 2026 The language of a session is not the language of the menu. It is the language of the person wearing the headset. The European Day of Languages is on 26 September. It was set up by the Council of Europe as a reminder that the continent speaks dozens of languages, and that this is an asset rather than an obstacle. In a virtual reality session, the language question has a less obvious answer than it seems. ## Many scenarios need no words Much of what a person sees in a session has no text and no narration: waves against the rocks, a church bell, a busy market. Ambient sound does not need translating. That is a practical advantage. A scenario without words works for the same person in Leiria or in Fortaleza, and it works for someone who can no longer follow long sentences. ## The words that count are the team's The spoken part of a session happens outside the headset. It is the team that explains what is about to happen, asks how the person feels, and says they can stop whenever they want. Those sentences have to be in the person's language. Not the system's, not the language of whoever installed the equipment, theirs. A safety instruction given in a language the person does not command is not a safety instruction. ## When the first language comes back Anyone who works with people living with dementia knows this: someone who lived their adult life in another language may, over time, return to the language of their childhood. An emigrant who spoke French for forty years may, in a care home, answer only in Portuguese. When that happens, the session follows. The team speaks the language the person understands today, which may not be the one on the admission form. ## Portuguese on both sides of the Atlantic Since this month, RVer has [a partner in Brazil](/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/en/). It is the same language, and it is not the same language: words, accents and references change, and a scenario that brings back a memory in Portugal may bring back nothing in Fortaleza. That is why the plan for Brazil includes, in time, content made for people who live there. Language is not just what is said. It is also what is recognised. Q: When is the European Day of Languages? A: On 26 September. It was established by the Council of Europe. Q: Do RVer scenarios have narration? A: Many do not: they are environments with natural sound, which need no translation. The spoken part of the session is run by the team, in the person's language. ### World Pharmacists Day: non-pharmacological does not mean anti-medication URL: https://rver.pt/blog/dia-do-farmaceutico-nao-farmacologico-nao-e-contra/en/ Date: 25 September 2026 "Non-pharmacological" describes what something is. It does not mean it is against medication. World Pharmacists Day is on 25 September. It is a good day to clear up a confusion that comes up often when people talk about virtual reality in healthcare. We say RVer is a **non-pharmacological** and **complementary** intervention. Some people hear that as a criticism of medication, as if the aim were to take pills away from someone. It is not. ## Complementary means alongside "Non-pharmacological" describes what the thing is: an activity, not a substance. "Complementary" describes where it sits: alongside the treatment plan, not in its place. No virtual reality session justifies changing a prescription. That decision is medical, and it stays medical. What a session can do is fill a space in the person's day that medication does not fill (a meaningful activity), without touching what has already been decided. ## The pharmacist's questions Anyone working with older adults knows polypharmacy: many people take several medicines a day, prescribed over the years. Some have effects that matter directly to a virtual reality session. **Do any medicines cause dizziness?** Someone prone to dizziness may feel worse inside a headset. The session is done seated or lying down, with calmer content, and the team stays attentive. **Do any medicines cause drowsiness?** Then the time of the session matters. Booking it straight after a dose that makes someone sleepy is booking a session that will not go well. **Have there been recent changes?** A change in medication over the past few days is a good reason for the team to look more carefully at the next session. None of these questions is for the VR team to answer alone. They are questions for the pharmacist and the doctor, which is exactly why it is worth involving them. ## An ally, not an opponent The pharmacist who supports a care home or a service knows each person's medication list better than anyone. Involving them in how sessions are run is not bureaucracy: it puts one more person in the room who knows what could go wrong. Q: Can a virtual reality session replace medication? A: No. It is complementary and non-pharmacological. Any decision about medication remains a medical one. Q: Why does medication matter in a virtual reality session? A: Because some medicines cause dizziness or drowsiness, which affects how and when the session is run. The pharmacist and the doctor are best placed to say. ### Autumn reaches care homes too: when the garden closes at five URL: https://rver.pt/blog/outono-nos-lares-quando-o-jardim-fecha-cedo/en/ Date: 24 September 2026 In summer, an afternoon in a care home is spent in the garden. In November it is dark by five. Autumn started this week. For most people it means different clothes. In a care home it means a different routine. In summer, part of the afternoon happens outside: in the garden, on the terrace, by the door. From October it rains more, and in November it is dark by five. The world of someone living in a care home, which was already small, shrinks by a few more metres. ## What disappears is not just the sun When the garden closes, things disappear that nobody had written into an activity plan: the chat on the bench, the walk to the gate, watching who goes by in the street. They were activities without a name, so nobody replaces them when they stop. This is where the phrase "meaningful activity" earns its weight. It is not about filling time. It is about making sure that, in the indoor months, each person still has things that belong to them, and not just the same hours of television in the lounge. ## Planning winter in September Activity coordinators and occupational therapists know this by heart. What tends to be missing is treating it as a plan rather than improvisation: knowing, before the rain starts, what will replace the garden for each person. For some it will be the workshop, for others music, for others a family visit booked for Sunday. Virtual reality can be one of the options on the list, and only that. ## Where virtual reality fits, and where it does not A session can take someone to the sea on a rainy afternoon, or to the place where they grew up. [Choosing the scenario](/blog/atividade-significativa-como-se-escolhe-um-cenario/en/) is done by the team with the person, with what matters to them in mind. What virtual reality does not do is replace going outside when going outside is possible. A sunny day in December is still better spent in the garden. The session is for the days when the door is shut, and autumn has plenty of them. ## A question for the team meeting Before November, it is worth asking one simple question about each resident: "what did this person do outside, and what will they do when they cannot?". The answer is the winter plan. Q: Does virtual reality replace going outside? A: No. When going out is possible, going out is better. The session is an option for the days when it is not. Q: Who chooses the scenario in a session? A: The clinical team, with the person, based on what is meaningful to them, and not from a generic catalogue. ### New headsets are coming tonight. Your institution does not need to worry URL: https://rver.pt/blog/meta-connect-2026-headset-novo-e-a-instituicao/en/ Date: 23 September 2026 Tonight Meta shows what is new. Tomorrow someone in your institution will ask whether the equipment is already out of date. Meta Connect 2026 runs on 23 and 24 September. The main keynote is today, at 4 pm California time (midnight in Lisbon). The expected topics are artificial intelligence, smart glasses and virtual reality. We do not know what will be announced, and this piece does not depend on it. It depends on a question that will come up tomorrow in some meeting: "is the equipment we have already out of date?" ## The manufacturer's calendar is not yours Consumer electronics makers release new models at the pace of the consumer market: every year or two. A healthcare institution decides at a different pace: annual budget, procurement procedure, IT sign-off, staff training. If every launch reopens the decision, the institution gets stuck in a cycle where it is always buying and never using. ## Why we do not sell equipment It is one of the reasons why, with RVer, [the equipment is ours](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/). The institution contracts a service; the equipment comes with it. In practice, the question "is this model still good enough?" stops being the institution's. It is ours. If a device stops being fit for purpose, it is replaced within the service: no new procurement, no hardware inventory to write off. ## What does not change with the model The part that matters to a clinical team is not in the headset. It is in what runs on it and around it: - the **content library**, chosen for clinical use; - **how the session is run**: who is present, how to stop, what is recorded; - the **record** of what happened in each session. None of that starts from scratch because of an announcement. That is why a hardware launch, however interesting, is technology news and not a clinical decision. ## Watch with curiosity, decide calmly It is worth watching what Meta presents. Some advances (sharper screens, lighter devices) may come to matter for someone wearing a headset for twenty minutes in bed. When they do, the upgrade arrives through the service, tested, not on impulse. Q: When is Meta Connect 2026? A: On 23 and 24 September 2026. The main keynote is on the 23rd, at 4 pm California time (midnight in Lisbon). Q: Does the institution need to buy new equipment when a new model comes out? A: Not with RVer. The equipment belongs to RVer and comes with the service; replacement, when needed, is handled by us. ### "If you feel discomfort, take it off and say so" URL: https://rver.pt/blog/aula-aberta-terapia-ocupacional-universidade-leiria-oeste/en/ Date: 22 September 2026 We taught certified training to student occupational therapists today, two hundred metres from the hospital where the system is already in use. The last slide was not a summary. It was a safety instruction. This morning, at the **School of Health Sciences of the University of Leiria and Oeste**, in Portugal, we taught a session to student occupational therapists: **"RVer: Virtual Reality in the (re)habilitation of children through to older adults"**. Free, certified, organised by the **aTOPlab**, Assistive Technology and Occupational Performance Laboratory, together with the **Occupational Therapy** degree programme. The room seats fifty. Sixty people came. ## The slide that matters [Image: School of Health Sciences, University of Leiria and Oeste, Campus 5, 22 September 2026. Slide 26 of 26.] What it says, in Portuguese: > Questions, and now, anyone who wants to try a bit of the system, let's do it. If you feel any discomfort, take it off and say so. Three decisions in two lines, and not one of them is marketing. **The demo comes last.** First you explain what the thing is, where it fits, and what it does not do. Put the headset on someone first and they spend the rest of the session talking about the effect rather than the work. **Trying it is optional.** In a room of sixty people there is always someone who would rather not, and nobody has to explain why. **If you feel discomfort, take it off and say so.** That is the part most often left out. Someone wearing a VR headset cannot see the rest of the room and does not know whether interrupting is allowed: so you tell them, beforehand, that it is. In a lecture that is good manners. In a session with a patient it is clinical practice: comfort is not a detail of the experience, it is the first decision you make. ## Why this happens in a health school Because the person running an RVer session is not us. It is the clinical team. The system is managed remotely, the content sits on the device, and a session runs without depending on an internet connection. None of that is the hard part. The hard part is the one software does not solve: choosing a scenario for one particular person, knowing when to stop, and fitting twenty minutes of session into a shift that is already full. You learn that from people studying occupational therapy, and you teach it to the people about to practise it. Hence a session with the aTOPlab and the degree programme, rather than a sales pitch in a borrowed room. ## The hospital is next door Campus 5 is not the university's main site: it sits apart, **directly across from Leiria Hospital**. In the palliative care service of ULS Leiria the system is used with patients: as [SIC](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) and the [Jornal de Leiria](https://www.jornaldeleiria.pt/noticia/tecnologia-permite-aos-utentes-dos-cuidados-paliativos-viajar-sem-sair-do-lugar) both showed in 2024. Teaching future therapists two hundred metres from the service where the system is already in use is not a pretty coincidence: it is the only way this does not end up as a technology in search of a problem. The people who will use it are across the street. ## What a class like this gives us Questions from the people who will use it. Not the questions buyers ask: we know those already. These come from whoever will be holding the headset halfway through an afternoon, with one patient in front of them and another waiting. Each one is something to make simpler, and the list that comes out of a morning like this beats a week of guessing in an office. This was the second time we took the system into an educational institution. The first was at [ISLA Santarém](https://www.islasantarem.pt/pt/isla-media/eventos/realidade-virtual-terapeutica), in June 2024. If there is a third, we will write that one up too. Q: What is the aTOPlab? A: The Assistive Technology and Occupational Performance Laboratory at the School of Health Sciences of the University of Leiria and Oeste. It organised the training together with the Occupational Therapy degree programme. Q: Was the training certified? A: Yes, and free. It was aimed at occupational therapy students and professionals, at the university's Campus 5. Q: Why does the demo always come last? A: Because whoever tries it first spends the rest of the session talking about the effect rather than the clinical work. First you explain what the system is, where it fits and what it does not do; trying it is the last step, and it is optional. Q: Did the institution change its name? A: Yes. In 2026 the Polytechnic Institute of Leiria became the University of Leiria and Oeste. This session was at Campus 5, next to Leiria Hospital. ### RVer has a partner in Brazil: Instituto Gabriel Benício URL: https://rver.pt/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/en/ Date: 21 September 2026 Eight days ago we said nothing had been signed in Brazil, and that when something was, we would say who with. Something has. Eight days ago we published an article about Brazil that said, in plain words, that nothing had been signed, and that when something was, we would say who with. Something has. It is the **Instituto Gabriel Benício**, in Fortaleza, in the state of Ceará. ## What was signed Today, 21 September 2026, RVer and the Instituto Gabriel Benício signed a **reseller and distribution agreement** for the platform in Brazil. For now it is **exclusive** for the country: the Institute represents RVer on Brazilian soil, and it is the only one that does. The plan goes further than distribution. The next stage is **immersive content made specifically for the Brazilian market**: scenarios filmed there, for the people who live there. A video library shot in Portugal serves a great deal in Brazil, but it does not serve everything: the landscape that gives a resident in Leiria a memory back is not the one that does it for a resident in Fortaleza. That does not exist yet. What exists today is the agreement, and the first service in the country using the platform. ## What the Instituto Gabriel Benício is [Image: The Instituto Gabriel Benício logo.] It is an **inclusion and development** organisation based in Fortaleza, working with **children with disabilities and their families**. The work with RVer runs through the Institute's **MoviMente project**. [Image: The MoviMente project shirt, a gift from the Instituto Gabriel Benício to the RVer team. This is where the work begins.] The Institute is **both partner and client**, which is not a contradiction: whoever represents the platform in a country also uses it with their own patients, like any other institution. It is, in fact, the best way to represent it. Anyone selling something they do not use ends up describing it badly. ## The headset that stayed in Fortaleza In September we took a demonstration unit from Portugal to Brazil. It is in the photograph in the [previous article](/blog/a-rver-no-brasil-o-que-ja-e-e-o-que-ainda-nao-e/en/): a headset resting on its box, on a balcony facing the sea. That unit **stayed**. It stopped being the demo headset and became the first RVer device in service in Brazil. The first sessions ran on it today: two of them, on the day the agreement was signed. Crossing the Atlantic does not change the model: **the equipment remains ours**. The institution contracts a service and the equipment comes with it: [we explained why here](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/). The difference planned for Brazil is where the hardware comes from: as more services come online, the headsets are bought in the country and **configured remotely**, with no fleet crossing customs and no import cost added to the service. ## What it still is not The September article put the limits up front. They are still there, and they are worth repeating rather than quietly dropping now that there is a signature. RVer **is not registered with ANVISA**, the Brazilian regulator. The registration we hold is a **Class I Medical Device registration in EUDAMED and with INFARMED**, it covers the base product, and it is valid where it was issued: it has effect in the European space, not a worldwide credential. It is a process we will be dealing with shortly, now that the Brazilian partner it presupposes exists. Until that happens, the internal rule stands: **no therapeutic claims in Brazil**. What is presented to a Brazilian institution is what the product does (meaningful activity, comfort, occupation, a record of what happened in the session) without promising clinical effect. Regulation follows the claim made, not the type of buyer. And there is still no Brazilian company, no office and no local team. There is a partner, which is a different thing and, for now, a better one. ## Portugal, Brazil, and what comes next This is the first step of internationalisation, and there are meant to be more. Portugal, now Brazil, and others after that: there are conversations under way in other markets. We are not naming them. That was the rule in September, when Brazil was still a calendar full of meetings, and there is no sense in changing it now that it worked: **announcing conversations as though they were agreements is the fastest way to ruin them**. When there is a signature, we say who with. That is what happened today. What we can explain is the criterion, and it is not market size. **Patient need first.** We go where there is work to be done, not where the population is largest. **Then someone on the ground.** Either we build a team, or we partner with whoever is already there, and whoever is already there has to have a footing in healthcare, in technology, or in both. Knowing how to sell is not enough. **Distance is not the obstacle.** The platform is managed remotely by design: the content sits on the device, the session runs without depending on an internet connection, and configuration is done from Leiria. You do not need to be in the country for the system to work in the country. You need to be in the country to understand who is going to use it, and that is what a partner is for. Which is why the order is this one: partner first, operation second. The first one closed today. Q: Is RVer now a Brazilian company? A: No. RVer is a Portuguese company with a partner in Brazil. There is no company incorporated in the country, no office and no local team. The Instituto Gabriel Benício represents RVer on Brazilian soil under a reseller and distribution agreement. Q: Is RVer registered with ANVISA? A: No. RVer holds a Class I Medical Device registration in EUDAMED and with INFARMED, covering the base product, valid where it was issued: it has effect in the European space. The ANVISA process will be dealt with shortly. Until then the internal rule stands: no therapeutic claims in Brazil. Q: Is the agreement exclusive? A: For now, yes: the Instituto Gabriel Benício is RVer's only representative in Brazil. Q: Do Brazilian institutions buy the equipment? A: No. The model is the same as in Portugal: the institution contracts a service and the equipment comes with it, remaining RVer's property. As more services come online in Brazil, the headsets will be bought in the country and configured remotely. Q: Which countries come next? A: There are conversations in other markets, and we do not name them until there is a signature. The criterion is not market size: it is patient need, and having someone on the ground with a footing in healthcare, in technology, or in both. ### Childhood Cancer Awareness Month: what changes when the patient is a child URL: https://rver.pt/blog/setembro-dourado-criancas-sessao-realidade-virtual/en/ Date: 20 September 2026 A session with a child is not an adult session made smaller. September is Childhood Cancer Awareness Month: marked by the gold ribbon. It is the month when people talk about children who spend months in hospital, between treatments, tests and waiting. Virtual reality often comes up in those conversations, nearly always through the same door: distraction during procedures. That is not what we want to discuss here, and we make no claims about pain or anxiety. We want to talk about what changes in the session itself when the person putting on the headset is a child. ## Two people decide With an adult there is one consent. With a child there are two: the parents' or guardians', and the child's own assent. The second is not a formality. A child who says yes because the adults around them want a yes is not choosing. Asking differently, "do you want to see the sea, or would you rather keep drawing?", and accepting the answer is part of the session. ## The equipment has a minimum age VR headset manufacturers set a minimum age of use and give guidance on fitting the equipment to smaller faces. Before any paediatric session, you check what the manufacturer states for the model in use, and that decides, before anything else, whether the session happens. ## Shorter, and with someone holding their hand Sessions with children are shorter. Attention works differently, the tiredness of a hospital day is different, and the goal is not to last until the end. And there is always a familiar adult in the room: a parent, the named nurse. A child wearing a headset cannot see who is beside them. Knowing that the hand holding theirs is the same one as before the headset went on is what makes the session safe for them. ## The child chooses the content Within what the team considers appropriate, the child chooses. Animals, the beach, the snow they have never seen. Being able to choose something, in a place where nearly everything is decided by others, matters. ## From 10 to 100, but not in the same way RVer is used with people aged 10 to 100. That does not mean the session is the same for everyone: it means the rules for each age are written down before the session starts. Q: What is Childhood Cancer Awareness Month? A: An international awareness month for childhood cancer held every September, identified by the gold ribbon. Q: Is there a minimum age for VR headsets? A: Yes. Manufacturers set a minimum age and fitting guidance. Before a paediatric session, always check what the manufacturer states for the model in use. ### RVer in the Jornal de Leiria URL: https://rver.pt/blog/rver-jornal-de-leiria-setembro-2026/en/ Date: 19 September 2026 The Jornal de Leiria published a piece about RVer today. We are using the occasion to put down in writing, from our side, the three things the article raises. ## What the piece says Journalist Daniela Franco Sousa writes about Amplified Creations (a Leiria company, founded in 2015, five people) and about RVer, the virtual reality system for assisted clinical use that we registered in EUDAMED and with INFARMED (Portugal) as a medical device. The piece sums up the three uses the system has in the field: comfort and distraction during procedures, reducing anxiety before examinations, and stimulation activity with care-home residents. It is the same description we use in our proposals. There is nothing new to announce here, and that is what we like about the piece. ## The sentence that matters From the article: “The session is always run by a health professional from the institution itself.” If a single line were to travel out of here, it would be this one. RVer is not a 360° video player handed to a patient and left running. It is an assisted clinical system: the institution's care team picks the content, runs the session, stops it when it needs stopping, and records it. The headset is the least interesting part. That is also where the limits come from. It does not treat, does not diagnose, does not assess, and replaces no medical care. It is a non-pharmacological complement, always under the supervision of the care team. ## Where we actually are The piece mentions national and international expansion, and that is true: it is the plan. On current geography, the map is this: the head office is in Leiria, there is a company space in Lisbon for meetings, and installation and training are done remotely. As for clients, the institutions using the system are spread across several parts of the country rather than concentrated in one region, although today they all sit from Lisbon northwards. Meetings happen online and the system lives at the institution itself, so geography constrains little about who can work with us. ## Not the first time This is worth reading as a series, not as a one-off: - **2022**: the Jornal de Leiria follows [the residents of Casa das Janelas Verdes, in Alpedriz](https://www.jornaldeleiria.pt/index.php/noticia/idosos-de-alpedriz-espreitam-o-mundo-atraves-da-realidade-virtual). The system did not yet have the name it has today. - **2024**: [SIC Notícias](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) and the [Jornal de Leiria](https://www.jornaldeleiria.pt/noticia/tecnologia-permite-aos-utentes-dos-cuidados-paliativos-viajar-sem-sair-do-lugar) visit the Palliative Care unit in Leiria. The most requested destination is Fátima. That same month the Diário de Leiria runs its own piece in print. - **2026**: [today's piece](https://www.jornaldeleiria.pt/noticia/amplified-creations-aplica-realidade-virtual-na-saude), now with the medical device registration done. Four years between the first report and this one. That was the time it took to turn something that worked into something that can be installed, documented and defended in front of a regulator. ## Read the piece [Amplified Creations aplica realidade virtual na saúde](https://www.jornaldeleiria.pt/noticia/amplified-creations-aplica-realidade-virtual-na-saude), Jornal de Leiria, 19 September 2026 (in Portuguese). :::note Press coverage is not clinical evidence. The studies that do exist on virtual reality in health settings are gathered, with all the caveats, in our [study library](/estudos/en/). ::: Q: Is RVer a medical device? A: The video library, which is the base product, is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, no. CDM 94571546), CE marked under MDR 2017/745 and without a notified body. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. Q: Who runs the virtual reality sessions? A: A health professional from the institution itself. The team picks the content, runs the session and stops it when needed. We do not place our own staff running clinical sessions. ### Mobility Week: and those who cannot leave their bed? URL: https://rver.pt/blog/semana-europeia-mobilidade-quem-nao-sai-da-cama/en/ Date: 18 September 2026 This week is about cycle lanes and public transport. For a bedbound person, the world is the size of one room. European Mobility Week runs every year from 16 to 22 September. It is about cycle lanes, public transport, car-free streets. It is a week about how we get around. For some people that question has stopped existing. A person who is bedbound in a palliative care unit, or in a care home, does not get around. Their world is the size of the room, and the view is the ceiling and the window, when there is a window. ## It is not giving back what was lost Virtual reality gives nobody their mobility back. It is not motor rehabilitation, and saying otherwise would mislead whoever is deciding whether to use it. What it does is smaller: for twenty minutes, it changes what is in front of the person's eyes. They stay in the same bed, with the same team beside them. The room simply stops being the only thing there is. ## A horizon, for someone who only sees the ceiling For someone who spends the day lying down, what is missing is often not a specific place: it is distance. Their gaze always lands on the ceiling, the wall, the curtain. So for these people the team often chooses scenarios with a horizon: the sea in the distance, an open field, a square with people passing far off. The point is not to be spectacular. It is being able to look far away again, and for the person to decide, with the team, where. ## The movement that shows up on its own There is a detail teams notice. Someone who has not moved in days turns their head to follow what they are seeing. Sometimes they bring their hands together, in front of an altar. We do not call this therapy, and we do not promise it. It is the small amount of movement a meaningful place invites, and it is the clinical team who decides whether that movement is welcome or whether the session should stay stiller. ## What the week could include A week about mobility could, just once, remember the people who no longer go out. Not to sell them a solution, but to recognise that the question "where can this person go?" still makes sense, even when the answer is a room. Q: When is European Mobility Week? A: Every year, from 16 to 22 September. Q: Does virtual reality give bedbound people their mobility back? A: No. It is not motor rehabilitation. It changes what the person sees during the session, with the clinical team present, and nothing more should be promised. ### Patient safety: with a chronic condition, the session repeats URL: https://rver.pt/blog/seguranca-do-doente-doenca-cronica-sessao-que-se-repete/en/ Date: 17 September 2026 The first session almost always goes well. The safety question is a different one: does the thirtieth go the same way? World Patient Safety Day falls on 17 September. In 2026 the World Health Organization dedicated it to **noncommunicable diseases** (diabetes, cardiovascular disease, chronic respiratory disease, cancer) under the slogan "Safe care for life!". The reason for the theme is in how these conditions unfold. They are not treated in one appointment: they are followed for years, in different places, by different teams. Every handover is a place where something can go wrong. ## The first session is not the worrying one In a virtual reality session, the first time is the most closely watched. Everyone is paying attention, the person is observed, someone asks how they feel. With a chronic condition the session does not happen once. It repeats (weekly, for months) and that is where attention drops. The safety of a session that has already run twenty times depends on the twenty-first following the same script as the first, not on the team remembering. ## What has to be the same every time **Who is in the room.** A person wearing a VR headset cannot see what is around them. There is always a member of the team present, and that person is not doing something else at the same time. **How to stop.** The person knows, before starting, that they can take the headset off whenever they want, and that saying they are not well is not failing the session. **What gets recorded.** How many times, for how long, what was watched. The record does not assess or diagnose; it exists so that a slow change (sessions getting shorter, for instance) shows up on paper before it shows up in the person. **Who chooses the content.** The clinical team chooses the scenario for that person, on that day. Content that was calm yesterday may not be today. ## Several settings, the same rule The WHO theme is about care that moves between places. A person may have sessions on a ward, then in a care home, then at home with community support. If each place does it its own way, safety depends on where the person happens to be. We want the opposite: the session follows the same rules wherever the equipment is, because the equipment and the way it is used come together. ## What this is not None of this makes virtual reality a treatment for a chronic condition. It is a complementary, non-pharmacological activity run by the clinical team. The safety we are talking about is the safety of the session itself: it does not replace the care plan, and it does not claim to improve it. Q: What is the theme of World Patient Safety Day 2026? A: WHO dedicated it to safe care for people living with noncommunicable diseases, under the slogan "Safe care for life!". Q: Does virtual reality treat chronic conditions? A: No. In RVer it is a complementary, non-pharmacological activity run by the clinical team. It does not replace any treatment. ### RVer in Brazil: what is true, what isn't yet, and what ANVISA has to do with it URL: https://rver.pt/blog/a-rver-no-brasil-o-que-ja-e-e-o-que-ainda-nao-e/en/ Date: 16 September 2026 In September we spent fifteen days in Brazil meeting distributors and partners. When this article came out nothing was signed, and the registration we hold in Portugal does not apply there. *Update, 21 September: we signed our first agreement in Brazil, with Instituto Gabriel Benício. [Read the news](/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/en/).* On 14 September, RVer arrived in Brazil for fifteen days of meetings with distributors, institutions and potential partners, and this article exists because the news is easy to tell badly. So let us tell it with the limits up front. ## What is already true We are a **Portuguese company entering the Brazilian market**. We are not a Brazilian company, not yet. There is no entity incorporated in Brazil, no office, no local team. We started in Fortaleza. What there is, is a schedule: two weeks across the country meeting the people who distribute health technology, the people who run long-term care institutions, and the people who have already noticed that the non-pharmacological side of care has very little serious supply. ## What is not true yet **Nothing is signed.** No contract, no exclusivity, no distribution agreement. That is precisely why this text names nobody on the Brazilian side: we are evaluating partners, and announcing conversations as if they were deals is the fastest way to ruin them. When something is signed, we will say who it is. ## The regulatory part, which is the part that matters The registration RVer holds is a **Class I Medical Device registration in EUDAMED and with INFARMED**, and it covers the **base product**: the immersive video library. It is a registration, with effect in the European space. It is not a worldwide credential and it does not travel in a suitcase. In Brazil, medical devices are regulated by **ANVISA**. RVer **holds no ANVISA registration**. Three practical consequences follow, and they are internal rules, not suggestions: 1. **We do not invoke the Infarmed registration in Brazil** as though it applied there. It applies where it was issued. 2. **We make no therapeutic claim in Brazil.** What is presented to a Brazilian institution is what the product does: meaningful activity, comfort, occupation, a record of what happened in the session, without promising a clinical effect. Regulation follows the claimed intended purpose: it is the claim that pulls a product into the regime, not the type of buyer. 3. **The ANVISA door opens with a Brazilian partner**, when the path requires it. From what we have established, the process presumes a holder with legal presence in the country: one more reason for the order to be this one, partner first, registration after, not the other way round. For the European framing, see [what a Class I Medical Device is](/blog/dispositivo-medico-classe-1-realidade-virtual/en/). ## How a small company reaches a country it is not in This is the part that makes the trip possible, and it is not commercial: it is operational. **The equipment stays ours.** The model is the same as in Portugal: the institution does not buy hardware, it contracts a service and the equipment comes with it: see [the headsets stay ours](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/). The difference planned for Brazil is where the equipment comes from: **once a contract is signed, the headsets are bought in-country**, same model, and **configured remotely**. No fleet crosses customs, and no import cost is added to the service. None of that is true yet. The only equipment of ours on Brazilian soil is the one in the photograph above: the demo headset, carried over from Portugal for this trip, because there is no operation there yet to justify anything else. Remote configuration is not improvisation: it is how the platform was designed from the start. Content sits on the device and the session runs without depending on an internet connection, see [content on the device](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/en/), and management happens through the companion app, see [remote control of the session](/blog/app-companion-controlo-remoto-realidade-virtual/en/). The result is that distance stops being a logistics problem and goes back to being what it always was: a people problem. Someone has to be in the room with the resident. That part is not solved remotely, here or there. ## Where we will lose, and it is better written down **The library is European.** Most scenes were filmed in Portugal and in Europe. For activity, comfort and conversation, that works anywhere. For **reminiscence**, which depends on the person recognising the place, it does not work the same way for someone who never lived here. Developed in [when the person's place isn't in the library](/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/en/). **The platform is in European Portuguese and in English.** Usable, readable, but not the same thing as being written in the language of the people using it every day. **And we have no track record in Brazil.** Every installation, every resident and every usage record we can show is European. Anyone evaluating RVer there is evaluating a foreign company with no local references, and that is a legitimate argument against us until it stops being one. ## What we are looking for in these fifteen days Distributors with real work behind them in health and long-term care institutions. Clinical partners willing to run a serious pilot, with the criteria defined before it starts: the recipe is in [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/). And people who will tell us where the European model does not fit, which is the most valuable thing a trip like this can bring home. We are promising no dates. When there are any, we will write them here. ## RVer's role RVer's **base product** is an immersive video library, registered as a Class I Medical Device in EUDAMED and with INFARMED: a registration, with no effect outside the European space. **RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration.** The platform records the session: it does not assess, grade or diagnose, and does not replace clinical assessment or the team's decision. Q: Has RVer opened a company in Brazil? A: No. RVer is a Portuguese company entering the Brazilian market. There is no entity incorporated in Brazil, no office and no local team. Since 14 September 2026 we have been in the country for fifteen days, meeting distributors, institutions and potential partners. Q: Where did the trip start? A: In Fortaleza, on 14 September 2026. It is fifteen days in the country, with meetings in more than one city. Q: Is there already a partner or distributor in Brazil? A: Nothing is signed: no contract, exclusivity or distribution agreement. That is why we name nobody on the Brazilian side: we are evaluating partners, and announcing conversations as if they were deals ruins them. When something is signed, we will say who it is. Q: Does the Infarmed Class I Medical Device registration apply in Brazil? A: No. It is a registration with effect in the European space, and it covers the base product: the immersive video library. In Brazil, medical devices are regulated by ANVISA, and RVer holds no ANVISA registration. We do not invoke the European registration as though it applied there. Q: So how does RVer present itself in Brazil? A: By what the product does: meaningful activity, comfort, occupation and a record of what happened in the session, with no therapeutic claim. Regulation follows the claimed intended purpose, and it is the claim that pulls a product into the medical device regime, not the type of buyer. Q: When will the ANVISA registration happen? A: When the path requires it, and with a Brazilian partner. From what we have established, the process presumes a holder with legal presence in the country: one more reason the order is partner first, registration after. Q: How does the equipment get there? A: Today, the only equipment of ours in Brazil is the demo headset, carried over from Portugal for this trip. The planned model is different: once a contract is signed, headsets are bought in-country, same model, and configured remotely, still belonging to RVer, as in Portugal. Content sits on the device and the session runs without an internet connection, which is the technical reason this works at a distance. Q: Does the library work for Brazilian residents? A: For activity, comfort and conversation, yes. For reminiscence, not in the same way: most scenes were filmed in Portugal and in Europe, and reminiscence depends on the person recognising the place. The platform is also in European Portuguese and English, and we have no installation track record in Brazil. ### The headsets stay ours: why RVer doesn't sell hardware URL: https://rver.pt/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/en/ Date: 15 September 2026 "How many headsets do we have to buy?" None. The headsets are ours and come with the service, which decides who carries the risk of a technology that ages fast. A question comes up early in almost every meeting, usually not phrased this way: *how many headsets do we have to buy?* The answer is **none**. The headsets are ours. The client does not buy hardware from RVer, not in year one and not in year five. They contract an annual service, and the equipment comes with it. This is not a contract detail. It decides who carries the risk of a technology that ages fast, and it is worth explaining why, including the part where the model is worse for the client. ## Hardware ages faster than a procurement process A headset bought today is, three years from now, a discontinued model with accessories nobody makes any more. An institution that bought it as a capital asset ends up with an item in inventory, a depreciation schedule running, and no simple way to swap it, because swapping means opening another procurement process. When the equipment is ours, replacement is an operational decision, not a tender. ## Responsibility sits where the knowledge is If the equipment is ours, the fault is ours, the update is ours, the replacement is ours, and the battery that no longer lasts an afternoon is ours. Nobody at the institution has to learn to manage a fleet of headsets, or decide when one of them is past it. This is the point that changes daily life the most. The alternative (the client owns it and we support it) always produces the same conversation: *is this a fault or is this misuse?* With the equipment on our side, that conversation does not exist. ## What is contracted is the service, not the box The value is not in the headset. It is in the validated library, the updates, the remote configuration, the team training and the session record. See [what the clinical team sees in a session record](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/). A headset without any of that is an expensive toy in a drawer, and that is exactly where a good share of campaign-bought health equipment ends up. ## It is not capital expenditure For many institutions, the difference between buying equipment and contracting a service is the difference between an investment process and an operating line. It is not an accounting trick: it is why some projects start in weeks and others wait for next year's budget. The point is developed in [whoever pays is not whoever saves](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/en/). [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## What this obliges us to do The model has an obvious flip side, and it is fair to write it down: - we replace faulty equipment, without arguing about whose fault it was; - we keep the equipment updated for the whole contract; - when the contract ends, the equipment is collected. That last line is the one a careful buyer cares about. ## Where the client loses **At the end, they keep nothing.** If the institution stops the service after three years, there are no headsets in the cupboard. Whoever bought hardware still has hardware: old, but theirs. There are institutions for which that is decisive, usually because of internal asset rules or funding that requires an inventoriable item at the end. For them, our model is the wrong model, and it is better to know that in the first meeting than in the third. **The second loss is control.** The equipment arrives configured by us, in a controlled-use mode. It is not a tablet you install things on. For the clinical team that is an advantage (see [where the equipment lives](/blog/onde-vive-o-equipamento-realidade-virtual-hospital/en/) and [hygiene and safety](/blog/higiene-seguranca-equipamento-realidade-virtual/en/)), but it is still less freedom than owning the thing outright. ## And the price? It is not public, and not out of mystery: the figure depends on the number of services and of headsets, and a loose number without that structure invites the wrong comparisons. What can be said here is the shape (**an annual subscription per service, equipment included**) and that the return analysis is not done with the price of a headset, as covered in [cost and ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/en/). ## RVer's role RVer's **base product** is an immersive video library, registered as a Class I Medical Device in EUDAMED and with INFARMED (Portugal). **RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration.** The platform records the session: it does not assess, grade or diagnose, and does not replace clinical assessment or the team's decision. Q: Does the institution have to buy the headsets? A: No. The equipment belongs to RVer and is included in the annual service. The client does not buy hardware: not in year one, not later. Q: Who pays for a fault or a replacement headset? A: RVer does. Because the equipment is ours, the fault, the update and the replacement are ours, and there is no argument about whether it was a fault or misuse. The institution manages no fleet and decides nothing about end of life. Q: What happens to the equipment when the contract ends? A: It is collected. The institution keeps no headsets. That is the direct flip side of never having paid for hardware, and it is worth knowing in the first meeting. Q: When is this the wrong model? A: In two cases. When internal asset rules or a funding line require an inventoriable item at the end: then buying is what works. And when the institution wants full freedom over the device: ours arrives configured in a controlled-use mode, not as a tablet you install things on. Q: Does this count as capital or operating expenditure? A: Contracting the service is an operating line, not an equipment investment process. For many institutions that is the difference between starting in weeks and waiting for next year's budget. It should always be confirmed with the institution's own finance team. Q: What does it cost? A: The price is not public. It depends on the number of services and of headsets, and a loose figure without that structure invites the wrong comparisons. The shape is an annual subscription per service, with equipment included. ### Mild cognitive impairment: usable first, useful after URL: https://rver.pt/blog/defice-cognitivo-ligeiro-primeiro-usavel-depois-util/en/ Date: 14 September 2026 It looks like the study you run when you lack the nerve to measure efficacy. It is the opposite. There are trials under way studying virtual reality cognitive and physical rehabilitation in people with **mild cognitive impairment**: the intermediate state between normal ageing and dementia. And what those trials are measuring, at this stage, is not what most people expect. They measure **feasibility, usability and acceptability**. That is: can the person use it? Do they want to come back? Can the team fit it into what they already do? ## Why that is not a lesser result At first glance it looks like the study you run when you lack the nerve to measure efficacy. It is not. In a device you place on the head of a 78-year-old, feasibility **is** the question. If half the participants give up in the second minute, if the weight bothers them, if the interface demands coordination that is not there, or if the team needs fifteen minutes to get it working during a shift that has no fifteen minutes, no efficacy question is even answerable. That is the right order: first usable, then useful. A field that skips the first question produces handsome results under conditions that exist nowhere. :::note Almost every device sitting in an institution's storeroom failed the first question, not the second. ::: ## What we have learned, in practice We do not have a trial of our own, and we are not going to pretend otherwise. What we have is use in the real world (more than 50,000 sessions in Portuguese institutions) and a few lessons that look a lot like what these trials set out to measure: - **Fitting the headset is the critical moment.** Whoever runs the session has to know how to place it on someone with limited neck mobility, without crushed glasses and without a fright. - **The first session decides the second.** If the person was startled, no scene makes up for it. - **Refusal is a legitimate outcome.** We wrote about it in [when the patient refuses virtual reality](/blog/quando-o-utente-recusa-realidade-virtual/en/): insisting is the most expensive mistake in this field. - **Duration is not what people imagine.** That deserves its own article: [session duration and frequency](/blog/duracao-frequencia-sessao-realidade-virtual/en/). ## And cybersickness It is the objection that always comes up, and rightly: motion sickness in virtual reality is real and is common in computer-generated content with free camera movement. We made a different choice: **real filmed video**, with a mostly static camera, rather than 3D environments with locomotion. We have no reported cases of cybersickness to date. That is not a clinical trial and is not presented as one: it is what we have observed in use, and the reason the instruction to stop at any dizziness, nausea or discomfort is in every implementation guide. ## What this means for an institution today That the right question, before asking "does it work?", is: **can our people use this inside the week they already have?** If the answer is no, the rest is conversation. If it is yes, then it is worth discussing what to measure, with whom, and for how long. --- **Source:** trial registered at [ClinicalTrials.gov](https://clinicaltrials.gov/study/NCT07638748) on feasibility, usability and acceptability of virtual reality-based cognitive and physical rehabilitation in people with mild cognitive impairment. Q: Why do the trials measure feasibility rather than efficacy? A: Because in a device placed on an older person's head, feasibility is the first question. If the person gives up, if the headset bothers them or if the team cannot fit it into a shift, no efficacy question is even answerable. Q: Does RVer cause motion sickness? A: We have no reported cases of cybersickness to date, which is an observation from use and not a clinical trial. Choosing real filmed video with a mostly static camera reduces exposure to the movement that causes sickness. The instruction is to stop immediately at any dizziness, nausea or discomfort. Q: Does RVer treat cognitive impairment? A: No. It is used by clinical teams in cognitive stimulation settings. It does not assess, classify or diagnose, and it does not replace any clinical assessment. ### Clinical VR research nearly quadrupled. What that proves URL: https://rver.pt/blog/investigacao-em-rv-quadruplicou-o-que-isso-prova/en/ Date: 13 September 2026 Nearly four times as many papers in ten years. Publication volume and evidence quality are different axes. A bibliometric review published this year counted the literature on virtual reality exposure therapy: **76 publications in 2015, 281 in 2025**, an annual growth rate of about 14%. Nearly four times as many papers in ten years. It is a good number for a slide and a dangerous number for a purchasing decision. The two are worth separating. ## What the number says It says the field is no longer marginal. Ten years ago, proposing virtual reality in a clinical meeting was a conversation about science fiction; today there is enough literature for a systematic review to have work to do. It also says where it is concentrated: graded exposure in anxiety disorders and post-traumatic stress is by far the most studied area. That is where the protocols, randomised trials and meta-analyses are. ## What the number does not say **It does not say the results are good.** Publication volume and evidence quality are different axes. A field can grow quickly because small studies are easy to publish, with thirty participants and no active control group. **It does not say it applies to what you want to do.** Most of this literature is about therapeutic exposure: environments built to confront a specific fear gradually, run by a psychologist, inside a protocol. That is a very different thing from an 84-year-old man watching Porto's riverside on a Thursday afternoon. We keep that distinction explicit ourselves, and it gives a whole article its name: [virtual reality and mental health are two different things](/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/en/). :::note Citing the exposure literature to justify a relaxation session is the same manoeuvre as citing morphine trials to sell tea. Both are taken by mouth. ::: ## What to do with it in a purchasing decision Three questions any supplier should answer without fidgeting: 1. **Are the studies you are showing me about the same use you are proposing?** Therapeutic exposure, distraction during a procedure and meaningful activity in dementia are three separate literatures. 2. **What is the product registered for?** RVer is a Class I medical device (base product) registered in EUDAMED and with INFARMED (Portugal). The registration covers the base product: modules under development are not covered, and we say so everywhere, including where it does not help the sale. 3. **What does the supplier claim in writing?** An efficacy claim printed in a brochure is a regulatory claim, not a marketing line. If it is there, it has to be supported. ## The position we take RVer does not claim to treat, to reduce symptoms or to replace care. It is a virtual reality system for clinical use, used by clinical teams in pain, rehabilitation, anxiety, cognitive stimulation, palliative care and mental health settings. What it is for, in which patient and at which moment, is decided by the clinician. The growth of the literature is good news for the field. It is not proof about a product, not even ours. --- **Source:** systematic review and bibliometric analysis of clinical applications and research trends in virtual reality exposure therapy, [*Frontiers in Virtual Reality*](https://www.frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2026.1826777/full), 2026. Q: Do more publications mean better evidence? A: No. They are different axes. A field can grow quickly because small studies with few participants and no active control group are easy to publish. Q: Does the exposure literature justify other uses of virtual reality? A: No. Therapeutic exposure, distraction during a procedure and meaningful activity in dementia are separate literatures, with different populations and designs. Q: What does RVer claim? A: That it is a virtual reality system for clinical use, registered as a Class I medical device (base product) in EUDAMED and with INFARMED (Portugal) and used by clinical teams. It does not claim to treat, reduce symptoms or replace care. ### When care leaves the institution URL: https://rver.pt/blog/quando-o-cuidado-sai-da-instituicao-sad-mais-saude/en/ Date: 12 September 2026 Social support and health care coming through the same door. Five institutions do not change a country: the design does. The SAD+Saúde pilot brings together social home support and health care for people in situations of dependency, incapacity or disability who cannot, temporarily or permanently, meet their basic needs or health care needs. It started with protocols between Portugal's Social Security Institute and five social-sector organisations, one per mainland region: Associação de Solidariedade de S. Pedro (North), Santa Casa da Misericórdia de Arganil (Centre), Fundação AFID Diferença (Lisbon and Tagus Valley), Santa Casa da Misericórdia de Mora (Alentejo) and Santa Casa da Misericórdia de Portimão (Algarve). Services include meals, personal hygiene, medication support, laundry, house cleaning, accompaniment outside the home (pharmacy, supermarket) and psychosocial support. The teams are multidisciplinary, drawn from social, behavioural and health fields. ## What it signals Five institutions do not change a country. What changes is the design: for the first time in a pilot of this shape, **social support and health care come through the same door**, in the person's home. Anyone working in this field knows the absurd boundary this is trying to erase. The lady has home support from the Misericórdia, which brings lunch and helps her wash. She has a health team from the health centre, which visits when it visits. The two rarely speak. The person is the same and the problem is the same, but there are two records and decisions are made blind on each side. :::note Integrated care does not fail for lack of goodwill. It fails because there are two budgets, two ministries and two information systems, and the person is in the middle. ::: ## What it means for anyone thinking about technology Something uncomfortable, worth saying: **the home is the hardest context for any equipment.** In a care home there is a room, a known socket, a responsible person and a routine. At home there are stairs, a sofa pushed against the window, a carer who is already exhausted, and a professional who stays forty minutes and has six more visits that day. We have written about what technology does, and mostly what it does not, in [informal carers: what technology does at home](/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/en/). The conclusion stands: at home, the most valuable thing is rarely a new device. It is somebody's time, and information that crosses the boundary between social care and health. ## Where RVer fits into this Honestly: today, not in the individual home. The system is used by clinical teams in institutions: hospitals, clinics, care homes, continuing care and palliative units. That is where the routine, the training and the responsible person an accompanied session requires actually exist. What SAD+Saúde signals, and what matters in the medium term, is something else: care is moving into the home. Anyone designing tools for this sector has to assume the activity room will not be the only place they are used, and that a tool needing internet, technical configuration and an IT person nearby will not get there. It is one of the reasons playback works with no internet and the device runs in kiosk mode. It was not designed for the home; it was designed for institutions where the network is poor and nobody has time. It turns out the second condition describes the first rather well. --- **Sources:** [Government launches the SAD+Saúde pilot](https://portugal.gov.pt/gc25/comunicacao/noticias/governo-lanca-projeto-piloto-sadsaude-para-apoiar-pessoas-dependentes-em-casa), Portuguese Government; [SAD+SAÚDE project](https://www.afid.pt/projetos/projeto-sadsaude-a-decorrer/), Fundação AFID Diferença. Q: Which institutions take part in the pilot? A: Five social-sector organisations, one per mainland region: Associação de Solidariedade de S. Pedro, Santa Casa da Misericórdia de Arganil, Fundação AFID Diferença, Santa Casa da Misericórdia de Mora and Santa Casa da Misericórdia de Portimão. Q: Is RVer used in private homes? A: No. The system is used by clinical teams in institutions (hospitals, clinics, care homes and continuing or palliative care units) where the routine, the training and the responsible person an accompanied session requires actually exist. Q: Why does the system work without internet? A: Because it was designed for institutions where the network is poor and nobody has time for technical configuration. Playback is offline and the device runs in kiosk mode. ### "Patient-centred" is measured on Thursday afternoon URL: https://rver.pt/blog/cuidados-paliativos-centrado-no-doente-e-quinta-a-tarde/en/ Date: 11 September 2026 Nobody writes in a plan that their care is institution-centred. The difference shows up elsewhere. Portugal's Strategic Plan for Palliative Care rests on four axes: organisation and integration of care, patient-centred care, training, and quality. Read like that, it looks like the list any plan would have. The second axis deserves attention, because it is the hardest to audit and the easiest to invoke. ## "Patient-centred" is a worn phrase Everyone says their care is patient-centred. Nobody writes in a plan that theirs is institution-centred. The difference shows up in the detail: **who decides what happens on Thursday afternoon.** If the answer is "it depends what the patient wants, and we know because we asked and wrote it down", the axis is alive. If it is "we have activities scheduled", the axis is a heading. In palliative care this weighs more than anywhere else, for a simple reason: the time available is short and known. An afternoon spent badly is not recovered next week. ## What is hard to organise The National Network for Integrated Continuing Care has convalescence units, medium-stay and rehabilitation units, long-stay units and home care teams. Palliative care cuts across all of it, and that is where integration gets expensive: the person moves, the team changes, and what was known about them (what settles them, what irritates them, what they want and what they have already said they do not want) is often left behind. :::note A transferred patient arrives with the right medication and without the story of who they are. The first travels in the file; the second travels in the head of whoever stayed behind. ::: Equipment does not solve this. Records do: the same argument we made in [“The session and the patient's clinical file”](/blog/a-sessao-e-o-processo-clinico-do-doente/en/). ## Where an immersive session fits, and where it does not In palliative care, RVer is used to offer meaningful experiences: returning to a place the person knows, seeing somewhere they always wanted to see, being in an environment they recognise. The session is short, it is accompanied, and it stops whenever the person wants. What it is **not**: it is not treatment, it is not symptom control, and it neither replaces nor alters any part of the therapeutic plan. Whether it makes sense, and when it does not, is decided by the team following the patient. One question comes up often and deserves an honest answer: is it worth it with a patient who no longer communicates? We wrote about that in [“A patient who no longer communicates: is a session worth it?”](/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/en/). The short answer is that the decision belongs to the team and the family, and that the absence of a verbal response is not, on its own, a criterion. ## The family, who are also in the plan The plan speaks of patient **and family**. In a unit, the family is there. At home, or 300 kilometres away, they are not. That is why the family call exists in the system: someone who cannot be present sees what their person is seeing, and talks to them. It is not a clinical feature and is not presented as one. It is a way of shortening a distance that, at that moment, costs more than at any other. ## Two questions for a team 1. **What do we know about this person that is written nowhere?** If the answer is "a lot", the next shift starts from zero. 2. **Who asks, and when?** "Patient-centred" without a scheduled moment to ask is an intention. --- **Sources:** [Strategic Plan for Palliative Care](https://www.sns.min-saude.pt/wp-content/uploads/2026/03/MS_Plano-Est-Cuid-Paliativos-2025_26.pdf), Executive Board of the Portuguese NHS; [National Network for Integrated Continuing Care](https://diariodarepublica.pt/dr/detalhe/decreto-lei/101-2006-353934). Q: Is virtual reality used for symptom control? A: No. In palliative care RVer is used to offer meaningful experiences, in short accompanied sessions. It is not treatment, not symptom control, and it neither replaces nor alters any part of the therapeutic plan. Q: Is it worth it with a patient who no longer communicates? A: That is a decision for the team and the family. The absence of a verbal response is not, on its own, a criterion either way. Q: What is the family call? A: It lets someone who cannot be present see what their relative is seeing and talk to them during the session. It is not a clinical feature and is not presented as one. ### Pain Congress 2026: where non-drug care fits URL: https://rver.pt/blog/congresso-da-dor-2026-onde-entra-o-nao-farmacologico/en/ Date: 10 September 2026 Pharmacotherapy, neuropathic pain, orthoses, referral. No session on the non-pharmacological, and there is a good reason for that. The Multidisciplinary Pain Congress takes place on 16, 17 and 18 September in Porto, at the Fundação António Cupertino de Miranda. The programme is worth a look beforehand, because it says something about the state of the field. ## What is on the programme Multidisciplinary pain assessment. Paediatric pain. Musculoskeletal physical examination. Orthoses. Pharmacotherapy: anti-inflammatories, corticosteroids, opioids, paracetamol, adjuvant drugs. Neuropathic pain. Referral to orthopaedics and to physical and rehabilitation medicine. The role of general practice. It is a solid programme and it is a **largely pharmacological** one. In the public programme there is no session dedicated to non-pharmacological approaches or to technology. This is not a criticism of the congress. It is a faithful portrait of where the centre of gravity of pain medicine sits in Portugal, and anyone selling or buying something else is better off knowing that than pretending otherwise. ## The question left over If pain is multidisciplinary enough to put orthopaedics, physical medicine, paediatrics and general practice in one room, why does the non-pharmacological usually enter only through the physiotherapy door? Part of the answer is good: pharmacotherapy has decades of trials, doses, contraindications and comparable scales behind it. That is accumulated knowledge, and enthusiasm does not dislodge it. Part of the answer is less good: the non-pharmacological often arrives wrapped in promises it cannot support. Anyone who has heard "this cuts pain by 40%" from a salesperson with no trial behind them is rightly wary the next time. :::note A prescriber's scale is not enthusiasm, it is evidence. A tool that overclaims today pays for it for years, in every conversation that follows. ::: ## What virtual reality is, in this conversation An alternative focus of attention during a procedure or a treatment. Nothing more than that, and nothing less. What RVer does is place the person inside a filmed environment, with ambisonic sound, while the team does what it has to do. It is not analgesia. It replaces no drug, changes no dose and removes no clinical decision. Whether it makes sense for that patient, at that moment, is decided by whoever follows them. We wrote in more detail about where this fits, and where it does not, in [“The pain clinic: where virtual reality fits”](/blog/consulta-da-dor-onde-entra-a-realidade-virtual/en/) and [virtual reality in the emergency department](/blog/realidade-virtual-nas-urgencias-o-que-respondemos/en/). ## If you are going, three useful questions Not for the speakers. To take back to the department: 1. **Which procedures are the ones where waiting and anticipation weigh most?** Those, not "pain" in general, define where a non-pharmacological approach is tried first. 2. **Who is responsible for running it and recording it?** Without a name, any pilot ends up in a drawer. 3. **What will be measured, and compared against what?** With no before, there is no after. They are the same three questions we ask anyone who gets in touch. They sell nothing, but they separate a project that will happen from a project that will be discussed. --- **Source:** [Multidisciplinary Pain Congress 2026](https://im3m.pt/congresso-2026/), 16–18 September, Porto. Q: When and where is the congress? A: 16, 17 and 18 September 2026, in Porto, at the Fundação António Cupertino de Miranda. Q: Does virtual reality reduce pain? A: That is not what RVer claims. It is used during procedures and treatments as an alternative focus of attention. It is not analgesia, replaces no drug, changes no dose and removes no clinical decision. Q: Where does a department start? A: With the procedures where waiting and anticipation weigh most, with one named person responsible for running and recording it, and with a measure defined before starting. ### What death certificates do not count about dementia URL: https://rver.pt/blog/o-que-as-certidoes-de-obito-nao-contam/en/ Date: 9 September 2026 Fewer than a third had a neurodegenerative disease on the certificate. The cohort is very particular, but the mechanism is not. A cohort study in *JAMA Network Open* looked at 202 brain donors from the UNITE Brain Bank (former American football players, recruited between 2008 and 2021) and compared two things: the dementia diagnosis established by clinicians, and what ended up written on the death certificate. Fewer than a third had a neurodegenerative disease recorded as the underlying cause of death. The authors estimate the certificate field misses roughly **69% of dementia-related deaths** in that population. ## The caveat, first This is a very particular population: men, professional athletes, with repeated head trauma, and brains donated precisely because someone suspected pathology. The number does not transfer to Portugal, nor to a care home in Viseu. What does transfer is the mechanism. **A death certificate is not a research instrument.** It is filled in quickly, often by someone who did not follow the person for years, and it tends to record the final event (pneumonia, sepsis, cardiac arrest) rather than the disease that brought the person there. ## Why it matters to people who provide care Because administrative records are the raw material of decisions that later land on institutions. Ask what dementia costs a country and the answer comes out of databases. Decide how many continuing-care beds are needed, databases. Allocate funding across disease areas, databases. If dementia systematically shows up smaller than it is, everything downstream is calibrated smaller than it should be. :::note This is not a theory about statistics. It is why a field's budget can be smaller than the field's reality, with nobody able to point at where the count went missing. ::: We have written about this gap closer to the ground: [what the health system measures and what stays invisible](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/en/). The death certificate is the same problem, at the end of the line. ## What an institution can do, and cannot **It cannot** correct death certificates. That is a medical act, and whoever performs it is not in the activity room. **It can** look after the record while the person is alive, which is the source everything else drinks from: 1. **Diagnosis in the file, with a date and a source.** "Dementia" and nothing else is the start of a lost record. 2. **Observation instead of impression.** "Asked the same question four times in twenty minutes" is a record. "Seems more confused" is not. 3. **What was tried, and what happened.** An activity, a session, a change of routine: what was done, for how long, what was observed. This is what gives a referral letter substance. None of the three costs anything. All three depend on someone deciding that the record is part of the care and not paperwork after it: the argument we made in [“The session and the patient's clinical file”](/blog/a-sessao-e-o-processo-clinico-do-doente/en/). ## And technology? A virtual reality system solves none of this, and it is worth saying plainly. What a tool with logging does is more modest: it writes down what happened in a session (duration, scene, what the team observed) and saves the part of the record that gets lost to tiredness at the end of a shift. That will not correct a death certificate ten years from now. It makes it less likely that Thursday's hour vanishes without a trace. --- **Source:** cohort study in *JAMA Network Open* on 202 UNITE Brain Bank donors and neurodegenerative disease recording on death certificates, [reported by AJMC](https://www.ajmc.com/view/nfl-dementia-deaths-often-miss-neurodegenerative-diagnosis). Q: Does the 69% figure apply to Portugal? A: No. The cohort is former professional American football players with repeated head trauma, whose brains were donated because pathology was suspected. What transfers is the mechanism, certificates record the final event rather than the underlying disease, not the percentage. Q: Can an institution fix this? A: Not on certificates, which are a medical act. It can look after the record while the person is alive: diagnosis with date and source in the file, observation rather than impression, and a record of what was tried and what happened. Q: Does virtual reality help with records? A: A tool with logging writes down what happened in the session: duration, scene, team observations. It does not correct administrative records or replace the clinical file; it saves the part of the record lost at the end of a shift. ### The dementia plan changed hands. And started counting something else URL: https://rver.pt/blog/plano-demencias-o-que-passou-a-ser-contado/en/ Date: 8 September 2026 The org chart changed, they say. The indicators changed too, and those always trickle down to whoever delivers the care. The Portuguese National Health Plan for Dementia has had a new governance model since April 2026. At the time it was read as an administrative reshuffle: the Executive Board of the National Health Service now coordinates delivery, after the regional health administrations were wound up. Anyone working in a care home or a convalescence unit shrugged, and with apparent reason: the org chart changed, Thursday afternoon did not. The part that matters is not who coordinates. It is what is now counted. ## The indicators The order sets evaluation indicators for the implementation of care pathways in local health units. Among them: - the **number of integrated care pathways** actually implemented; - the **share of health professionals with specific training** in dementia; - the **support provided to informal carers**; - individual care plans, plus service indicators such as admissions, emergency attendances and referral to continuing and palliative care. The second and third are worth pausing on. A national plan that measures **staff training** and **carer support** is saying, in the language of indicators, that care for a person with dementia is not settled by a drug and an appointment. It is settled by prepared people and by the family alongside. ## What it changes for an institution None of this obliges a private institution, a care home or a non-profit to do anything. The order binds the NHS. But the indicators of a national plan have a habit of trickling down: they show up later in tender documents, in [funding applications](/en/aquisicao/), in monitoring visits and in conversations with the local health unit. If the question "how many of your staff have specific dementia training?" is going to be asked of somebody, it is better to have the number. :::note Counting before you are asked is cheap. Counting afterwards is a meeting. ::: ## Where a non-pharmacological tool fits Honestly: not in the indicators. None of them measures equipment, and that is as it should be: a plan that counted devices purchased would be measuring budget, not care. It fits somewhere else, which is more interesting. Two of the indicators, team training and informal carer support, describe **work done by people**. Any tool, whether a [virtual reality system](/en/solucoes/lar-residencial/), a Snoezelen room or an activity trolley, only counts if the team knows how to use it and if a [record of what happened](/blog/a-sessao-e-o-processo-clinico-do-doente/en/) reaches the patient's file. Equipment on its own produces none of these numbers. It is the same conclusion we reached elsewhere, writing about [what the health system measures and what stays invisible](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/en/): what is not recorded does not exist for whoever evaluates it, however well it went. ## Three things to do this week 1. **Count who has training.** Not "the team is aware of it": how many people, what training, what year. 2. **Look at how contact with the informal carer is recorded.** In a notebook, it does not count. In the file, it counts. 3. **Call the local health unit** and ask whether it already has an integrated dementia pathway, and who the contact is. It is one phone call. None of the three needs budget, and none needs technology. They are the ones that decide whether the fourth, buying anything at all, makes any sense. --- **Sources:** Order approving the new governance model of the National Health Plan for Dementia, published 13 April 2026; [National Dementia Plan](https://alzheimerportugal.org/plano-nacional-para-as-demencias/), Alzheimer Portugal. Q: Does the plan oblige care homes and non-profits to do anything? A: No. The order binds the NHS. But national plan indicators tend to trickle down into tender documents, funding applications and monitoring visits: so it is worth having the numbers before they are asked for. Q: Is there any indicator about equipment or technology? A: No. The indicators measure pathways implemented, staff training, carer support, individual care plans and service indicators. A plan counting devices purchased would be measuring budget, not care. Q: What is RVer, and what is it not? A: RVer is a virtual reality system for clinical use, registered as a Class I medical device (base product) in EUDAMED and with INFARMED (Portugal) and used by healthcare and care-home teams. It does not diagnose, does not assess and does not replace any clinical assessment or decision. ### They were not disengaged: they could not hear URL: https://rver.pt/blog/perda-auditiva-o-que-muda-numa-sessao/en/ Date: 7 September 2026 “Wouldn't engage”, “didn't like it”, “didn't understand”: three phrases that appear in the log after a failed session, and which sometimes describe nothing more than a hearing aid with a dead battery. Worth ruling out before changing the content. Hearing loss is the risk factor that combines two rare things: **it is among the heaviest in dementia** and **among the easiest to correct**. In the 2024 update of the *Lancet* Commission it accounts for around **7%** of attributable risk: the highest on the list, level with midlife LDL cholesterol. It was 9% in 2017 and 8% in 2020, and the estimate itself is criticised for not accounting for overlap between factors, which is worth saying whenever such a percentage is quoted. We covered the full list in [“The 14 risk factors”](/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/en/). But this article is not about ten-year dementia risk. It is about Tuesday: **hearing decides whether today's session works**, and it is the most mundane, and most overlooked, explanation for a session that went badly. ## What hearing loss does to a session Four effects, none of which looks like deafness at first glance: - **The instruction does not arrive.** “Look to your right”, said from the side over background noise, is not heard, and what gets recorded is that the person did not follow the instruction. - **Listening effort is tiring.** Someone hearing poorly spends attention decoding rather than on what they are seeing. Twenty minutes becomes a lot. - **It is mistaken for cognitive decline.** Answering off-topic, asking for repetition, giving up on conversation: the classic picture of someone who cannot hear, and the classic picture of someone declining. Without ruling out hearing, the second hypothesis wins by default, the same problem we describe in [undiagnosed decline](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/en/). - **It isolates.** People who hear poorly take part less in groups, and that is where the withdrawal nobody records begins. ## Two minutes before the session The check is not clinical and needs no equipment: 1. **Does the aid exist?** Many residents have one, in a drawer. 2. **Does it have a battery, and is it on?** The commonest single cause, fixed in thirty seconds. 3. **Is it seated properly?** A badly fitted mould whistles, the person removes it, and never puts it back. 4. **Which side do they hear better on?** Everyone on the team should know this by heart for the residents they work with. 5. **Is there wax?** Common, mundane, and reversible in one appointment. If any of those five fails, **fix it before changing the scene**. No content compensates for an aid in a drawer. ## Seven adaptations that change the outcome None requires different equipment from what you already have: - **Speak face on, at eye level**, before the headset goes on. What is agreed beforehand is what will hold during. - **Agree hand signals** for “stop”, “I'm fine” and “louder”. Someone wearing a headset cannot see anyone's face, and this applies to everybody, not only to people who hear poorly. - **Lower the room noise.** Television off, door closed. Background noise hurts someone with hearing loss far more than it hurts anyone else. - **Choose content that does not depend on narration.** A scene that explains itself beats good narration that is not heard: a criterion to add to [choosing a scene](/blog/atividade-significativa-como-se-escolhe-um-cenario/en/). - **Do not shout: articulate and slow down.** Shouting distorts and, with an aid, can hurt. - **Watch the headset volume.** Someone hearing poorly asks for more, and a hearing aid amplifies on top of it. Start low and raise it with the person telling you. - **Make it shorter.** If listening effort tires, fifteen good minutes beat thirty dragged ones: the logic in [session length and frequency](/blog/duracao-frequencia-sessao-realidade-virtual/en/). ## What to record Two lines, and they change the next session: **whether the aid was in and working**, and **which side you spoke from**. Without them, the next session starts from zero and the team again attributes to the person what belongs to the setting. It is the same principle as the rest of this series: what is not written down does not reach whoever runs it next time. ## Our part in this Our content has audio, and none of the above removes that. When a service asks whether RVer suits someone with severe hearing loss, the honest answer is: **it does, if the activity is chosen to be watched rather than listened to**, and if the team agrees beforehand how to communicate. That is not a product adaptation: it is a session adaptation, and the team makes it. The general limits of who can and cannot use it are in [accessibility](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace hearing assessment, diagnosis or clinical follow-up. Q: How much does hearing loss weigh in dementia risk? A: In the 2024 update of the Lancet Commission, hearing loss accounts for around 7% of attributable risk: the highest on the list, level with midlife LDL cholesterol. It was 9% in 2017 and 8% in 2020. The estimate is criticised for not accounting for overlap between factors, which is worth noting whenever it is quoted. Q: What should be checked before a session with someone who hears poorly? A: Five things, in two minutes and with no equipment: whether the hearing aid exists, whether it has a battery and is switched on, whether it is seated properly, which side the person hears better on, and whether there is wax. The battery is the commonest single cause and takes thirty seconds. Q: Can hearing loss be mistaken for cognitive decline? A: Yes, and often. Answering off-topic, asking for repetition and giving up on conversation are the classic picture of someone who cannot hear and also of someone declining. Without ruling out hearing, the cognitive hypothesis wins by default. Q: How do you adapt a session for hearing loss? A: Speak face on before the headset goes on, agree hand signals for stopping and adjusting, lower the room noise, choose content that does not depend on narration, articulate rather than shout, start with low volume and raise it with the person telling you, and shorten the session: because listening effort is tiring. Q: Does RVer suit someone with severe hearing loss? A: It does, if the activity is chosen to be watched rather than listened to, and if the team agrees beforehand how to communicate. It is not a product adaptation but a session adaptation, made by the institution's own team. ### Virtual reality in labour: what the evidence shows, and what a delivery suite must settle first URL: https://rver.pt/blog/realidade-virtual-trabalho-de-parto-dor-e-ansiedade/en/ Date: 6 September 2026 The literature on virtual reality in labour is consistent in one direction: less reported pain, less anxiety, no signal of harm. It is also small and heterogeneous. And between what the trials show and what happens in a delivery room sit five practical questions nobody answers for you. It is one of the requests that reaches us with the most enthusiasm and the least preparation: *we want this in the delivery suite*. The enthusiasm is grounded in the literature. The preparation is what decides whether it survives week three. ## What the evidence shows Two syntheses, and what each adds. A **systematic review with meta-analysis** in *JMIR Serious Games* pooled **12 studies with 1095 participants**, searched across seven databases, on virtual reality in pregnancy and childbirth. It assessed pain, anxiety, labour duration, satisfaction and **adverse events**, and that last outcome is the one a service cares about: the review was designed to answer safety, not only efficacy. A **2025 integrative review** in *Pain Management Nursing* screened 1227 studies and included **13** (10 of them randomised trials), adding to the quantitative results the **women's own experience**, usually the part missing from meta-analyses. Read together, without stretching: **the trials point consistently to reduced reported pain and anxiety during labour**, with good acceptability and no signal of harm. And, as the authors themselves note, heterogeneity between studies is high and sample sizes are small for something as variable as birth. Encouraging evidence, not settled evidence. :::note One thing the literature does not say, and no supplier should imply: this **is not analgesia** and replaces no decision about analgesia. It does not change the indication for an epidural, does not treat pain, and is not a clinical decision tool. ::: ## Why labour is a favourable case Three reasons, and they explain why results show up even in small trials: - **Pain has a large attentional component**, and the gap between contractions is a natural window to work on it: the mechanism we describe in [pain management](/blog/realidade-virtual-gestao-da-dor/en/). - **Anticipatory anxiety amplifies pain.** Someone arriving frightened feels more, the same pattern seen in [pre-operative anxiety](/blog/realidade-virtual-ansiedade-pre-operatoria/en/). - **The person is awake, engaged and has time.** Unlike almost anything else in a hospital. ## The five questions that decide, none of them about content This is where projects fail, and no better catalogue solves any of them. **1. Who interrupts?** The woman must be able to take the headset off **in one second**, without asking, without hunting for a button. If that answer is not immediate and obvious, nothing else matters. It is the rule we already apply in [when someone refuses](/blog/quando-o-utente-recusa-realidade-virtual/en/). **2. Who runs it?** A session in labour happens during active clinical work and cannot add a person to the room. Either the team already there can run it with usage training, see [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/), or the equipment stays in the cupboard. **3. How is it cleaned between two women?** A delivery suite has its own protocol, and equipment that does not fit it does not come in. Our answers are in [hygiene and safety](/blog/higiene-seguranca-equipamento-realidade-virtual/en/), and the right question to ask us is the reprocessing time, not the material. **4. What about monitoring?** Cardiotocography, lines, the woman's mobility and position. The equipment must coexist with all of it, and the honest answer is that this depends on the room, not the product. **5. When is it offered?** An offer made in active labour is a bad offer. Consent belongs in the birth plan, discussed beforehand, with the full picture: including that it can be refused without explanation. Same principle as [informed consent](/blog/consentimento-informado-realidade-virtual-saude/en/). ## Nausea, which here is a question of its own Vestibular discomfort is rare and mild with well-chosen content, as we wrote in [comfort and motion sickness](/blog/conforto-e-enjoo-realidade-virtual/en/). In labour there is an added difficulty: **nausea is common for reasons that have nothing to do with the headset**: transition itself, analgesia, fasting. The practical consequence is about recording, not content: if nausea occurs, nobody will be able to say afterwards what caused it. Record what was used and when, so the team neither blames the equipment for a symptom that was coming anyway, nor the reverse. ## Where RVer stands Plainly: **we do not have an obstetric product**. The base product is a content library for comfort, distraction and activity, registered as a [Class I medical device](/blog/dispositivo-medico-classe-1-realidade-virtual/en/), with no treatment claim and no specific indication for labour. A service wanting to test this in a delivery suite can do so with the base product, and should do it as a pilot, with the five questions above answered in writing before the first woman tries it. If those answers do not exist, our recommendation is to start somewhere simpler and come back to the delivery suite later. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace analgesia, assessment or clinical follow-up. Q: Does virtual reality reduce labour pain? A: The trials point consistently to reduced reported pain and anxiety during labour, with good acceptability and no signal of harm. The systematic review in JMIR Serious Games pooled 12 studies with 1095 participants; a 2025 integrative review in Pain Management Nursing included 13 studies, 10 of them randomised. Heterogeneity is high and samples are small: encouraging evidence, not settled. Q: Does this replace an epidural or other analgesia? A: No. It is not analgesia, does not change the indication for any analgesic method and is not a clinical decision tool. It is a complementary comfort and distraction measure; decisions about analgesia remain entirely with the team and the woman. Q: Can the woman remove the headset at any moment? A: She must be able to, in one second, without asking and without hunting for a button. If that answer is not immediate and obvious, the equipment should not enter a delivery room. Q: Who runs the session during labour? A: The team already in the room, with usage training: usually specialist midwives. A session that requires adding a person to the room is not viable during active clinical work, and that is the commonest reason equipment ends up in a cupboard. Q: What about nausea, in a setting where it is already common? A: Vestibular discomfort is rare and mild with well-chosen content, but in labour nausea is common for independent reasons: transition, analgesia, fasting. The consequence is about recording: note what was used and when, so the team neither blames the equipment for a symptom that was coming anyway, nor the reverse. Q: Does RVer have an obstetrics product? A: No. The base product is a content library for comfort, distraction and activity, registered as a Class I medical device, with no treatment claim and no specific indication for labour. A service can pilot it, with the room-level questions answered in writing first. ### “The earlier you know, the more you can do”: the diagnosis missing in care homes URL: https://rver.pt/blog/mes-mundial-alzheimer-2026-o-diagnostico-que-falta/en/ Date: 5 September 2026 This September's international campaign has a theme that, in Portugal, lands on a concrete number: “the earlier you know, the more you can do”. In Portuguese care homes there is a substantial group of residents nobody knows about for certain. *Written for World Alzheimer's Month 2026. The five things apply in any month.* September is **World Alzheimer's Month**, with World Alzheimer's Day on **21 September** (it is in our [health awareness days calendar](/en/ferramentas/dias-mundiais/), with the rest). Alzheimer's Disease International's 2026 campaign theme is **“The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters”**. It is a theme that lends itself to posters. It also lends itself to an uncomfortable question, and that is the one worth asking inside an institution. ## The number that matches the theme A cross-sectional study across **423 Portuguese residential care homes**, by researchers at the Universities of Coimbra and Aveiro within the SINDIA project and published in *Acta Médica Portuguesa*, found on average: roughly **a third** of residents with a formal dementia diagnosis, and roughly **a fifth** with **suspected cognitive decline and no diagnosis on record**. We wrote about what that changes in running a session in [undiagnosed cognitive decline in care homes](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/en/). What matters here is different: that fifth **is exactly the population the campaign is about**. These are not people undiagnosed in some distant clinic: they are in an institution, seen by staff every day. :::note Diagnosis is a clinical act. Nothing in this article, and nothing in a virtual reality headset, replaces an assessment. What an institution can do is **shorten the path to one**. ::: ## Why “earlier” changes anything The honest objection arrives early: *why diagnose, if there is no cure?* It has three answers, none of them a therapeutic promise. **It changes what is reversible.** Some suspected dementia is not dementia: it is depression, hypothyroidism, B12 deficiency, medication effects, a urinary infection, or poorly corrected hearing and vision. Without assessment those are indistinguishable, and they are treatable. **It changes the decisions the person can still make alone.** Where to live, what care to receive, who decides when they no longer can. A late diagnosis takes away the window in which those decisions are still theirs, and Portugal's [Statute for Older Persons](/blog/estatuto-da-pessoa-idosa-atividades-e-autonomia/en/) makes that autonomy a right. **It changes how the team reads behaviour.** “He's being difficult” and “he has a condition affecting his language” produce different care, from the same people on the same budget. And the specific condition changes what works in an activity, as we describe in [types of dementia](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/). ## Five things to do, depending on no one None needs a budget, and none needs technology: 1. **Count.** How many residents have a diagnosis in their file? For how many is there written suspicion with no assessment? The gap between those two numbers is September's work. 2. **Write the observation, not the impression.** “Asked the same question four times in twenty minutes, on 3 September” is useful in a consultation. “He's more confused” is not. 3. **Check hearing and vision first.** A hearing aid with no battery and an un-operated cataract both imitate cognitive decline, and are the two easiest things to rule out. Hearing loss is, in fact, among the heaviest items on the list of [14 risk factors](/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/en/). 4. **Take the list to the attending physician**, with dates. A dated sequence of observations is worth more in a twenty-minute consultation than the memory of whoever is on shift. 5. **Talk to families.** September is the perfect excuse for the conversation everyone keeps postponing, and that is precisely what the campaign is for. ## What technology does here, and what it does not **It does not diagnose.** No virtual reality session assesses, grades or detects dementia, and be wary of anyone implying otherwise. What a consistent session record gives is **raw material for whoever does assess**: what was used, for how long, how the person reacted, what interrupted it, dated observations of functioning **outside the consultation**, which is where most of life happens. A good activity log gives the same thing; the difference is that this one is easier to keep. The rest of what we do (reminiscence, stimulation, comfort) is [wellbeing and activity](/blog/realidade-virtual-demencia-alzheimer/en/), measured in how the afternoon went, and that is how it fits into the day of a [care home](/en/solucoes/lar-residencial/). It does not alter the course of the disease, and this month's campaign is not asking anyone to claim that. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, diagnosis or clinical follow-up. Q: What is the theme of World Alzheimer's Month 2026? A: “The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters”. It is Alzheimer's Disease International's campaign for September 2026, with World Alzheimer's Day on 21 September, and it centres on timely diagnosis. Q: What is the point of diagnosing dementia if there is no cure? A: Three reasons, none therapeutic. Some suspected dementia is not dementia: depression, B12 deficiency, hypothyroidism, medication effects, poorly corrected hearing or vision, and those causes are treatable. A timely diagnosis preserves the window in which the person still decides about their own life. And it changes how the team reads behaviour, on the same budget. Q: How many care home residents in Portugal have suspicion without diagnosis? A: In a study across 423 Portuguese care homes (SINDIA project, Universities of Coimbra and Aveiro, published in Acta Médica Portuguesa), roughly a fifth of residents showed suspected cognitive decline with no diagnosis on record, and roughly a third had a formal diagnosis. The figures refer to the surveyed universe. Q: What can an institution do in September without a budget? A: Count how many residents have a diagnosis and how many have suspicion without assessment; record dated observations rather than impressions; check hearing and vision, which imitate cognitive decline and are easy to rule out; take that list to the attending physician; and use the campaign as a reason for the conversation with families. Q: Does virtual reality help detect dementia? A: No. No session assesses, grades or detects dementia. What a consistent session record gives is raw material for whoever does assess: dated observations of how the person functions outside the consultation. ### Fourteen dementia risk factors: where technology fits, and where it does not URL: https://rver.pt/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/en/ Date: 4 September 2026 The Lancet Commission on dementia updated its list in 2024: there are now 14 modifiable factors, and up to 45% of cases could in theory be prevented if all were eliminated. One of them is social isolation, and it is the only one where a technology session has anything to say. In July 2024, the *Lancet* Commission on dementia prevention, intervention and care published its updated report. There are now **14 modifiable risk factors** across the life course, and the figure that went around is this: **up to 45% of future dementia cases could be prevented** if all 14 were eliminated. It is a number that appears in many decks, technology suppliers' included. It is worth understanding what it says. ## The fourteen To the previous twelve (low education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol, traumatic brain injury, air pollution and **social isolation**), the 2024 update added two: - **high LDL cholesterol in midlife**, contributing around 7% of attributable risk; - **untreated vision loss in later life**, around 2%. ## What “45% preventable” means, and what it does not This is the part lost in the citation, and the part that matters. **It is a population estimate, not an individual promise.** It says what would happen to incidence in a country if those factors all disappeared. It does not say that a specific person correcting one factor reduces their risk by any known percentage. **It is a limit case.** “If all 14 were eliminated” is not a plan; no health system on earth eliminates air pollution and low education. **Attributable risk is not demonstrated causality** for each factor, as the Commission itself notes. It is the best available synthesis, and it remains a synthesis. **And most factors are midlife or earlier.** Education, hypertension, cholesterol, tobacco: by the time someone enters a care home, the window on several of them closed decades ago. Serious prevention happens long before that door. ## What a care home can actually act on Six things, none of them technological: - **Hearing loss**: check the aid exists, has a battery, and is worn. Probably the best effort-to-effect ratio on the whole list. - **Vision loss**: the 2024 addition. Un-operated cataracts and wrong prescriptions are common and treatable. - **Hypertension and diabetes**: already being managed; the question is whether they are controlled. - **Physical inactivity**: what exists, how often, and for the people who never attend group classes. - **Depression**: under-diagnosed, and mistaken for “he's quieter lately”. - **Social isolation**: the only one where the conversation below applies. If a care home wants to act on dementia risk from this list, **this is where it starts**, not with a supplier catalogue. Saying so runs against our immediate commercial interest and is the only honest reading of the report. ## Social isolation, and the boundary Social isolation has been on the list since before 2024, and it is real: the Portuguese data we cited in [undiagnosed cognitive decline in care homes](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/en/) describe an institutionalised population with very little outside contact: three in four people with dementia in care homes never go outside, and more than a quarter never receive visitors. Precision matters here, because this is where everyone stretches: **Reducing isolation with technology is not the same as reducing dementia risk.** The factor the Commission identifies is isolation **over years**, not loneliness on one afternoon. No study shows that virtual reality sessions change dementia incidence, and we know of none that has even tried to measure it. **Human contact is not substitutable.** What the evidence associates with lower risk is real, sustained company. A [video call with family](/blog/videochamadas-familia-realidade-virtual/en/) is human contact with a medium in between; an immersive scene, however good, is not. **What remains is modest and true:** a session can give someone something to talk about, pleasure on an afternoon, company beside them, and a reason to leave their room. That is worth having on its own: it does not need to be sold as dementia prevention, and should not be. That is how RVer fits into the day of a [care home](/en/solucoes/lar-residencial/). ## The sentence not to let pass If a supplier (us or anyone else) links a product to the Commission's 45%, the question is simple: **in which trial did this product reduce dementia incidence?** The honest answer today, for every virtual reality product on the market, is *none*. What exists is literature on wellbeing, reminiscence and stimulation, which we describe in [dementia and Alzheimer's](/blog/realidade-virtual-demencia-alzheimer/en/) and [cognitive stimulation](/blog/estimulacao-cognitiva-idosos-realidade-virtual/en/), and it measures something else (the library gathers it under [quality of life](/estudos/tema/qualidade-de-vida/en/)). The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care, and do not prevent, treat or delay dementia. Q: What are the 14 modifiable dementia risk factors? A: Low education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol, traumatic brain injury, air pollution and social isolation (the previous twelve), plus the two added in 2024: high LDL cholesterol in midlife (around 7% of attributable risk) and untreated vision loss in later life (around 2%). Q: What does it mean to say 45% of cases are preventable? A: It is a population estimate in a limit case: what would happen to incidence if all 14 factors were eliminated. It does not say a specific person correcting one factor reduces their own risk by a known percentage, and it is not the same as demonstrated causality for each factor. Q: Does virtual reality prevent dementia? A: No. We know of no study showing that virtual reality sessions change dementia incidence, and the existing literature measures other things: wellbeing, reminiscence, participation. Any product linking itself to the Commission's 45% should face one question: in which trial did it reduce incidence? Q: Social isolation is a risk factor. Doesn't that validate technology? A: Not in the way it is usually used. The factor identified is isolation over years, not loneliness on one afternoon, and what the evidence associates with lower risk is real, sustained company. A session can give someone something to talk about, pleasure, and a reason to leave their room, worth having on its own, without being presented as prevention. Q: What can a care home do from this list? A: Six things, none technological: check hearing aids (that they exist, have a battery and are worn), treat vision loss such as un-operated cataracts and outdated prescriptions, confirm hypertension and diabetes are controlled, look at physical activity for those who never attend group classes, and stop mistaking depression for “he's quieter lately”. ### Fear of falling empties the room before any fall happens URL: https://rver.pt/blog/medo-de-cair-idosos-o-que-a-realidade-virtual-faz/en/ Date: 4 September 2026 Long before there is a fall, there is a person who stopped going to the day room because they are afraid of falling in the corridor. The literature treats that as an outcome in its own right, and it is where virtual reality's numbers are most consistent. In a care home team, the conversation about falls is almost always about falls: how many, where, what changed afterwards. It is the right conversation, and it is missing half. The other half is **fear of falling**: measured in the literature as an outcome of its own, separate from falls, and usually arriving first. The person stops going to the day room, stops going to the bathroom without calling, stops leaving their room. There is no incident report anywhere, and the life has shrunk all the same. Often it shrank **because** of the fear, not the capacity. ## What the evidence shows A **2025 meta-analysis** in the *Journal of Nursing Scholarship* pooled **17 randomised trials with 988 participants**, published between 2016 and 2025, on virtual reality interventions in older adults. The pooled results: | Outcome | Effect (SMD) | 95% confidence interval | | --- | --- | --- | | Fear of falling | −0.40 | −0.72 to −0.08 | | Balance | 0.45 | 0.07 to 0.83 | | Postural control | 0.50 | 0.13 to 0.86 | Three honest readings of these numbers, worth more than the numbers themselves: - **These are small-to-moderate effects, not transformations.** An SMD of 0.40 to 0.50 is a serious result in rehabilitation, and far less than the word “effective” usually implies in a slide deck. - **The confidence intervals nearly touch zero** in all three. The effect is real in aggregate, and may not show up in any single trial. - **Heterogeneity is high for balance** (I² ≈ 74%): the trials are not measuring the same thing the same way. It is the least trustworthy of the three. And the limitation that closes the reading: **these outcomes are not “fewer falls”**. Fear of falling, balance and postural control are measured with scales and tests. Demonstrating a reduction in falls requires larger, longer trials of a different design, and it is a claim nobody should make from this meta-analysis, ourselves included. ## Why fear of falling is the more useful target in a care home Three practical reasons. **It arrives first.** You can act months before there is a fall to record. **It feeds itself.** Someone afraid moves less; someone who moves less loses strength and balance; someone losing balance has more reason to be afraid. That is the cycle that takes an independent resident to bed with no new illness: the same cost of staying still we describe in [immobility during a hospital stay](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/en/). **It can be measured without equipment.** Validated fear-of-falling scales exist, and the team can apply them before and after any intervention: an exercise class, a new handrail, technology. If a pilot is going to measure one thing, this is among the few that answer within weeks. ## Where RVer fits, and where it does not Precision matters here, because the temptation to stretch is large. **RVer's base product is not balance training.** It is a content library for comfort, distraction and meaningful activity, and that is what the [Class I medical device](/blog/dispositivo-medico-classe-1-realidade-virtual/en/) registration covers. It does not assess fall risk, does not prescribe exercise and does not replace physiotherapy. **Guided movement is [RVer Motion](/blog/rver-motion-reabilitacao-com-realidade-virtual/en/)**, a **module in development, not covered by that registration**. When it ships, the boundary holds: the physiotherapist decides what a person should do. What the base product does, which is not nothing: it gives someone a reason to sit, attend and be occupied for twenty minutes, and gives the team a dated observation of how they responded. If that helps keep someone active during a period when they were withdrawing, it is useful, and it is not the same as reducing fear of falling, which is what the meta-analysis measures in exercise programmes. ## What to do with this on Monday Four steps, none of which require buying anything: 1. **Ask.** Of the residents who move around unaided, how many say they are afraid of falling? It is not a question that appears in the file on its own. 2. **Separate it from the falls log.** They are two different lists, and the longer one is usually fear. 3. **Apply a scale** before changing anything, so the change has something to be read against. 4. **Look at what already exists**: adherence to physiotherapy decides the outcome more than anything else, which is what we cover in [adherence to physiotherapy](/blog/realidade-virtual-fisioterapia-idosos-adesao/en/). If technology then helps, it helps on top of a measured problem. If nobody takes the four steps, no equipment solves it: ours included. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, physiotherapy or clinical follow-up. Q: Does virtual reality reduce falls? A: That is not what the available evidence shows. The 2025 meta-analysis cited here measures fear of falling, balance and postural control, and not the occurrence of falls. Demonstrating a reduction in falls requires larger, longer trials of a different design, and it is not a claim that can be made from these data. Q: What does the 2025 meta-analysis say about fear of falling? A: Published in the Journal of Nursing Scholarship, it pooled 17 randomised trials with 988 participants (2016–2025) and found significant effects on reducing fear of falling (SMD −0.40; 95% CI −0.72 to −0.08), improving balance (0.45; 0.07 to 0.83) and postural control (0.50; 0.13 to 0.86). These are small-to-moderate effects, with confidence intervals close to zero and high heterogeneity for balance. Q: Why is fear of falling measured separately from falls? A: Because it arrives first and has consequences of its own: the person reduces activity, loses strength and balance, and gains more reason to be afraid. That cycle can take an independent resident to immobility without a single recorded fall. Q: Does RVer do balance training? A: The base product does not. It is a content library for comfort, distraction and meaningful activity; it does not assess fall risk or prescribe exercise. Guided movement is RVer Motion, a module in development that is not covered by the Class I registration. Q: How do you measure fear of falling in a care home? A: With validated scales, applied by the team before and after any change: a class, a new handrail, a piece of equipment. It is one of the few outcomes that responds within weeks and needs no technology at all to be measured. ### In the US, virtual reality already has a reimbursement code. Here it does not, and what that changes URL: https://rver.pt/blog/codigo-de-reembolso-realidade-virtual-eua-e-portugal/en/ Date: 4 September 2026 Since April 2023 Medicare has had a code for a therapeutic virtual reality device. It is a true fact, quoted in nearly every commercial deck in the sector, occasionally against us. It is worth knowing exactly what it covers. It comes up early in many procurement conversations, and it comes up well: *“there's already reimbursement for virtual reality in the United States”*. That is true. And it is far narrower than the sentence suggests. This article sets out exactly what exists, and what it does, or does not, mean for anyone building a budget in Portugal. ## What exists On 1 April 2023, **CMS** (the body running Medicare) created code **E1905**, described as a *virtual reality cognitive behaviour therapy device, including pre-programmed therapy software*. It was the **first** code assigned to a therapeutic VR device, following an application by a US manufacturer, and came with a determination placing the product in the **DMEPOS** category: durable medical equipment. The device in question, RelieVRx, had FDA authorisation for **chronic low back pain, for home use**, and had been through the breakthrough devices programme. Those four things (the code, the category, the authorisation and the indication) travel together and do not come apart. :::note What follows is a supplier's reading of funding frameworks, not legal or coding advice. Always confirm with the payer, including against what is written here. ::: ## What the code is not **It is not a code for “virtual reality”.** It is a code for *that* device, with *that* indication, in that context of use. A second piece of equipment does not become reimbursable because the first obtained a code. **It is not a guarantee of payment, not even in the US.** Having a code means there is a way to ask; actual coverage varies by payer, requires medical-necessity documentation and, in some cases, prior authorisation. **And it does not cross the Atlantic.** Medicare is one country's system. Nothing decided there creates eligibility in Portugal: not in the NHS equivalent, not in the subsystems, not in private insurance. ## Why it matters to buyers here For two opposite reasons, both useful. **The first is a real signal.** A large public payer accepted, for one concrete case, that virtual reality is clinical equipment and not a wellness accessory. That funds nothing in Lisbon, but it changes the tone of an internal conversation: the subject stopped being exotic. **The second is a defence.** When a supplier quotes E1905 in a proposal, two questions settle it in thirty seconds: 1. **Is the code for your product, or someone else's?** In the overwhelming majority of cases it is someone else's, and that is the honest answer. 2. **What practical consequence does it have for our budget?** If the answer is “none directly”, it is correct. If it is anything else, ask for it in writing. Our answer to both is here: **E1905 is not ours**, we have no reimbursement code in Portugal, and no part of your investment is recoverable that way. ## What actually exists here The Portuguese framework is set out in [funding and reimbursement](/blog/financiamento-comparticipacao-realidade-virtual-saude/en/), and the sentence worth repeating is this: **medical device registration does not confer eligibility for public funding.** They are separate things, and confusing them has already cost more than one project time. What remains is the calculation an institution makes with its own numbers, [the cost and return pillar](/blog/custo-roi-realidade-virtual-instituicao-saude/en/), and honesty about what that calculation can prove, which we discuss in [what cannot be proven](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## What would sit behind a Portuguese code It is worth understanding the distance, because it explains why this is not imminent. A reimbursement code is not requested: it is built on a **specific clinical indication**, with **evidence supporting it for that indication** and a **device in the matching risk class**. RVer is [Class I](/blog/dispositivo-medico-classe-1-realidade-virtual/en/) and its intended purpose is comfort and activity, not treatment. A product wanting a code would first have to change its claim, and with it its class, its regulatory burden and its cost. That is a legitimate road and companies are walking it. It is not the road we are on, and saying so up front saves everyone a meeting. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace clinical follow-up. Q: Is there reimbursement for virtual reality in Portugal? A: There is no reimbursement code for therapeutic virtual reality in Portugal. Medical device registration does not confer eligibility for public funding: they are separate things. The investment is assessed like any other equipment purchase by the institution. Q: What is Medicare's E1905 code? A: A HCPCS code created by CMS on 1 April 2023 for a virtual reality cognitive behaviour therapy device with pre-programmed software, following an application by a US manufacturer. It was the first code assigned to a therapeutic VR device and placed it in the durable medical equipment (DMEPOS) category. Q: Does that code cover any virtual reality equipment? A: No. It covers that device, with that indication (chronic low back pain for home use, with FDA authorisation) and in that context of use. Other equipment does not become reimbursable because this one obtained a code. Q: Does RVer have a reimbursement code? A: No. E1905 is not ours, there is no Portuguese equivalent, and no part of the investment is recoverable that way. We say so up front because the alternative is finding out midway through a procurement process. Q: What would it take for such a code to exist in Portugal? A: A specific clinical indication, evidence supporting it for that indication, and a device in the matching risk class. RVer is Class I and its intended purpose is comfort and activity, not treatment: changing that would mean changing the claim, the class and the regulatory burden. ### Two different things are called “virtual reality in mental health” URL: https://rver.pt/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/en/ Date: 3 September 2026 Mental health is now the fastest-growing segment of healthcare virtual reality. The trouble is that two products with different purposes, requirements and risks are sold under the same label, and buying the wrong one costs money and credibility. Every market analysis points the same way: within healthcare virtual reality, **mental health is the fastest-growing segment**: ahead of surgery, training and rehabilitation. The interest is real, and in some areas so is the evidence. The side effect is less pleasant: “virtual reality in mental health” today covers **two different products**, which demand different things of the buyer. A service that acquires one thinking it is acquiring the other finds out late: usually with equipment already in a cupboard. This article is a map for telling them apart, and it says plainly which one RVer is. ## The first: virtual reality exposure therapy It is **psychotherapy**. It recreates the feared situation under control (the height, the aeroplane, the spider, the audience) so the person can face it in steps, with intensity rising at their own pace, until the fear response subsides. Two features define it, and both are demanding: - **It is delivered by a mental health professional**, within a therapeutic plan. The technology is the scene; the treatment is the clinician's work. - **It provokes anxiety on purpose.** That is the mechanism, not a side effect to be avoided. The evidence for specific phobias is among the strongest in all healthcare VR research, and we gathered it in [virtual reality for treating phobias](/blog/realidade-virtual-tratamento-fobias/en/). Across anxiety disorders in general the picture is more mixed: see [virtual reality and anxiety disorders](/blog/realidade-virtual-perturbacoes-ansiedade/en/). What an institution needs to use this: psychologists or psychiatrists trained in the technique, consultation time, a clinical framework and, depending on the manufacturer's claim, a device in a higher risk class than ours. Without those people the equipment does nothing: this is not software you install and let run. ## The second: comfort and wellbeing environments This is not psychotherapy and should not be presented as such. It is an experience of comfort, distraction and meaningful activity, run by the institution's own professionals, which **complements** existing care. The mechanism is the opposite of the first: instead of moving the person towards what frightens them, it moves attention away from what is bothering them: the wait, the procedure, the long afternoon, the room that never changes. The success criterion differs too: not the extinction of a fear response over weeks, but how **this** session went, today. **This is where RVer sits.** The base product is a Class I medical device, and the boundary that implies is set out in [Class I medical device](/blog/dispositivo-medico-classe-1-realidade-virtual/en/): we make no treatment claims, we do not replace clinical follow-up, and we do not provide exposure therapy. ## Why the distinction is not cosmetic Three practical consequences of swapping one for the other: **Who runs it.** In the first case, a mental health professional trained in the technique. In the second, the institution's own team with usage training (nursing, occupational therapy, activity coordinators) as described in [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). Buying the first without having the first's people is buying a cupboard of idle equipment. **What gets promised.** A service presenting comfort environments as anxiety treatment creates an expectation the product cannot meet, and it is the institution, not the supplier, standing in front of the patient when that shows. **What gets measured.** Psychotherapy metrics (symptom reduction across a plan) applied to wellbeing sessions produce a report saying the project failed, when the project never promised that. Choosing the wrong metric is the quietest way to kill a pilot that was going well. ## Six questions to put to any supplier They work over the phone, before going further: 1. What is the product's **stated intended purpose**, and what is the device's risk class? 2. Does the product **treat** any condition, or complement care? Ask for the exact sentence, in writing. 3. **Who has to be in the room** for a session: a psychotherapist, or a team member with usage training? 4. Does the experience **provoke anxiety on purpose** at any point? 5. What **evidence** exists for the stated purpose specifically, and not for “VR in healthcare” in general? 6. What **training** is included, and for which professional profile? The answers to 3 and 4 separate the two products in under a minute, and there is no bad answer: there is the answer that matches what the service needs and the one that does not. The full procurement criteria are in [how to choose therapeutic virtual reality](/blog/como-escolher-realidade-virtual-terapeutica/en/). ## What this does not mean It does not mean the second product is the poor relation of the first. It means they answer different questions. Most of the services that contact us do not have a waiting list of specific phobias to treat: they have anxious patients waiting for a scan, residents with empty afternoons, bedbound people with nothing to do between visits. For those situations a VR psychotherapy plan would be the wrong tool: expensive, oversized and dependent on people the service does not have. And if what the service actually needs is the first product, the most useful thing we can do is say so in the first meeting, which is what we do. The place of non-pharmacological approaches in the system, and their limits, is set out in [mental health in Portugal](/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/en/). The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, psychotherapy or clinical follow-up. Q: Does RVer provide virtual reality exposure therapy? A: No. Exposure therapy is psychotherapy delivered by a mental health professional within a therapeutic plan, and it provokes anxiety deliberately and under control. RVer provides comfort, distraction and meaningful activity environments, run by the institution's own professionals, which complement existing care and do not constitute treatment. Q: What is the practical difference between the two kinds of product? A: Who runs it, and what the mechanism is. Exposure therapy requires a mental health professional trained in the technique in the room, and the experience deliberately moves the person towards what frightens them. A comfort environment is run by a team member with usage training, and moves attention away from what is bothering them. The metrics differ too: symptom reduction across a plan in one case, how today's session went in the other. Q: What should I ask a supplier before buying? A: Six things: the stated intended purpose and the device's risk class; whether the product treats a condition or complements care, with the exact sentence in writing; who has to be in the room during a session; whether the experience provokes anxiety on purpose; what evidence exists for the stated purpose specifically; and what training is included, for which professional profile. Q: Does a VR comfort environment treat anxiety? A: No, and presenting it that way creates an expectation the product cannot meet, with the institution, not the supplier, standing in front of the patient when that shows. What these environments do is offer comfort and distraction at a specific moment, under a professional's supervision. Q: Why is mental health the fastest-growing segment of healthcare VR? A: A combination of unmet need and mature evidence in some specific areas, above all the treatment of phobias. The growth in interest brings the side effect of grouping products with very different purposes and requirements under one label. ### Portugal's new Statute for Older Persons: what changes in care-home activities URL: https://rver.pt/blog/estatuto-da-pessoa-idosa-atividades-e-autonomia/en/ Date: 3 September 2026 Portugal's Law 7/2026 came into force in February and put one thing in writing that changes any care home's activity plan: older people decide on their own involvement in activities. Here is the operational reading, article by article. Law 7/2026 of 25 February approved Portugal's **Statute for Older Persons**. It created no new social response and no new funding: it gathered scattered rights into a single instrument and applied them expressly to non-profits and to every establishment, public or private, that houses and cares for older people (article 2(3)). For a care home's technical director the useful question is not “what is the Statute”. It is **what changes on Monday morning**. This article answers that for the part we work in, activities, and also says where technology has no business being. :::note This is a technology supplier's reading of the law, not legal advice. The full text was published in Diário da República, 1st series, no. 39, of 25 February 2026. ::: ## The four articles that touch the activity plan **Article 6(b): autonomy.** Older people have the right to autonomy, being free to take decisions about their own life, including where they wish to live, the care they wish to receive, and **their involvement in social, political and cultural activities**. Read that last part slowly: **taking part in an activity is the person's decision**. Not a good-practice suggestion, not a line in a quality manual. A right, in an act of parliament. **Article 18: cultural and leisure activities.** A single sentence: older people have the right to take part in cultural, sporting and leisure activities. The right is to take part, and article 6 says the decision to take part is theirs. **Article 3(3)(c)** lists among the underpinnings of these rights the primacy of *alternative* forms of participation, occupation and interaction **with other generations**. Bingo and television is not what the legislator had in mind. **Article 8(2)** names, in point (b), services combining medical and nursing care, psychology, physiotherapy and “cognitive, sensory and motor stimulation”, and in point (f) instructs that responses be reinforced with technological tools that improve their efficiency. As far as we can tell, it is the first time cognitive and sensory stimulation is named in an instrument of this kind: alongside medicine, nursing, psychology and physiotherapy, not as decoration. ## What it changes in practice ### 1. The activity plan can no longer be only collective If the decision to take part is individual, a plan made only of scheduled group activities answers article 6 badly for anyone who will not, cannot or is unable to be in the group. In a care home that is a lot of people: the bedbound resident, the one with aphasia, the one who becomes agitated late in the day, the one who never liked singing along. The honest reading is this: **the Statute does not require you to buy anything**. It requires you to have an answer for whoever falls outside what already exists. We wrote about building that plan in [activity plans for care homes](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). ### 2. A resident's “no” now has legal standing Refusing an activity has always been a moral right. Now it is a written one. What that mostly changes is **recording**: a refusal that is never written down becomes, two months later, a “he never wanted to join in” that nobody can date or justify. Our own rule predates the law and is set out in [what to do when someone refuses](/blog/quando-o-utente-recusa-realidade-virtual/en/): the session ends when the person wants it to, with no persuasion, and the refusal is recorded like any other event. ### 3. Consent moves up a level Article 10 covers information and decisions about health care, revocable at any time. For a non-clinical wellbeing activity that is not a heavy process, but it is why consent for people using our equipment is described in [informed consent](/blog/consentimento-informado-realidade-virtual-saude/en/), including the case where someone cannot consent unaided. ### 4. Going outside remains irreplaceable Here we have to be clear against our own commercial interest. Article 3 speaks of interaction **with other generations**, and article 22 of mobility and the removal of barriers. No technology inside a building delivers that. A walk, a visit, a child in the room: **there is no digital equivalent**. When a care home uses equipment to stop doing the outings it used to do, the result is worse than before it bought anything, and runs against the spirit of the law. Our place is in what is left over: the days when going out is impossible, and the people who can no longer go out at all. ## What the law does not say The Statute **does not mention virtual reality**, nor should it. It creates no duty to acquire equipment, sets no activity ratios, fixes no deadlines and carries no funding. Anyone telling you “the new law requires X” is selling X. What the law does is shift the burden: you now have to explain why a given resident has **no** participation offer, rather than simply pointing at an activity plan pinned to the wall. ## A short list for the next team meeting Four questions you can answer without buying anything: 1. Of your current residents, how many took part in at least one activity last week? And how many took part in **none**? 2. For those, is the reason written down: refusal, clinical condition, or simply nothing on offer that fitted? 3. Are refusals recorded, with a date and who was present? 4. What exists today for someone who does not leave their room? If the answer to the fourth is “not much”, there is a problem there that predates any supplier's catalogue, ours included. And if technology then helps, it helps because it is useful to specific people, not because it is new. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace clinical follow-up. Q: Does the Statute for Older Persons require care homes to use technology in activities? A: No. Law 7/2026 mentions neither virtual reality nor any equipment, creates no purchasing obligation and carries no funding. What it establishes is the right of older people to take part in cultural, sporting and leisure activities (article 18) and to decide freely on their involvement in them (article 6(b)). Q: When did it come into force and who does it apply to? A: It was published on 25 February 2026 (Law 7/2026, Diário da República, 1st series, no. 39). It applies to people at or above the normal old-age pension age and, under article 2(3), to non-profits and to every public or private establishment that supports, houses and cares for older people. Q: What changes in a care home's activity plan? A: The burden changes. A plan made only of scheduled group activities is still lawful, but leaves without an answer anyone who cannot or will not join the group, and it is for those residents that article 6 now demands a justification. In practice it means recording refusals and having some individual offer for people who do not leave their room. Q: Can a resident refuse a virtual reality session? A: Yes, at any moment and without giving a reason. That follows from article 6(b), and it is also RVer's own rule of use: the session ends when the person wants it to, and the refusal is recorded. Q: Does virtual reality replace outings and intergenerational contact? A: No, and it should not be used for that. Article 3 values participation and interaction with other generations, and article 22 covers mobility: a walk, a visit or an activity with children have no digital equivalent. Technology serves the days when going out is impossible and the people who can no longer go out. Q: Does the Statute mention cognitive stimulation? A: Yes. Article 8(2)(b) refers to home-support services combining medical and nursing care, psychology, physiotherapy and cognitive, sensory and motor stimulation. Point (f) of the same paragraph calls for responses to be reinforced with technological tools that improve their efficiency. ### Undiagnosed cognitive decline in care homes: what it changes in a session URL: https://rver.pt/blog/declinio-cognitivo-sem-diagnostico-nos-lares/en/ Date: 3 September 2026 In a survey of 423 Portuguese residential care homes, suspected cognitive decline with no diagnosis on record appears in roughly a fifth of residents. For whoever runs an activity this is not a statistical problem: it is why the resident's file is not enough to prepare a session. A cross-sectional study across **423 Portuguese residential care homes**, carried out by researchers at the Universities of Coimbra and Aveiro within the SINDIA project through a survey of technical directors and published in *Acta Médica Portuguesa*, leaves two numbers worth reading together: - on average, roughly **one third** of residents have a **formal dementia diagnosis**; - roughly **one fifth** have **suspected cognitive decline with no diagnosis on record**. The same work points to territorial inequity in access to diagnosis and in institutional responses, and reports two figures about life inside these institutions that are hard to forget: **75% of people with dementia in care homes never go outside, and 28% never receive visitors**. :::note The figures are the study's own and refer to the surveyed universe, not to a representative sample of every care home in the country. The reading that matters here is not epidemiological: it is operational. ::: ## What the second number actually means A fifth of residents sit in a grey zone: the team notices something has changed, but there is no assessment, no code, nothing written in the file. And what is not in the file **never reaches whoever prepares the activity**. In practice that means three things: 1. Whoever runs the session works with incomplete information about a substantial share of the people they work with. 2. The adaptation they would make knowing the diagnosis (pace, verbal support, length, choice of content) is not made, or is improvised on the spot. 3. When a session goes badly, the recorded explanation tends to be about the person (“would not engage”, “did not like it”) rather than about the preparation. This article is not about diagnosing. Diagnosis is a clinical act, it is not what we do, and it is not something technology should try to do. It is about **running activities in a setting where the diagnosis frequently does not exist**. ## Three practical consequences ### 1. Prepare from observed functioning, not from the label The label says little even when it exists: differences between conditions change a great deal of what works in a session, as we wrote in [types of dementia: what changes in a session](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/). When it does not exist, the alternative is not guessing: it is **describing what you observe**. Four questions answerable without any formal assessment, which change a session more than any diagnostic code: - Does the person follow a one-step instruction? A two-step one? - Roughly how long do they hold attention before disengaging? - Do they recognise people and places? Which ones? - What agitates them: noise, darkness, being touched, being rushed? This is what should be written down before the first session, and read before the second. ### 2. Start shorter than seems necessary With uncertainty about cognitive status, the expensive mistake is starting long. A short first session that goes well gives enough information to extend the next one; a long session that goes badly shuts the door on that person for weeks, sometimes for good, because it is recorded as “does not tolerate it”. Length and frequency are not a universal number, and we go through the variables in [session length and frequency](/blog/duracao-frequencia-sessao-realidade-virtual/en/). ### 3. Record what happened, not the impression of the day This is where the grey zone resolves itself, over time. A consistent session record (what was used, for how long, how the person reacted, what interrupted it) is one of the few bodies of material a team accumulates about how someone functions **outside** the consultation. It is not a diagnosis and replaces none. But when the attending physician asks “how long has it been like this”, a dated sequence of observations is worth far more than the memory of whoever is on shift that day. That is why the [session record](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/) exists and what it is for: nothing more. ## About the 75% who never go outside This is the number technology does not fix, and it is better said here than left for someone else to say for us. A session on a headset can give someone fifteen minutes on a beach or in the street where they lived (and we know, from what teams tell us, that for a bedbound person that is not nothing) but **it is not going outside**. The right answer to 75% of people never leaving is organised outings, adapted transport, and opening the institution to the community. If equipment is used as a substitute for that, it makes the problem more comfortable to ignore, which is worse than not having it. Technology's honest place is the remainder: the days when going out is impossible, the winter, the person who no longer has the mobility to leave, and the 28% who never get visitors: for whom what we have seen work best is not a scenario at all, but a [video call with family](/blog/videochamadas-familia-realidade-virtual/en/). ## Three questions for the next meeting 1. How many of your residents have a recorded diagnosis, and for how many is there suspicion with no assessment? 2. For those, is there any written functional description: instructions, attention, recognition, agitation triggers? 3. When someone stops taking part in an activity they used to do, is that recorded as a dated event, or does it disappear quietly? None of the three needs a budget. All three change daily practice more than the next purchase. The RVer platform's base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal). Sessions are run by the institution's own professionals, complement existing care and do not replace assessment, diagnosis or clinical follow-up. Q: How many care home residents in Portugal have dementia? A: In a cross-sectional study across 423 Portuguese care homes (SINDIA project, Universities of Coimbra and Aveiro, published in Acta Médica Portuguesa), on average roughly a third of residents had a formal dementia diagnosis and roughly a fifth showed suspected cognitive decline with no diagnosis on record. The figures refer to the surveyed universe. Q: Does virtual reality help diagnose dementia? A: No. Diagnosis is a clinical act and no virtual reality session replaces or anticipates it. What a consistent session record gives is a dated sequence of observations of functioning outside the consultation, useful to the clinical team doing the assessment: nothing more. Q: How do you prepare a session when there is no diagnosis? A: From observed functioning rather than the label: whether the person follows one- or two-step instructions, how long they hold attention before disengaging, what and whom they recognise, and what agitates them. Those four answers change how a session is run more than the diagnostic code, and they need no formal assessment. Q: How long should a first session be with someone without a diagnosis? A: Shorter than seems necessary. A short first session that goes well lets you extend the next one; a long session that goes badly tends to be recorded as intolerance and shuts the door on that person for weeks. Q: Does virtual reality make up for residents never going outside? A: No. In the same study, 75% of people with dementia in care homes never go outside and 28% never receive visitors: problems solved by outings, adapted transport and opening the institution to the community. Using equipment as a substitute makes the problem easier to ignore. Technology's place is the days when going out is impossible and the people who can no longer go out. ### When the person's place isn't in the library: choosing a reminiscence scene URL: https://rver.pt/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/en/ Date: 2 September 2026 That person's place is not in the library, and it will not be. That does not end the reminiscence session: it changes the unit of choice, which is almost never the name of the place. Reminiscence does not work because of the image. It works because of **recognition**. The person sees a place, the place gives something back, and that is what opens the conversation. Without recognition, a beautiful scene is just a beautiful scene. What follows is the practical problem that shows up in almost every care home in the second week of use: **that person's place is not in the library**. Not their street, not their village, not the house where they raised their children. And it will not be: no catalogue covers biographies. ## The first mistake The mistake is treating the library as if it were the person's photo album, and giving up when it isn't. The team looks for one specific region, cannot find the right village, and concludes that reminiscence is not for that resident. It is. The unit of recognition is just rarely the place name. ## Three substitutions that work **1. The kind of place, not the place.** Someone who grew up by the sea recognises a fishing harbour they have never seen. Someone who spent their life inland recognises a dirt track between stone walls. The brain is not validating coordinates: it is recognising a category of place it has been in many times. **2. The season and the calendar.** A grape harvest, a fair, a procession, snow, a crowded summer beach. The calendar is one of the last things to go and it brings the rest with it. **3. The activity, not the landscape.** Someone who was a cobbler, a seamstress, a fisherman or a driver recognises the gesture before they recognise the setting. Choosing by what the person did, rather than where they lived, changes the outcome of a lot of sessions. ## What not to do **Do not insist on a "similar" place once the person has said it is not theirs.** If they correct you, the correction is information, not resistance. Note it and change the scene. **Do not correct the person.** If they say that beach is one particular beach and it is not, the session is not about geography. Correcting costs you the whole conversation and gives nothing back. **Do not use the library blind.** The questions are asked **before** the session: to the family or from the record, not during it. Where were they born, where did they work, where did they spend holidays, what did they do on Sundays: four questions that settle scene choice for months. Same principle as in [how a scene gets chosen](/blog/atividade-significativa-como-se-escolhe-um-cenario/en/). ## And when it genuinely does not work It works for many people and not for everyone. There are residents for whom recognition does not happen: because of the stage of the disease, because nobody knows the biography, or simply because it does not. For them the session still holds value as **comfort and activity**, which is a different and smaller claim, and should be stated as such rather than sold as reminiscence. ## The record closes the loop Choosing well is half of it. The other half is **knowing what worked**. What went well with that resident stays in the session record (content chosen, actual duration, how it ended) and reading it is always the team's job. After three or four sessions the pattern is there: this person responds to the sea, this one to the countryside, this one to none of it. See [what the clinical team sees in a session record](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/). ## Where RVer loses, and it is worth saying We do not film each resident's street. There is no way to do that at scale, and anyone promising it is promising a film crew per resident. And there is a larger limit: **most of our library was filmed in Portugal and in Europe**. For a Portuguese resident that is an advantage. For a resident who has never been here, reminiscence proper is off the table and what remains is the first column of the table below: activity, comfort, novelty. Those are good things, but they are not the same thing, and a European catalogue does not get sold as a universal biography. | What the scene does | Needs recognition? | |---|---| | Activity and comfort | No | | Novelty and conversation | No | | A way into talking about a life | Helps a great deal | | Reminiscence proper | Yes | The library is validated and organised by the clinical team, see [a validated library](/blog/biblioteca-validada-equipa-clinica-realidade-virtual/en/), and the choice itself stays with whoever knows the person. ## RVer's role RVer's **base product** is an immersive video library, registered as a Class I Medical Device in EUDAMED and with INFARMED (Portugal). The platform **records** the session: it does not assess, grade or diagnose, and does not replace clinical assessment or the team's decision. Choosing the scene belongs to whoever accompanies the person. Q: Does reminiscence only work if the scene is the person's exact place? A: No. What opens the conversation is recognition, and it rarely depends on the place name. Someone who grew up by the sea recognises a fishing harbour they have never seen; someone from inland recognises a dirt track between stone walls. The useful unit is the kind of place, the season, or the activity, not the name of the town. Q: What should you ask the family before choosing a scene? A: Four questions settle months of choices: where were they born, where did they work, where did they spend holidays, and what did they do on Sundays. Ask before the session, of the family or from the record, not during it. Q: What if the resident says the place is not theirs? A: Note it and change the scene. The correction is useful information, not resistance. And do not correct the person: if they name the beach wrongly, the session is not about geography, and correcting costs you the whole conversation. Q: Does RVer film each resident's own place? A: No. There is no way to do that at scale: it would mean a film crew per resident. The library covers kinds of place, seasons and activities, and the choice is made from there. Q: Does the library work for residents who never lived in Europe? A: For activity, comfort and conversation, yes. For reminiscence proper, no: most of the library was filmed in Portugal and in Europe, and without recognition the proposition is a different and smaller one. Better to say so than to sell one as the other. Q: What gets recorded from these choices? A: The content chosen and actually played, the real duration and how the session ended. It is a record of the activity: RVer does not score, grade or interpret. After three or four sessions the team can read each resident's pattern of preferences. ### Does the project survive the person who brought it in? The test almost nobody passes URL: https://rver.pt/blog/o-projeto-sobrevive-a-quem-o-trouxe/en/ Date: 1 September 2026 There is a pattern that repeats so often it stopped being an anecdote: the equipment arrives through someone who believed in it, and leaves the department's life in the month that person changes shift, department or job. Every clinical technology project we have seen work well started the same way: **one person wanted it.** A nurse, a care home manager, a physiotherapist. Without that person there is no project at all, and we have written that [the first of the six yeses belongs to the department](/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/en/). The problem is the next step, and almost nobody takes it: **the project remains that person's forever.** They are the one who knows how to switch it on, who has the PIN, who knows the scenarios, who remembers to charge it. And when they move on, which in healthcare happens often, the project is handed to nobody. It simply stops. ## The test One sentence, and it needs no consultancy: > **Does this work in the week the person who brought it in is on holiday?** If the answer is no, there is no project yet. There is an enthusiast, and an enthusiast is a good and fragile thing. A harder variant, for services past their first year: **does it work on the night shift, over a long weekend, with half the team on agency cover?** [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## The five defences None is expensive. All are boring, which is why they do not get done. **1. Two trained people per shift, never one.** The most effective defence and the most ignored. One person per shift equals zero when that person is absent. And it helps if the second person is not the same second person on every shift. **2. The procedure written where the equipment is.** Not in an email from August, not in a shared folder nobody can find. Five lines taped to the cupboard door beat a thirty-page manual, [we argued this about logistics](/blog/onde-vive-o-equipamento-realidade-virtual-hospital/en/). **3. The task attached to a role, not a name.** "Ana puts it on charge" is fragile. "Whoever closes the shift puts it on charge" survives Ana leaving. True for charging, for hygiene and for the cupboard key. **4. Training for arrivals, not only for those already there.** Initial training is given once, to the team that existed that day. Two years later, half those people were not there. If a new professional's induction does not include this, the project dilutes without anyone deciding anything. **5. A formal owner, with a named deputy.** Someone answers for the project, and it is written down who answers when that person is away. It is the difference between a department's project and one person's project. ## What we solve, and it is little Let us be precise, because continuity is easy to sell as a feature. **We solve one thing:** the record. When every session is [logged](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/), knowledge about what was done stops living in one person's head. Whoever arrives can see what was done, with whom, and what was interrupted. That is knowledge transfer with no meeting required, and it is real. **We do not solve:** training, cover, ownership, shifts. None of that is a software feature, and a supplier telling you the platform "guarantees continuity" is selling something only the institution can do. We also do not solve the hardest part: **willingness does not transfer.** Someone inheriting a project rarely wants it with the intensity of whoever brought it in. What can be done is lower the cost of keeping it going, so that enthusiasm is not required to continue, only routine. ## An alarm signal that is easy to read If, after six months, **all sessions are logged under the same name**, the project has one person and no team. It is visible in the log in ten seconds, and that is the moment to act, not a year later, when that person leaves. ## In short - **Every project starts with one person**, and almost none stops depending on them. - **The test is the holiday one**, and the hard version is the night shift on a long weekend. - **Two people per shift, posted procedure, tasks by role, training for arrivals, an owner with a deputy.** - **Software does not guarantee continuity.** The log transfers knowledge; the rest belongs to the institution. - **If every session has the same name on it, the project has an expiry date.** Q: How do you stop a technology project dying when the person who brought it in leaves? A: With five simple measures: train two people per shift rather than one, post the procedure where the equipment is, attach tasks to roles rather than names, include the training in new arrivals' induction, and name a formal owner with a deputy. None is expensive; all are boring, which is why they rarely get done. Q: What is the test for whether a project is sustainable? A: Whether it works in the week the person who brought it in is on holiday. A more demanding variant, for services past their first year, is whether it works on the night shift over a long weekend with half the team on agency cover. Q: Does the platform help with continuity? A: In one respect only: logging every session means knowledge about what was done stops living in one person's head. Training, cover, shifts and assigning responsibility are not software features, and a supplier claiming the platform guarantees continuity is promising what only the institution can deliver. ### Meaningful activity: the occupational therapy idea that changes how you choose a scenario URL: https://rver.pt/blog/atividade-significativa-como-se-escolhe-um-cenario/en/ Date: 1 September 2026 There is a distinction occupational therapists have made for decades and that almost all material about technology for older people ignores: keeping someone occupied and giving them an occupation are different things. In a room with ten people it is possible to have everyone occupied and nobody doing anything that concerns them. Television does this very well. Occupational therapy has worked for decades with the distinction that matters here: **occupation is not pastime.** It is activity connected to who the person is: to what they did, the role they held, what defines them to themselves. A meaningful activity is one the person would recognise as theirs. It is worth importing that framing into choosing content, because it explains a pattern anyone working in these rooms knows and rarely manages to name. ## The pattern A technically flawless landscape (tropical beach, northern lights, diving with turtles) frequently yields **less** than an unremarkable image of a place the person knows. It is not about image quality. It is that the second one has the person inside it and the first does not. We have written about this from the [reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/) side. What occupational therapy adds is the explanation and a method. ## Occupation, roles, and what is lost first When someone enters an institution, what disappears first is not capacity. It is **roles**: they stopped being the one who cooked, who tended the garden, who drove to the market, who decided. They became the one who is cared for. So the useful question is not "what does she like?", it is: > **What did this person do when they still decided about their own life?** The answer to that is what makes an offer meaningful rather than merely pleasant. ## The five life-history questions None requires specialist training and all can be asked of the family in ten minutes: 1. **Where did this person spend most of their life?** Not where they were born, but where they lived. 2. **What did they look after?** Land, animals, a workshop, a house, accounts, grandchildren. 3. **Where did they go when they could choose?** Sundays, holidays, local festivals. 4. **What work did they do, and which of it made them proud?** 5. **Is there anything better avoided?** A sea where someone drowned, the place of a loss. This is the question almost nobody asks and the one that most prevents sessions going wrong. With those five answers you can write one line per person, and that line is worth more than any catalogue. ## The mistake the catalogue invites A large library invites choosing by what is beautiful, because that is what shows in the thumbnail. It is the wrong logic: **the criterion is not scenario quality, it is closeness to the biography.** And there is a related second mistake: choosing by diagnosis. As we wrote about [types of dementia](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/), diagnosis helps anticipate how the session will go; **biography chooses the content**. ## Where this fails, and it is honest to say so - **There is not always a biography.** People with no family present, no history gathered, a past out of reach. There you work with what exists and without pretence. - **Not everyone wants the past.** Some prefer new things, and projecting nostalgia onto a person is another way of not seeing them. - **Meaning is not produced by equipment.** A scenario of the right place may generate nothing. The conversation that follows is frequently the part that matters, and that is not the system's. - **The library is finite.** If the person is from one specific village, it is probably not there. What exists are categories (beaches, mountains, fields) and the closest possible, not the exact one. ## What the system does here The AI-assisted feature helps find scenarios from the **kind of moment** the team describes: relaxation, memory, orientation. It does not know the person, does not read life history and **does not decide**: it ranks and explains why it suggested, and the choice belongs to the team. The information that matters, the five answers above, lives in the heads of those who care and in the family. No system replaces it, and ours does not try. ## In short - **Occupying is not giving occupation.** The difference is whether the person recognises themselves in it. - **The question is what they did when they decided**, not what they like. - **Five questions to the family** are worth more than the whole library, and the fifth, what to avoid, saves the most trouble. - **The criterion is closeness to biography**, not image quality. - **Meaning does not come from the equipment.** It comes from whoever knows the person. Q: What is a meaningful activity? A: It is activity connected to who the person is (to what they did, the role they held, what defines them to themselves) rather than simply something that fills time. It is the distinction occupational therapy has made for decades between occupation and pastime, and it explains why a familiar place frequently yields more than a technically flawless landscape. Q: How do you choose content for a specific person? A: By biography, not by catalogue or diagnosis. Five questions to the family settle most of it: where they spent most of their life, what they looked after, where they went when they could choose, what work made them proud, and whether there is anything to avoid. The last is the least asked and the one that most prevents sessions going wrong. Q: Does the AI feature pick the right scenario for each person? A: No. It helps find scenarios from the kind of moment described by the team (relaxation, memory, orientation), ranks the content and explains why it suggested it. It does not know the person, does not read life history and does not decide. The choice always belongs to the clinical team, and the information that matters most lives with carers and family. ### The system does not integrate with the hospital. So how does the session reach the record? URL: https://rver.pt/blog/a-sessao-e-o-processo-clinico-do-doente/en/ Date: 1 September 2026 "No integration needed" is the sentence that makes hospital IT breathe out. It is true, it is a genuine advantage, and it has a consequence that only shows up three months later. When a hospital's IT department asks what needs integrating, the answer "nothing" settles the conversation in two minutes. It is one of the [eight questions](/blog/informatica-hospital-perguntas-realidade-virtual/en/) and usually the one that unblocks everything: no integration means no IT project, no development schedule, no third-party dependency. But there is a price, and it is fair to state it: **the session log stays where the system is, and not in the patient's clinical record.** ## Why that matters The clinical record is where care is accounted for. If something is not there, for practical purposes it did not happen: - the doctor seeing the patient the following week does not know sessions happened; - handover does not include it; - an audit does not find it; - and if anyone later wants to study what was done, the data sits elsewhere. On the other side there is a real advantage, which we explained regarding the [European Health Data Space](/blog/espaco-europeu-de-dados-de-saude-o-que-muda/en/): by not collecting clinical data and not being an electronic health record system, the regulatory surface is small. [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## The three routes **1. A manual note in the record.** Whoever ran the session writes a line in the hospital system, as they would for any other non-pharmacological intervention. - *Cost:* thirty seconds per session, and it depends on someone remembering. - *Gain:* it is in the record, with authorship and date, in the system the institution already audits. - **This is the route we recommend to start with**, and in most services it is the only one that ever exists. **2. Periodic export.** The system's log is exported and attached or summarised, typically by period or by patient. - *Cost:* someone has to do it, and what ends up in the record is a summary rather than the detail. - *Gain:* it does not depend on each shift's memory. - Useful when there are many sessions and manual logging degrades. **3. Custom integration.** Making the system write into the hospital system. - *Cost:* it is an IT project, with everything that implies: scope, schedule, security, maintenance, and a dependency that then exists forever. - *Gain:* automatic and complete. - **It is not what this system does today**, and be wary of anyone promising it as a simple matter. Integrating with hospital systems rarely is. ## What the manual note should contain If you take route 1, and you probably will, it is worth agreeing the content beforehand, because the difference between a useful note and a useless one is small and decides everything. **A useful note:** what was done, how long, and **what was observed in the words of what was seen**. "Twelve-minute session, beach scenario; stayed calm, talked about the Algarve, asked to repeat tomorrow." **A useless note:** "VR session carried out." It tells the next reader nothing. And one that should **not** be written: conclusions the system does not support. "Session reduced anxiety" is a clinical inference; if whoever writes it is a clinician taking responsibility, it is theirs. It is not the equipment's, which [does not assess or measure emotional states](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/en/). ## What exists on our side The [log of every session](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/): what played, when, for how long, whether it was stopped and at what point. It is operational information about equipment use, held inside the institution, and it is what feeds routes 1 and 2. What does **not** exist: automatic writing into the record, and any field that looks like a clinical outcome. ## In short - **Not integrating is an advantage at installation and a cost at the far end.** - **If it is not in the record, for practical purposes it did not happen.** - **Three routes:** manual note, periodic export, custom integration, in rising order of cost and fragility. - **Start with the manual note**, and agree what it should contain before the first session. - **Never write into the record a conclusion the equipment does not support.** Q: Does RVer integrate with hospital IT systems? A: No. The system works independently and runs on the institution's local network, which removes the need for an IT project and is usually the answer that unblocks the conversation with IT. The trade-off is that the session log stays in the system rather than in the patient's clinical record. Q: How does a session reach the clinical record? A: By three routes, in rising order of cost. A manual note written by whoever ran the session, which is the one we recommend to start with; a periodic export of the log, attached or summarised in the record; or a custom integration with the hospital system, which is an IT project and not what this system does today. Q: What should a session note in the record contain? A: What was done, how long it lasted and what was observed, in the words of what was seen: for example, a twelve-minute session with a beach scenario, stayed calm, talked about the Algarve, asked to repeat. It should not contain conclusions the equipment does not support: the system does not assess or measure emotional states, and any clinical inference belongs to whoever writes and owns it. ### European Health Data Space: the timeline and what changes for software buyers URL: https://rver.pt/blog/espaco-europeu-de-dados-de-saude-o-que-muda/en/ Date: 31 August 2026 It is the largest European health data framework ever, it starts applying on 26 March 2027, and most institutions still do not know whether any of their suppliers are covered. **Regulation (EU) 2025/327**, establishing the European Health Data Space, entered into force on **26 March 2025** and begins to apply on **26 March 2027**. It is not a proposal or a consultation: it is law in force with a phased timetable. As with almost everything in this area, the problem is not that the rule exists: it is that nobody knows who it applies to. ## The four dates | When | What | |---|---| | 26 Mar 2025 | Entry into force | | **26 Mar 2027** | **General application**, including rules on secure processing environments and health data access applications | | **26 Mar 2029** | **Secondary use** (Chapter III) and exchange of the first priority categories: patient summaries, ePrescriptions and eDispensations | | 26 Mar 2031 | Mandatory sharing of medical imaging and reports, test results and discharge reports | Note that the date everyone quotes, 2027, is the **least** demanding of the three. The obligations that most affect systems (secondary use and imaging sharing) are 2029 and 2031. ## Two halves that always get confused **Primary use** is about the person and their care: accessing your own record, carrying it between countries and providers, and systems being able to talk to each other. **Secondary use** is about research, innovation, public policy and regulation: access to de-identified health data through dedicated bodies, with applications, permits and secure processing environments. Confusing the two leads to the wrong conversations with suppliers. A system can be irrelevant to one half and central to the other. ## What changes for electronic health record systems This is the part that catches software: the regulation sets **requirements for electronic health record systems**, with mandatory interoperability and logging components, plus a conformity and declaration regime. So the useful question is not "are you EHDS compliant?", it is: > **Is your system an electronic health record system within the meaning of the > regulation? And if not, what health data does it process, and for whom?** A supplier answering "yes, we are fully EHDS compliant" about a regulation whose general application is in 2027 is telling you very little. ## Where RVer sits in this Being specific, because it is the only way this is useful: - **RVer is not an electronic health record system.** It is not a clinical record, does not replace one, and does not aim to be one. - **It does not collect patient clinical data.** What exists is the [session log](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/): what played, when, for how long, whether it was stopped, which is operational information about equipment use. - **It does not assess, classify or diagnose**, so it generates no new clinical data. - **It does not integrate with the [hospital IT system](/blog/informatica-hospital-perguntas-realidade-virtual/en/)**, and playback runs [on the headset itself, with no cloud](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/en/). This has one pleasant practical consequence and one unpleasant one. The pleasant one is that the EHDS exposure surface is small. The unpleasant one is that **it also means sessions do not enter the patient's clinical record**: anyone wanting that integration has to build it, and it is not what this system does. On GDPR, which continues to apply in parallel and was replaced by nothing, we have written [what there is to know](/blog/privacidade-rgpd-realidade-virtual-saude/en/), and a pre-filled DPIA template (in Portuguese) is on [How to fund and procure](/en/aquisicao/). ## What to ask any supplier, now Worth doing already, because answers take time to arrive: 1. **Is it an electronic health record system within the meaning of the regulation?** 2. **What data does it process, and where does it sit?** Inside the institution, on your server, on a third party's? 3. **Who is the controller, and who is the processor?** 4. **If covered, what is the plan up to March 2027?** A date and a name, not a statement of intent. 5. **What happens to the data if the relationship ends?** The last two tell you the most about the maturity of whoever is answering. ## What we do not know Plainly: **this is not legal advice.** We are a manufacturer, not a law firm. Parts of the regulation are still settling in practice for niche systems, implementing acts keep arriving, and the boundary between wellness software, medical device and record system is being drawn in real time. If your institution needs a formal position, it has to come from someone who can sign it. ## In short - **In force since March 2025**, general application **March 2027**, secondary use **2029**, medical imaging **2031**. - **Primary and secondary use are different conversations.** - **The right question is whether the system is an electronic health record**, not whether it "complies with EHDS". - **RVer is not one, and collects no clinical data**, at the cost of sessions not entering the patient's record. Q: When does the EHDS start to apply? A: Regulation (EU) 2025/327 entered into force on 26 March 2025 and general application begins on 26 March 2027. Secondary use obligations apply from 26 March 2029, and mandatory sharing of medical imaging, test results and discharge reports from 26 March 2031. Q: Is RVer covered by the EHDS? A: RVer is not an electronic health record system within the meaning of the regulation: it is not a clinical record and does not replace one, it does not collect patient clinical data, it does not assess or diagnose, and it does not integrate with hospital IT systems. What it logs is operational information about equipment use. This is not legal advice, and classifying each case is for the institution. Q: Does the EHDS replace the GDPR? A: No. The GDPR continues to apply in parallel and was not replaced. The EHDS adds its own framework for primary and secondary use of health data and requirements for electronic health record systems, but data protection obligations remain. ### Buying health technology from a small company: what to ask first URL: https://rver.pt/blog/comprar-tecnologia-de-saude-a-uma-empresa-pequena/en/ Date: 31 August 2026 It is the question nobody asks in the meeting and everybody thinks: what if you go under? It deserves a serious answer, and it is easier to give when we raise it ourselves. The European digital health market is growing and, at the same time, **concentrating**: capital goes to fewer and larger companies, and underneath sits a long tail of small suppliers. We are one of them. That creates a risk that rarely appears in a specification and belongs entirely to the institution: **the equipment stays, the supplier may not.** Better to discuss it head on than to hope nobody asks. ## Why this differs from other sectors If a chair supplier closes, the chairs remain chairs. In software and connected equipment, a product can stop working without anyone touching it: a licence that expires, a server that shuts down, an app store that stops serving the app. The right question is not "are you solid?", everyone says yes. It is: > **What keeps working on the day you disappear?** [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## The seven questions They apply to any small health technology supplier: 1. **Does the product work without your servers?** If the answer is no, you are buying a subscription to a service, not equipment. 2. **Does it need internet for normal use?** 3. **If the company disappears, what exactly stops working, and when?** 4. **Is data exportable in an open format, without asking you for anything?** 5. **Who can repair or replace the hardware other than you?** 6. **What does the contract provide for on termination, insolvency or acquisition?** 7. **How many people can keep this running?** If it is one, it is a person, not a company. ## Our answers, including the ones that do not favour us **What keeps working without us:** - **Playback of already installed content.** The scenarios sit on the device and run [without internet](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/en/). A headset with the library installed keeps running sessions. - **Control from the browser**, because it runs on the [institution's local network](/blog/app-companion-controlo-remoto-realidade-virtual/en/), not our cloud. - **The hardware.** The equipment is commercial and unmodified by us; it is not bricked. **What stops working:** - **New content.** The catalogue is generated from our backoffice. Without us, the library freezes at whatever is installed. - **Updates** to the application, fixes and new features. - **Support, training and replacement** of faulty equipment under contract. - **Modules in development**, which are already outside the medical device registration and should not weigh in a purchase decision. Plainly: **sessions continue, evolution stops.** That is a better answer than many products that need a cloud to function at all, and a worse one than "nothing changes", which would not be true. ## What an institution can require by contract None of this is exotic and most suppliers accept it, if asked: - **Data export** in an open format, on request and at no cost. - **Notice period** on discontinuation of service. - **A continuity clause** guaranteeing continued use of what is installed. - **Operating documentation** sufficient for someone else to understand the system. If a supplier refuses the first one, that is a signal in itself. ## The other side, which is also honest Large companies discontinue products just as readily: only without warning and with nobody to talk to. "Buy from the biggest" reduces insolvency risk and increases irrelevance risk: a small product inside a large company is the first thing cut in a reorganisation. What genuinely reduces risk is not supplier size. It is **the architecture** (does it work without them?) and **the contract**. ## In short - **The equipment stays, the supplier may not**, and the risk is the institution's. - **The question is what keeps working**, not whether the supplier is solid. - **With us: sessions continue** (installed content, local network, commercial hardware) **and evolution stops** (new content, updates, support). - **Require data export and a continuity clause.** Whoever refuses is answering you. - **Buying from the biggest trades one risk for another**, it does not remove it. Q: What happens to the equipment if the supplier closes? A: It depends entirely on the architecture. With RVer, playback of already installed content keeps working because the scenarios sit on the device and run without internet, browser control keeps working because it runs on the institution's local network, and the hardware is commercial and unmodified. What stops is new content, which is generated from our backoffice, plus updates, support and equipment replacement. Q: What should you ask a small supplier before buying? A: Whether the product works without the supplier's servers, whether it needs internet for normal use, what exactly stops working if the company disappears, whether data is exportable in an open format without asking permission, who can repair the hardware other than the supplier, what the contract provides for on termination or insolvency, and how many people can keep the system running. Q: Is it safer to buy from a large company? A: It trades one risk for another. It reduces insolvency risk and increases discontinuation risk: a small product inside a large company is usually the first thing cut in a reorganisation, often without warning and with nobody to talk to. What genuinely reduces risk is the product architecture and what the contract says, not the size of whoever sells it. ### Germany reimburses health apps. Portugal has nothing like it: why URL: https://rver.pt/blog/diga-pecan-e-o-que-portugal-nao-tem/en/ Date: 31 August 2026 A German doctor can prescribe an application and the insurer pays. A Portuguese doctor cannot prescribe any of it, because there is nothing to prescribe, and that difference explains much of how health technology gets bought here. Since 2019, a doctor in Germany can write a prescription for a **digital application** and statutory health insurance pays. It is called **DiGA**: *digitale Gesundheitsanwendungen*, and it goes through a BfArM assessment with a fast-track route allowing provisional listing while evidence is produced. France later created **PECAN**, an early-reimbursement route with similar logic: enter early, prove later. In **Portugal there is no equivalent.** There is no national register of digital therapeutics, no reimbursement route, and not even the concept of a "prescribable application". ## What this changes in practice In a German institution, part of the conversation is about **eligibility**: it is on the list, it is prescribable, the insurer pays. In a Portuguese institution the conversation is entirely different: **which budget does this come out of?** That is why almost all health technology buying in Portugal lands in the same problem we described in [whoever pays is not whoever saves](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/en/): one department carrying alone an expense whose benefits are spread. With no reimbursement route there is no third party sharing the cost, and every available route sits on the institution's side, as we listed in [how to fund it](/blog/financiamento-comparticipacao-realidade-virtual-saude/en/). ## What the German route demands in return, rarely mentioned Those citing DiGA as a model usually forget the entry price. Getting in requires, among other things: - being a **medical device** with CE marking, in a low class; - demonstrating information security, data protection and interoperability requirements; - and above all, presenting **evidence of positive healthcare effect** within a deadline: provisional listing is not permanent, and products have left the list for failing to demonstrate it. In other words: it is not a subsidy, it is a contract. You enter with a promise of proof, and those who do not prove, leave. ## Would RVer fit? No, and not out of modesty This is the part worth stating clearly, because the temptation to pretend otherwise is strong. The DiGA model was designed for **applications the patient uses alone**, at home, after prescription. It is a self-administration route. RVer is the opposite by design: its intended purpose requires [supervised use](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/), the intended users are professionals and trained carers, and the system lives inside an institution with a team running it. **It is not an application prescribable to a patient for their own use, and we will not bend the product to fit a funding route.** So if Portugal created a DiGA tomorrow, it would be excellent for the sector, and would probably change nothing for us. ## What would make a difference in Portugal, and it is not copying the model If the question is what would unlock adoption here, the answer is not a national list of apps. It is duller and more effective: 1. **Recognition in service contracts.** While non-pharmacological activity counts towards nothing an institution reports, it competes with what does count: the same logic as [what the system measures](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/en/). 2. **Clear eligibility in existing funding.** Continuing care, social support schemes, recovery funds: most doubts are about whether a budget line covers this, not about whether it is worth it. 3. **A route for small institutions.** A thirty-bed care home has no structure to bid for funds, and it is where the per-resident difference would be largest. ## What to ask anyone citing DiGA If a supplier tells you their product is "aligned with the DiGA model" or "would be eligible in Germany", three questions settle it: - **Are you on the BfArM list?** If so, the number. If not, it is a statement about the future. - **Is it self-administered or does it require a professional?** That decides whether the comparison makes sense at all. - **What evidence of positive healthcare effect exists, and published where?** It is the central requirement of the route being cited. We are not on the list, we are not eligible, and we say so before being asked. ## In short - **Germany (DiGA, since 2019) and France (PECAN)** have reimbursement routes; **Portugal has none.** - **The German route is not a subsidy**: it requires CE marking, technical requirements and proof of effect, with exit for those who fail. - **RVer would not fit it**, because DiGA is for self-administered use and our intended purpose requires supervision. - **What would unlock Portugal** is recognition in indicators and clear eligibility within funding that already exists. Q: What is Germany's DiGA? A: It is the German route through which digital health applications can be prescribed by a doctor and reimbursed by statutory insurance, in place since 2019. It goes through a BfArM assessment and includes a fast track with provisional listing while evidence of positive healthcare effect is produced. It is not a subsidy: it requires CE marking, security and data protection requirements, and products failing to demonstrate effect end up leaving the list. Q: Does Portugal have a reimbursement route for digital health? A: There is no equivalent. There is no national register of digital therapeutics, no reimbursement route and no concept of a prescribable application. In practice, the conversation in a Portuguese institution is not about eligibility but about which budget the expense comes from. Q: Would RVer be eligible for a DiGA-style route? A: No, and not out of modesty. The model was designed for applications the patient uses alone at home after prescription, and RVer's intended purpose requires supervised use by health professionals or trained carers inside an institution. It is not an application prescribable for personal use, and we do not distort the product to fit a funding route. ### Informal carers: what technology does at home, and what it does not URL: https://rver.pt/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/en/ Date: 21 August 2026 It is the country's most used social response and the least equipped. Someone, almost always a woman, almost always alone, caring for a relative at home, and receiving offers of technology designed for institutions. Portugal recognised the **Informal Carer Statute** in 2019, through Law 100/2019, creating a legal figure for something that had existed for decades: someone caring for a relative at home, without being a health professional and without hours. The statute distinguishes the **primary** carer, who cares permanently and has no professional activity, from the **non-primary**, who combines both. Only the primary can access the support allowance, subject to household means testing, which in practice excludes many people caring full time. Respite care also exists, with availability varying widely by municipality. We write this because it is the context where most technology is offered and where least of it helps. ## What actually weighs at home Talking to those who care, the problems repeat, and almost none are what technology usually promises to solve: - **no relief.** The person has not left the house in months; - **isolation**, which belongs to the carer and not only to the person cared for, and worth separating from [loneliness](/blog/solidao-isolamento-social-idosos-tecnologia/en/), which is a different thing; - **the nights**, when there is agitation or disturbed sleep; - **the dead hours**: the day is long and there are stretches with nothing to do and no way to leave; - **information**, which arrives in fragments and never at the right moment; - **guilt**, when institutional care starts being considered. ## What technology solves, honestly **Solves reasonably well:** communication with people far away, medication reminders, fall and door sensors, and telemonitoring in specific situations. These are concrete and cheap, and most already exist as consumer products. **Only appears to solve:** almost anything promising to "occupy" the person being cared for over long periods with nobody nearby. If the product requires the carer to be present and attentive, it returned no time at all, it only changed what is done with it. **Does not solve at all:** the absence of relief. No equipment turns up on Tuesdays so someone can go to their own doctor. That is the central problem and it is a services problem, not a device one. ## Where RVer sits in this, and the answer is uncomfortable Let us be direct, because the question reaches us often. **RVer is not a consumer product and is not sold to families for domestic use.** It is a Class I medical device registered in EUDAMED and with INFARMED (Portugal), and its intended purpose states that use is **always supervised**, the manual is explicit: never leave the person alone with the headset. The intended users are health professionals and **trained** carers. That has a practical consequence worth stating plainly: **in a domestic setting without professional support, a session requires the carer to be there, attentive, throughout.** In other words it returns no time, and time is exactly what is missing. Selling it as "an hour of rest" would be selling the opposite of what the product is. **Where it does make sense:** when there is a team behind it. Home support, [continuing care](/blog/realidade-virtual-cuidados-continuados-rncci/en/), a palliative team following the person at home, a day centre. There a professional runs the session and the carer does not gain another task. **And one thing makes sense in any case**, even with the person in an institution: the [video call during the session](/blog/videochamadas-familia-realidade-virtual/en/), which serves precisely the carer who cannot be there. ## If you care at home, what to ask whoever is selling 1. **Does it require me to be present?** If so, it returns me no time. It may still be good, but for another reason. 2. **Is it a medical device?** And if so, what is the intended purpose and who is the intended user? 3. **Does it work without internet?** 4. **What happens if I cannot manage it?** Is there training, is there someone on the phone? 5. **What does it cost per month, all included?** ## In short - **The Statute has existed since 2019**, but the allowance is means-tested and does not reach everyone who cares. - **The central problem is the absence of relief**, and that is services, not technology. - **A product requiring presence returns no time.** - **RVer is not sold for domestic use without professional support**: the intended purpose requires supervision. - **Where there is a team, it makes sense.** Where there is not, we say no. Q: Can RVer be used at home by a relative? A: Not as a consumer product. It is a Class I medical device whose intended purpose requires supervised use, with intended users being health professionals and trained carers, and the manual is explicit about never leaving the person alone with the headset. It makes sense at home when there is a team behind it: home support, continuing care or a palliative team. Q: What is the Informal Carer Statute? A: It is the legal figure created in Portugal by Law 100/2019, distinguishing the primary informal carer, who cares permanently and has no professional activity, from the non-primary, who combines both. Only the primary can access the support allowance, subject to household means testing, and respite care also exists with availability varying by municipality. Q: What technology actually helps someone caring at home? A: The concrete and cheap things: communication with people far away, medication reminders, fall and door sensors, and telemonitoring in specific situations. What equipment cannot solve is the absence of relief, which is the central problem and a services question. ### Mental health in Portugal: where non-pharmacological responses fit URL: https://rver.pt/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/en/ Date: 21 August 2026 There are two facts about mental health in Portugal that rarely appear in the same sentence, and the whole market for complementary responses lives in the distance between them. Two facts, and the tension between them. **First:** Portugal is consistently among the European countries with the highest consumption of benzodiazepines and antidepressants, and it is a long-standing pattern rather than a recent fluctuation. **Second:** access to psychotherapy in the public health service is limited. The number of psychologists per inhabitant has historically sat below what the World Health Organization recommends, and waiting times for psychology appointments are long across much of the country. The simplest reading is the most uncomfortable: when a psychological response is not available in useful time, **the pharmacological one is what remains**, and it is frequently given by someone who did not want to be the only response available, in the short time of a general practice appointment. ## The space this opens, and the risk it carries Between "do nothing" and "medicate" there is a large space. It is where support groups, exercise, structured activity, psychoeducation, contact with nature, and technology, live. It is a legitimate space. And precisely for that reason, **it is the space where illusions are easiest to sell**: someone suffering and without access buys hope, and plenty of people are selling. Worth saying that a complementary response is not an alternative. A prescribed anxiolytic and a relaxation session are not in competition, and presenting the second as a way of avoiding the first is a clinical decision that does not belong to a supplier. ## What RVer is, and is not, in this conversation Being explicit, because imprecision does harm here: - **It is not mental health treatment.** The base product is a Class I medical device registered in EUDAMED and with INFARMED (Portugal), used as a **non-pharmacological complement** for comfort, distraction and relaxation, under health team supervision. - **It does not replace psychotherapy, consultation or medication.** - **It does not assess, classify or diagnose** emotional states. There is no wellbeing score. - **It is not for self-administration.** The intended purpose requires supervision: which makes it, by design, unsuitable as an individual response for someone on a waiting list. **What exists:** literature on immersive environments in anxiety and stress, mostly in concrete situations: the moment before a procedure, an inpatient stay, an institutional setting. We gathered it in the [study library](/estudos/en/), where relaxation, stress and anxiety is among the best represented themes. And we have written about [pre-operative anxiety](/blog/realidade-virtual-ansiedade-pre-operatoria/en/), which is the best supported case. There is one exception worth naming precisely: **graded exposure** in phobias and post-traumatic stress disorder has its own, older body of research, always conducted by professionals. In our case that is [RVer Exposure](/blog/realidade-virtual-tratamento-fobias/en/): a module **in development and not covered by the registration**, in which the clinician picks the level and sets the pace, with no automatic progression, no score and no grading. ## Where it makes sense, and where it does not **It makes sense** inside a service already following the person: an inpatient stay, a day hospital, a unit, a care home. There is a professional, continuity and a record. **It does not make sense** as a response for someone on a waiting list with no follow-up. Not because the equipment does not work: because **that is not what it is**, and because the absence of follow-up is precisely the problem no equipment solves. If someone presents virtual reality to you as a way of reducing mental health waiting lists, that is the moment to ask which studies support it. We have none to give you. ## In short - **High psychotropic consumption and limited access to psychotherapy** are the same problem seen from two sides. - **The space for complementary responses is real**, and it is where hope is most sold. - **Complementary is not alternative**, and decisions about medication do not belong to a supplier. - **RVer does not treat, does not assess and does not replace** consultation or psychotherapy. - **Where a team is following the person, it makes sense. On a waiting list, it does not.** Q: Can virtual reality replace psychology appointments or medication? A: No, and we do not claim it. The base product is a Class I medical device used as a non-pharmacological complement for comfort, distraction and relaxation, under health team supervision. It does not treat, assess or diagnose, and does not replace consultation, psychotherapy or prescription. A complementary response is not an alternative. Q: Is it useful for someone on a psychology waiting list? A: No, and the reason is design rather than efficacy: the intended purpose requires supervised use, which makes it unsuitable as an individual response for someone without follow-up. It makes sense inside a service already following the person (inpatient stay, day hospital, unit or care home) where there is a professional, continuity and a record. Q: What about graded exposure in phobias and PTSD? A: It has its own, older body of research, always conducted by professionals. In our case it corresponds to the RVer Exposure module, which is in development and not covered by the medical device registration, and in which the clinician picks the level and sets the pace, with no automatic progression, no score and no grading. ### Pain clinics: where virtual reality fits, and where it does not URL: https://rver.pt/blog/consulta-da-dor-onde-entra-a-realidade-virtual/en/ Date: 21 August 2026 A pain unit receives people who have been through several doctors and several attempts. It is the context where a new promise is most welcome and where making one carelessly is most irresponsible. Pain clinics and pain units see patients at a specific point in their journey: they have seen several doctors, tried several things, and many have been told there is nothing more to be done. It is a context where any new proposal is met with hope, which is why it deserves the greatest care. There is one distinction that decides almost everything that follows. ## Acute and chronic pain are not the same conversation **Acute pain** (of a procedure, a dressing change, a cannulation) is an event with a beginning and an end. Attention is a limited resource, and occupying it for those minutes has documented effect. **This is where the most consistent evidence for virtual reality in health sits**, and we develop it in [pain management](/blog/realidade-virtual-gestao-da-dor/en/). **Chronic pain** is something else. It is not acute pain that went on: it involves changes in pain processing, fear of movement, avoidance, disturbed sleep, mood, and a life gradually organised around the pain. Distracting someone for twenty minutes changes none of that. Confusing the two is this sector's most common commercial error. **The evidence for the first is used to sell into the second.** ## What a pain unit does, and where this might fit A modern approach to chronic pain is multimodal: medication where indicated, exercise and reactivation of movement, a psychological component, pain education, sleep hygiene, and work on function rather than on intensity. If virtual reality has a place, it is **inside one of those components**, not alongside them: - **During procedures done in the unit**: injections, blocks, device placement. This is acute pain, and the good evidence applies. - **In supporting movement**, for those avoiding it out of fear. The obstacle is frequently fear rather than capacity. A necessary note: that corresponds to the **RVer Motion** module, which is **in development and not covered by the** Class I medical device registration. - **As a relaxation component**, inside a plan that already exists and run by whoever runs it. ## Where the evidence is weak, and it should be said In chronic pain, existing studies are mostly **small, short and heterogeneous**: different populations, different protocols, different outcomes. Several show improvements during the session that do not persist afterwards. That is an interesting signal, and not the same thing as lasting clinical effect. We gathered what exists in the [study library](/estudos/en/), where pain is among the best represented themes, and reading the list is more useful than any claim from us. Where the evidence does not support something, we say so there too, as we did in [what cannot be proven](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). **What we do not claim, and will not:** that RVer reduces chronic pain, that it reduces analgesic use, or that it replaces any component of a pain plan. The base product is a Class I medical device used as a **non-pharmacological complement**, under supervision. It does not assess pain, measure it or classify it. ## The specific risk in this population Worth naming, because it differs from other settings: **these people have been disappointed several times already.** A proposal presented with too much enthusiasm, which then does not deliver, is not neutral: it reinforces the idea that nothing works, and it costs credibility to whoever presented it, which is the team and not the supplier. So if you are going to test, it is worth telling the patient exactly what to expect: **"this may make this procedure easier"** is one thing; **"this may help with your pain"** is another, and the second does not hold. ## What a unit can test without promising anything 1. **One concrete procedure** already done in the unit, compared with usual care. 2. **Refusals and interruptions**, where problems appear first. 3. **Function, not intensity.** What the person can do is more informative than a number on a scale, and it is what the unit already tends to measure. 4. **Three months**, not three weeks. ## In short - **The good evidence is in acute pain**, and it is frequently used to sell into chronic pain. - **Chronic pain is multimodal**: if this enters, it enters inside a component. - **In chronic pain the studies are small and short**, with effects that often do not persist. - **We claim no reduction in pain or in analgesics.** - **Over-promising to this population costs the team credibility**, not the supplier. Q: Does virtual reality reduce chronic pain? A: We do not claim that. The most consistent evidence is in acute pain, particularly during procedures, where occupying attention has documented effect. In chronic pain the existing studies are mostly small, short and heterogeneous, and several show improvements during the session that do not persist afterwards. Q: What is the difference between acute and chronic pain here? A: Acute pain is an event with a beginning and an end, and occupying attention during those minutes has documented effect. Chronic pain involves changes in pain processing, fear of movement, avoidance, sleep and mood, and a life organised around the pain. Distracting for twenty minutes does not change that, and using the evidence for the first to sell into the second is the sector's most common commercial error. Q: Where can it fit in a pain unit? A: Inside a component of the plan rather than alongside it: during procedures done in the unit, such as injections or blocks, where acute pain evidence applies; in supporting movement for those avoiding it out of fear, noting that this corresponds to the RVer Motion module, in development and not covered by the registration; and as a relaxation component within an existing plan. ### Types of dementia: what they are, how they differ and what changes in a session URL: https://rver.pt/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/ Date: 21 August 2026 "Dementia" is not a disease: it is a group of signs that several diseases can cause. The main types are Alzheimer's, vascular, Lewy bodies, frontotemporal and mixed. How each one starts, what sets them apart, and what each one changes in a virtual reality session. "Dementia" is not a disease. It is the name for a group of signs (loss of memory, language, orientation, independence) that several different diseases can cause. The main types of dementia are **Alzheimer's disease**, **vascular dementia**, **dementia with Lewy bodies**, **frontotemporal dementia** and **mixed dementia**, when there is more than one cause at the same time. There are other, less frequent ones, such as Parkinson's disease dementia or alcohol-related dementia. And mild cognitive impairment, often confused with them, is not dementia. Knowing which one lies behind it changes what to expect, what to do and what to avoid. This guide brings together the most frequent types, the first signs of each and what sets them apart, and then what each one changes in a virtual reality session. It does not replace a medical assessment: diagnosis always belongs to a doctor, usually in neurology or psychiatry, and depends on tests no article can carry out. ## How many people live with dementia According to the [World Health Organization](https://www.who.int/news-room/fact-sheets/detail/dementia), 57 million people were living with dementia worldwide in 2021, with nearly 10 million new cases every year. It is now the seventh leading cause of death globally and one of the main causes of dependency among older people. It is not confined to old age: young-onset dementia, starting before 65, accounts for up to 9% of cases. In Portugal, [Alzheimer Portugal](https://alzheimerportugal.org/wp-content/uploads/2026/07/CI_Evento-Alzheimer-AR_20.07.2026.pdf) estimates that 238,401 people were living with dementia in 2025, 2.29% of the population, above the European average (1.77%). The projection for 2050 is almost 368,000. ## The most common types of dementia, side by side | Type | Frequency | Typical first signs | How it usually progresses | |---|---|---|---| | **Alzheimer's disease** | The most common: 60 to 70% of cases (WHO) | Forgetting recent events, repeating questions, misplacing things | Gradual and steady, over years | | **Vascular dementia** | The second most common | Slowed thinking, difficulty planning and deciding, changes in walking | Often stepwise: stable periods and sudden worsening | | **Dementia with Lewy bodies** | Less common; can be mistaken for Alzheimer's or Parkinson's | Visual hallucinations, fluctuating alertness, stiffness and tremor | Fluctuating: very different days, or hours | | **Frontotemporal dementia** | Less common, but an important cause before 65 | Changes in behaviour and personality, or difficulty with language | Starts earlier; memory may be spared at first | | **Mixed dementia** | Common at older ages | A combination of the above, mostly Alzheimer's with vascular | Depends on the diseases combined | ## Alzheimer's disease The most frequent cause of dementia. It results from a build-up of abnormal proteins in the brain (beta-amyloid plaques and tau tangles), which progressively damage and destroy nerve cells, often starting in the hippocampus, the area involved in laying down new memories. **First signs.** Memory for recent events fails before older memory: the person repeats the same question, forgets yesterday's conversation, yet remembers the village where they grew up in detail. Then come difficulties finding words, finding their way in familiar places and managing tasks such as money or medication. **Progression.** Slow and steady, usually over several years, through mild, moderate and advanced stages. ## Vascular dementia Caused by reduced blood flow in the brain: a stroke, several small infarcts, or small vessel disease over time. Not everyone who has a stroke goes on to develop dementia. The risk factors are largely those of the heart: high blood pressure, diabetes, cholesterol, smoking. **First signs.** More than memory, it is the speed and organisation of thinking that fails: difficulty planning, following a sequence of steps, concentrating and making decisions, sometimes with short spells of sudden confusion. Changes in walking, falls and mood changes are common. **Progression.** Often stepwise: periods of stability interrupted by sudden worsening, which may coincide with new damage. Variation within a single day can also be large. ## Dementia with Lewy bodies Named after abnormal deposits of a protein (alpha-synuclein) inside nerve cells, the Lewy bodies. It is closely related to Parkinson's disease and shares several of its signs, including difficulty with movement and a higher risk of falls. **First signs.** Very vivid visual hallucinations (people, animals), often from early on; marked fluctuations in attention and alertness; Parkinson-like motor signs; and sleep disturbances in which the person "acts out" their dreams, talking or moving. **Progression.** Fluctuating: the same person may be lucid in the morning and very confused in the afternoon. It is also a dementia with particular sensitivity to some antipsychotic medicines, which makes a correct diagnosis especially important. ## Frontotemporal dementia It mainly affects the frontal and temporal lobes, the areas linked to behaviour, personality and language. It usually starts earlier than the others, most often diagnosed between 45 and 65, which makes it an important cause of dementia in younger people. It is also the one most likely to run in families. **First signs.** It depends on the form: - in the **behavioural variant**, personality changes, disinhibition, loss of empathy, apathy, repetitive behaviour or changes in eating; - in the **language variants** (primary progressive aphasias), difficulty finding words, understanding what words mean or building sentences. Memory may remain relatively preserved at first, which often delays diagnosis: the signs are mistaken for depression, stress or "just the way they are". ## Mixed dementia At older ages it is common to have more than one cause at the same time. The most frequent combination is Alzheimer's disease with vascular dementia, but there are others, such as Alzheimer's with Lewy bodies. The signs blend, and it can be hard to tell how much each cause contributes. ## Other, less common types - **Parkinson's disease dementia:** when motor symptoms come first and dementia appears years later. According to the [Alzheimer's Society](https://www.alzheimers.org.uk/about-dementia/types-dementia), around a third of people with Parkinson's eventually develop dementia. - **Alcohol-related dementia** (alcohol-related brain damage, including Korsakoff syndrome, from vitamin B1 deficiency). Unlike most dementias, it does not always get worse over time. - **Huntington's disease:** inherited, with involuntary movements and behavioural changes. - **Creutzfeldt-Jakob disease:** very rare and progressing very quickly. - **Repeated head injuries** and some **infections**, such as HIV. ## When it looks like dementia but is not Some conditions cause similar signs and can be treated. It is one of the reasons a medical assessment is essential: - **Delirium:** sudden confusion, often from an infection (urinary, respiratory), dehydration or medication. It appears over hours or days, not months. - **Depression** in older people, which can mimic memory loss. - **Vitamin B12 deficiency** and **thyroid problems**. - **Side effects of medicines**, especially when several are combined. - **Normal pressure hydrocephalus:** changes in walking, incontinence and slowed thinking. And there is **mild cognitive impairment**, which [is not dementia](https://www.nhs.uk/conditions/dementia/about-dementia/causes/): memory or thinking difficulties greater than expected for age, but not yet affecting everyday independence. It does not always progress to dementia, and sometimes has a treatable cause. We wrote about it in [Mild cognitive impairment: usable first, useful after](/blog/defice-cognitivo-ligeiro-primeiro-usavel-depois-util/en/). If forgetfulness keeps recurring, gets worse and starts to interfere with daily life, the right step is to talk to a GP. ## What changes in a virtual reality session In this sector's marketing material, "dementia" almost always appears in the singular. Anyone working in an activity room knows it is not like that: what works with one person may be irrelevant to another and uncomfortable for a third, and the diagnosis explains part of that. None of this is ours to decide: the decision always belongs to the clinical team, who know the person. What follows is what tends to change in practice, so that the conversation with whoever is offering technology can be better informed. ## In a session: Alzheimer's disease The most common, and the one with the most literature on non-pharmacological activity. Memory for recent events deteriorates before older memory, which makes [reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/) the most natural territory: childhood places, the home town, the familiar sea. In practice: **old and familiar content before new content.** A generically beautiful landscape usually yields less than a place with personal history, and biography is worth more than any catalogue. We have written in detail about [Alzheimer's](/blog/realidade-virtual-demencia-alzheimer/en/). ## In a session: vascular dementia Two features change the planning. Progression is often stepwise rather than a steady decline: stable periods and abrupt drops. And variability within a single day can be large. In practice: what went well last week may not this week, and that is nobody's failure. Worth logging the session rather than trusting the shift's memory, so the team sees the pattern instead of guessing it. Motor impairment is frequently associated, which makes position (stable seated, or [lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/)) more important than in other cases. ## In a session: frontotemporal dementia The one that least matches the stereotype. It often starts earlier, sometimes before 65, and what changes first is behaviour, language or social judgement, not necessarily memory. In practice: **the person may understand perfectly and still refuse abruptly**, or lose interest halfway through without warning. That is not negotiated. It is also the population where it is easiest to misread signals: a flat reaction does not mean nothing is happening, and an intense one does not mean discomfort. And since many of these people are younger, reminiscence content "for older people" is inappropriate: the biography belongs to another generation. ## In a session: Lewy body dementia, and here caution is greater This deserves its own section, because it has features that interact directly with what an immersive experience does. **Visual hallucinations** are frequent and part of the picture, often from early on. There are also disturbances of visual perception and visuospatial processing, marked fluctuations in alertness through the day, and frequently parkinsonian motor signs. Placing an immersive display in front of someone whose visual perception is altered is not a neutral decision. We have no evidence of harm, and equally no evidence of safety in this population: what exists is reason for added caution and for the decision to be made by whoever knows the case, with close observation and short sessions, if at all. The neuroleptic sensitivity that characterises this dementia is unrelated to this, but it is a reminder that this is a picture where reactions depart from the expected. If there is one sentence to take from this article: a supplier presenting virtual reality as good for "dementia" without distinguishing Lewy body has not studied the subject. ## What is common to all - **The person, not the diagnosis**, decides the content. Diagnosis helps anticipate; biography chooses (the [life story form](/en/ferramentas/historia-de-vida/) helps gather it). - **Short sessions**, shorter than in other contexts. - **Someone familiar alongside**, talking. The voice is part of the session. - **Stop at the first sign**, and [refusal is not negotiated](/blog/quando-o-utente-recusa-realidade-virtual/en/). - **Log what was observed** in the words of what was seen, not in conclusions. ## What RVer does not do Worth being explicit: **it does not assess, classify or diagnose.** It does not distinguish types of dementia, does not suggest content based on diagnosis, and does not measure response. The AI-assisted feature helps find a scenario from the kind of moment the team describes, and the choice always belongs to the team. RVer is a Class I medical device (registered in EUDAMED, Basic UDI-DI 56006195127RVERTZ, and with INFARMED in Portugal, CDM 94571546), used as a non-pharmacological complement and always under the team's supervision. It does not treat any type of dementia or replace medical care. What is described here refers to the base product; modules in development are not covered. And the literature, which we gathered in the [library](/estudos/tema/qualidade-de-vida/en/), is mostly about **wellbeing and reminiscence in mild to moderate dementia**. For advanced stages, and for Lewy body in particular, it is thin. ## In short - **"Dementia" is a group of signs with several causes**, and the cause changes what to expect. In the singular, it is a commercial simplification. - **Alzheimer's:** the most common (60 to 70% of cases); starts with recent memory. In a session: reminiscence, old and familiar content. - **Vascular:** slowed thinking and difficult planning; stepwise progression. In a session: log rather than trust memory. - **Frontotemporal:** behaviour or language first; starts earlier. In a session: abrupt refusal, a different generation's biography. - **Lewy body:** visual hallucinations and fluctuations. In a session: greater caution, and no evidence of safety in this population. - **Mixed:** frequent at older ages, mostly Alzheimer's with vascular. - **Mild cognitive impairment is not dementia**, and some treatable conditions mimic it. Diagnosis is always medical. ## Sources - World Health Organization, [*Dementia*](https://www.who.int/news-room/fact-sheets/detail/dementia), fact sheet. - Alzheimer Portugal, [press release of 20/07/2026](https://alzheimerportugal.org/wp-content/uploads/2026/07/CI_Evento-Alzheimer-AR_20.07.2026.pdf) (prevalence in Portugal, 2025 and 2050; in Portuguese). - NHS, [*Causes of dementia*](https://www.nhs.uk/conditions/dementia/about-dementia/causes/). - Alzheimer's Society, [*Types of dementia*](https://www.alzheimers.org.uk/about-dementia/types-dementia). Q: What are the main types of dementia? A: The most frequent are Alzheimer's disease (60 to 70% of cases, according to the WHO), vascular dementia, dementia with Lewy bodies and frontotemporal dementia. At older ages it is common to have more than one cause at once (mixed dementia). Less common types include Parkinson's disease dementia and alcohol-related dementia. Q: What is the difference between dementia and Alzheimer's? A: Dementia is the name for the group of signs (loss of memory, language, orientation, independence); Alzheimer's disease is the most frequent cause of those signs. Alzheimer's is a type of dementia, but not all dementia is Alzheimer's. Q: Is mild cognitive impairment dementia? A: No. It describes memory or thinking difficulties greater than expected for age that do not yet affect everyday independence. It does not always progress to dementia and sometimes has a treatable cause. Anyone noticing forgetfulness that recurs and worsens should talk to a GP. Q: Is dementia hereditary? A: In most cases, not directly. There are rare forms with a clear genetic cause, mainly early-onset Alzheimer's, frontotemporal dementia (the type most likely to run in families) and Huntington's disease. Having a relative with dementia does not make it inevitable. Q: Can virtual reality be used in any type of dementia? A: The decision is always clinical and case by case. What changes between types matters: in Alzheimer's, reminiscence is the most natural territory; in vascular dementia there is large day-to-day variability; in frontotemporal dementia refusal can be abrupt and the person is often younger. In Lewy body dementia, where visual hallucinations and altered visual perception are frequent, added caution is warranted. ### Panic buttons, sensors, headsets: which technology solves which problem URL: https://rver.pt/blog/que-tecnologia-para-que-problema-idosos/en/ Date: 21 August 2026 Five product categories, sold at the same trade fairs, to the same buyers, with the same brochures. They solve completely different problems, and buying in the wrong order is the sector's most common waste. A care home manager, or a family organising support for someone at home, receives proposals for very different things in similar packaging: panic buttons, sensors, cameras, tablets, apps, headsets. All of them claim to improve older people's lives. The problem is that they **solve different problems**, and the useful question is not "which is best": it is **what is my problem**. ## The five problems **1. Safety.** Someone falls, leaves the house at night, leaves the hob on. **2. Autonomy.** Someone needs help remembering, orienting, managing the day. **3. Communication.** Someone is far from their family. **4. Occupation.** The fourteen waking hours of every day. **5. Clinical moment.** A procedure, a session, one concrete difficult moment. Almost every buying error we see is a product from one row bought for another row's problem. ## The map | Problem | What solves it | What it does not solve | |---|---|---| | Safety | Telecare with a button, fall sensors, door and hob sensors | Does not fill the day or improve the experience of anything | | Autonomy | Medication dispensers, reminders, watches with location | Does not replace presence or supervision | | Communication | Simplified video calling, tablets with reduced interfaces, digital frames | Is not company; see [loneliness and isolation](/blog/solidao-isolamento-social-idosos-tecnologia/en/) | | Occupation | Activities, tablets with games, music, and yes, virtual reality | None of them occupies with nobody nearby, if supervised | | Clinical moment | Virtual reality for clinical use, under supervision | Does not replace the team, and is not for monitoring | Notice something: **the panic button and the headset do not compete.** They are in different rows. Choosing one instead of the other is like choosing between a fire extinguisher and a chair. ## The order that makes sense If the budget is limited, and it always is, there is a defensible order: **Safety first.** It is the only category where failure has irreversible consequences. A fall nobody knows about for hours is a different order of seriousness from a boring afternoon. It is also the cheapest category. **Then communication.** It costs little, solves a real and immediate problem, and is what families most appreciate. **Then occupation.** This is where most of everyday quality of life lives, and it is the most neglected category: precisely because its failure produces no incident to report. **Finally, the clinical moment.** It makes sense when there is a team, a concrete case, and once the previous three are settled. **We are in the fourth row**, and sometimes the third. If someone has an unsolved safety problem, buying a clinical system first is the wrong choice, and we say so. ## Five questions to separate the wheat from the chaff They apply to any supplier in these five categories, including us: 1. **Which of the five rows is yours?** If the answer is "all of them", it is none. 2. **Does it work with nobody present?** That changes everything. A sensor works; a supervised session does not. 3. **Does it need internet? And if that fails?** 4. **Who installs, who trains, and who answers the phone when it breaks?** 5. **What happens to the data, and who is the controller?** That is a [GDPR](/blog/privacidade-rgpd-realidade-virtual-saude/en/) question, and cameras and sensors raise it more sharply than a headset collecting no clinical data. ## The special case of cameras Deliberately left out of the table, because it deserves a note: video surveillance in bedrooms solves a safety problem at the cost of a dignity and data protection problem. It is a decision requiring its own framework and consent, and it is not comparable with the other rows. If someone sells you a camera as "wellbeing monitoring", you are buying surveillance under another name. ## In short - **Five problems, not one.** The question is which is yours, not which product is best. - **Safety first**, because it is the only one whose failure is irreversible, and it is the cheapest. - **Occupation is the most neglected**, because its failure generates no incident. - **The panic button and the headset do not compete.** - **If safety is not settled, do not buy ours first.** Q: What should you buy first to support an older person? A: Safety, because it is the only category whose failure has irreversible consequences and it is also the cheapest: telecare with a button, fall sensors, door and hob sensors. Then communication, then occupation of the day, and finally solutions for concrete clinical moments, which make sense once there is a team and a defined case. Q: Are a panic button and a virtual reality system alternatives? A: No, they solve different problems. A panic button answers safety: someone falls or needs immediate help. A clinical virtual reality system answers occupation of the day and concrete clinical moments, under supervision. Choosing between them is like choosing between a fire extinguisher and a chair. Q: What about cameras in bedrooms? A: They solve a safety problem at the cost of a dignity and data protection problem, and require their own framework and consent. They are not comparable with the other categories. If presented as wellbeing monitoring, that is surveillance under another name. ### Guided meditation or virtual reality: when an app is enough URL: https://rver.pt/blog/meditacao-guiada-ou-realidade-virtual-qual-usar/en/ Date: 21 August 2026 It is the question a sensible management team asks, and one almost no supplier answers honestly: if the goal is to help someone settle, why not a five-euro-a-month app? If the goal is helping someone settle, there is an option costing a few euros a month, fitting on a phone that already exists and needing nobody's authorisation: a **guided meditation app**. It is a legitimate question, and answering it with "but ours is immersive" is not an answer. Worth separating what the two things actually do. ## They do not do the same thing **Guided meditation** is an **active** practice. It asks for directed attention, following an instruction, returning to the breath when the mind wanders. The work belongs to the person; the voice is scaffolding. It has a considerable body of evidence, particularly in adults able to follow verbal instruction. **An immersive environment** is largely **passive**. It asks for no task: the person is somewhere else, and the proposed mechanism is attention being occupied by the environment, not trained. That is why the most consistent literature in health is about **distraction** during procedures, not attention training. This difference decides almost every case. ## Where guided meditation wins, and clearly - **Cost.** A few euros a month against a system. No argument. - **Autonomy.** The person does it alone, at home, whenever. A medical device with [mandatory supervision](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/) does not compete here and should not pretend to. - **Evidence in adults.** An older and more solid base. - **Nothing to install, clean or charge.** No [hygiene routine](/blog/higiene-seguranca-equipamento-realidade-virtual/en/), no battery, no cupboard. - **Zero risk of motion sickness.** ## Where it falls short - **When the person cannot follow verbal instruction.** This is the central case. In moderate to advanced dementia, in acute confusion, in delirium, "notice your breathing" is not an accessible instruction. The app assumes a capacity that is no longer there. - **When the problem is the moment, not the state.** During a cannulation, a dressing change or a dialysis session, the goal is not training attention: it is occupying it, now, without effort from the person. - **When there is no space.** On a six-bed ward with a television and trolleys, the app competes with the environment. The environment wins. - **When memory is the point.** An app takes nobody to the town where they were born; [reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/) needs concrete, personal imagery. ## The four situations where the answer is the app We say this as the manufacturer of the other product, and we mean it: 1. **Autonomous adults with mild anxiety**, able to practise on their own. 2. **Health professionals**, for themselves. If the problem is [team burnout](/blog/realidade-virtual-burnout-profissionais-saude/en/), an app each person uses when they want is more practical than scheduling shared equipment. 3. **When there is no budget and you have to start somewhere.** Starting small beats not starting. 4. **When there is nobody to run sessions.** Without someone to run them, a supervised system does not work, and we say so before selling. ## And there is an answer that is neither Worth saying, because it gets forgotten: for many people, what works is a person sitting alongside and talking, familiar music, or going out to the garden. It has no supplier, no licence and appears in no deck. If it works, it is the right answer. ## How to decide, in three questions 1. **Can the person follow a verbal instruction and hold it for a few minutes?** If yes, start with the app. 2. **Is the goal a specific difficult moment, or a general state?** A moment points to immersive; a state points to regular practice. 3. **Is there someone to run it and somewhere to keep the equipment?** If not, the previous question is academic. ## In short - **They do not do the same thing:** one trains attention, the other occupies it. - **The app wins on cost, autonomy and simplicity**, and there is no point pretending otherwise. - **It falls short when the capacity to follow instruction is missing**, which is the most frequent case in the settings we work in. - **In four concrete situations, the app is the right choice.** - **Sometimes the answer is no technology at all.** Q: Does a guided meditation app replace virtual reality? A: In several cases yes, and it is the right choice: autonomous adults with mild anxiety, health professionals for their own use, situations without budget, and situations where there is nobody to run sessions. The two do not do the same thing: guided meditation is an active practice asking for directed attention, while an immersive environment is largely passive and occupies attention without asking for a task. Q: When is guided meditation not enough? A: Mainly when the person cannot follow verbal instruction, which happens in moderate to advanced dementia, acute confusion or delirium. Also when the goal is a specific difficult moment, such as a cannulation or dressing change, where attention needs occupying without effort from the person, and when the concrete personal imagery of reminiscence is what matters. Q: Which of the two has more evidence? A: Guided meditation has an older and more solid body of evidence in adults able to follow verbal instruction. The most consistent literature on virtual reality in health is about distraction during procedures rather than attention training. They are different bases for different goals. ### Choosing a care home: the questions about activities almost nobody asks URL: https://rver.pt/blog/escolher-um-lar-perguntas-sobre-atividades/en/ Date: 21 August 2026 A care home visit lasts an hour and decides years. Almost all of that hour goes on looking at facilities, the part easiest to improve and the part that says least about how life is lived inside. This article is about a hard hour: visiting a care home with a relative at home waiting on a decision. We wrote it for families, but it also serves whoever runs an institution: because these are the questions they will start hearing, and it is worth having answers. One note of honesty upfront: we manufacture a system used in care homes. None of the questions below is about our product, and most good institutions answer them well with no technology at all. ## What almost everyone asks Single or shared room, menu, price, distance, whether there is a doctor. Necessary questions and insufficient ones: they are all about **facilities and contract**, the visible part and the easiest to arrange for a visit. What decides someone's life inside is different: **what happens between meals.** A day has fourteen waking hours. ## The twelve questions **About the day** 1. **What are most people doing right now?** Ask it while looking at the room. The best answer matches what you can see. 2. **How many hours a day is the television on in the common room?** Not to condemn television. To understand whether it is the programme or the ambience. 3. **What happens between 3pm and 6pm?** It is the window where agitation most often appears in people with dementia, and where the difference between institutions is largest. We have written about [sundowning](/blog/agitacao-fim-da-tarde-demencia-sundowning/en/). 4. **Who does not leave their room, and why?** Every institution has those residents. The good answer names them and explains; the bad answer is that there are none. **About activities** 5. **Who plans the activities, and with what training?** 6. **What do you do with those who do not join in?** The most revealing question on the list. A plan only for those already joining in is half a plan. 7. **Are there individual activities, or only group ones?** People with advanced dementia, hearing loss, or who simply dislike groups fall outside programmes that are group-only. 8. **Is it recorded what each person did?** Or is the record only medication and incidents? Without a record, nobody can say in three months whether anything changed. **About family and the person** 9. **How do you find out what this person used to enjoy?** Is there a life-history conversation, or an admission form? Biography is the only thing that makes an activity personal. 10. **What are the visiting hours, and what happens outside them?** 11. **How does the family in England speak to her?** Half of Portuguese families have someone abroad. If the answer is "we have the phone in the lounge", that is an answer. 12. **Who calls me if something changes, and how quickly?** ## Signs that should worry you - **"We have activities every day" without being able to describe yesterday's.** - **An activity plan on the wall, out of date.** It says more than no plan at all. - **Everyone seated in rows facing the same direction**, at any hour. - **No answer about those who do not join in.** - **Technology displayed on the visit with no agreed use.** True of our equipment as much as anyone's: if it is on a shelf impressing visitors, it is not being used. ## About technology, frankly If they show you equipment, virtual reality or anything else, ask three simple questions: **how many sessions last month, who runs them, and where is that recorded.** If there is no answer to those three, the equipment is decoration. And the reverse is also true: **a care home with no technology at all can be excellent.** What distinguishes them is not equipment, it is having someone who knows the person's name, what they used to enjoy, and what they did yesterday. ## In short - **The visiting hour is spent almost entirely on what matters least.** - **The most revealing question is what they do with those who do not join in.** - **Without a record of what each person does, nobody can prove anything**, good or bad. - **Equipment with no counted sessions is decoration.** - **A good care home without technology beats a bad one with it.** Q: What should you ask when visiting a care home? A: Beyond the room, the menu and the price, it is worth asking what most people are doing at that moment, what happens between 3pm and 6pm, who does not leave their room and why, what they do with residents who do not join in activities, whether there are individual activities as well as group ones, and whether what each person did is recorded. Q: What is the clearest warning sign on a visit? A: No answer about those who do not join in. An activity plan serving only those already participating is half a plan, and the residents who stay in their rooms are exactly the ones whose day depends most on the institution. An out-of-date plan on the wall also says more than no plan at all. Q: Is a care home with technology better than one without? A: Not necessarily, and we say so as manufacturers. If they show you equipment, ask how many sessions were run last month, who runs them and where it is recorded. Without answers to all three, the equipment is decoration. A good care home with no technology beats a bad one with it. ### Virtual reality in the emergency department: the question we get and the answer we give URL: https://rver.pt/blog/realidade-virtual-nas-urgencias-o-que-respondemos/en/ Date: 21 August 2026 It is the suggestion that comes up in every conversation about hospital waiting, and it is seductive: if people have been there six hours, why not give them a better place to be? The short answer is that the waiting room is the worst possible place. Emergency department waiting times are among the most searched health topics in Portugal, and the suggestion always follows: if people are waiting for hours, why not fill that time with something better? We get the question often. The honest answer has two parts, and the first is unwelcome. ## The waiting room is the worst place It is not a matter of willingness. Five things fail at once: **1. There is nobody to supervise.** This is the obstacle that comes before all others. The system's intended purpose requires [supervised use](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/), and in a waiting room nobody is available to supervise. Without that it is not a session: it is a lent device. **2. The patient needs to see and hear what is happening.** They are waiting to be called. Equipment that covers vision and hearing is exactly the opposite of what that moment requires, and the first missed call ends the experience for everyone. **3. Clinical status is not yet established.** A waiting room holds people with nausea, dizziness, unassessed head injury, intoxication. It is the population where least is known about who can use it, and triage was not designed to answer that question. **4. Hygiene and turnover.** Equipment shared between strangers, with a [cleaning routine](/blog/higiene-seguranca-equipamento-realidade-virtual/en/) between each, in a room seeing dozens of people an hour. The arithmetic does not work. **5. It does not solve the problem.** And this matters most: **the waiting time is unchanged.** Emergency waiting is a problem of capacity, flow and staffing. No equipment touches it. Anyone selling you virtual reality as an answer to waiting times is selling something else under the wrong name. ## Where the answer is yes Inside the same department there are moments with all the conditions the waiting room lacks: a professional present, the patient already seen, and a concrete goal. **1. Painful or frightening procedures.** Suturing, line placement, cannulation, foreign body removal, burn dressing. This is where the most consistent literature in health sits: **distraction during the procedure**, particularly in children. We have written about [needle fear](/blog/realidade-virtual-medo-de-agulhas-procedimentos/en/) and about [paediatrics](/blog/realidade-virtual-pediatria-criancas/en/). **2. Waiting on a trolley already inside the department**, with the patient assigned to a team. Here there is supervision and continuity. It is different from the general waiting room, even if the word "waiting" is the same. **3. Patients under prolonged observation.** When someone stays for some hours under observation with an assigned team, the same reasoning as an inpatient stay applies. ## What to ask before going ahead If you run an emergency department and want to try, three questions settle most of the conversation: 1. **Who runs the session, on each shift?** If the answer is "whoever can", there is no project. It is the [first of the six yeses](/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/en/). 2. **At exactly which moment, and for which patients?** "In the ED" is not a use case. "During suturing, in children aged 4 to 12" is. 3. **Where does the equipment live, and who cleans it between patients?** In an emergency department this weighs more than anywhere else. ## A note on what to measure If you run a pilot, **do not measure waiting time.** It will vary for reasons unconnected to you, and attribution is impossible. Measure what is close to the procedure: how often it had to be repeated, whether restraint or sedation was needed, and what the team observed. We develop that in [“The ROI that cannot be proven”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## In short - **In the waiting room, no.** Supervision, environmental awareness, adequate triage and hygiene all fail, and none of it is workable around. - **Waiting time does not change.** It is capacity and flow, not technology. - **During procedures, yes**, and that is where evidence is most consistent, particularly in children. - **"In the ED" is not a use case.** The exact moment is. Q: Does virtual reality reduce emergency department waiting times? A: No. Waiting time is a problem of capacity, flow and staffing, and no equipment touches it. Anyone presenting virtual reality as an answer to waiting times is describing something else under the wrong name. Q: Why is the waiting room not suitable for a session? A: Five conditions fail at once: there is nobody to supervise and the intended purpose requires supervision; the patient needs to see and hear in order to be called; clinical status is not yet established, with nausea, dizziness or unassessed injury present; a hygiene routine between strangers is unworkable at emergency department pace; and the waiting time is unchanged regardless. Q: Where does it make sense inside an emergency department? A: In three moments with a professional present and a concrete goal: during painful or frightening procedures such as suturing, cannulation or burn dressing, particularly in children, which is where the literature is most consistent; while waiting on a trolley already inside the department with an assigned team; and in patients under prolonged observation. ### When the patient refuses, or the first session goes badly URL: https://rver.pt/blog/quando-o-utente-recusa-realidade-virtual/en/ Date: 20 August 2026 Almost all material about this technology describes sessions that go well. It is worth talking about the others: because they decide whether a team keeps offering or quietly gives up. There is a number nobody publishes: the proportion of times a session is offered and the person says no. In the practice of the teams we work with, it is not rare. And what happens next matters more than the refusal itself. The most common reflex is to treat it as an obstacle: insist, persuade, "just try it for a moment". It is the worst route available, for a practical reason before an ethical one: **someone talked into a session they did not want refuses every future one**, and takes the rest of the ward with them. ## Seven reasons, and what changes in each Worth separating, because only three resolve by changing something. **1. They did not understand what it is.** The most frequent, and the easiest. "Virtual reality goggles" means nothing to someone who has never seen a pair. Show the equipment, let them touch it, explain it comes off at any moment. Often the no becomes a yes here, and not through insistence, but through information. **2. They fear being left in the dark or trapped.** Legitimate and common, especially among older people. Answer with facts: they stay where they are, someone stays beside them, it comes off with one hand. **3. It is not a good moment.** Pain, nausea, a visitor waiting, having just been repositioned. This is not a refusal of the technology: it is a refusal of **now**, and offering at another moment is the right response. **4. They do not like what was offered.** A beach scene for someone with bad memories of the sea. Here you change the scenario, not the conversation. **5. They do not like the thing.** Some people simply do not want a device on their face, and that needs no justification. It is a preference, to be respected like any other. **6. They are exercising control.** In a life where almost everything is decided by others, saying no to something optional may be the only choice available that day. Insisting removes exactly what was being exercised. **7. There is a clinical reason.** It should have been picked up earlier, and there are [situations where it is not the right offer](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). ## The three that resolve Only reasons 1, 2 and 4 resolve by changing something: information, safety, content. The other four resolve by **accepting**. Knowing which one you are in is the competence that matters here, and no trick replaces it. ## When the session starts and goes badly Different from refusal, and more delicate. The person agreed, put it on, and halfway through there is discomfort, confusion or agitation. The sequence is always the same, and is worth writing down before it is needed: 1. **Stop.** Do not ask whether they want to stop: stop. Ask afterwards. 2. **Remove the headset** and give orientation back: say where they are, who is there, what time it is. 3. **Stay.** The minutes afterwards matter more than the session. 4. **Log what happened**, including at what point. That is what stops the next person repeating the same offer blindly. 5. **Do not offer again the same day.** Worth distinguishing [motion sickness from emotional discomfort](/blog/conforto-e-enjoo-realidade-virtual/en/): the first has physical signs and resolves by sitting and waiting; the second asks for presence and conversation, and sometimes asks that it not be repeated. ## What this requires of whoever offers One thing, and it is not technical: **whoever offers has to be genuinely willing to hear no.** If the session is being offered because there is purchased equipment that has to show usage, the person in front of you notices. They always notice. It is also why [consent](/blog/consentimento-informado-realidade-virtual-saude/en/) here is not a form: it is the real possibility of saying no without it costing the person anything. ## Where we do not help We have nothing that increases acceptance, and be wary of anyone claiming they do. No feature persuades anybody. What exists on our side is modest and concrete: the session stops instantly and remotely from the Companion, without whoever is running it having to reach the headset; and refusals and interruptions are logged like anything else, which surfaces patterns a shift's memory loses. A system that logged only the sessions that went well would be prettier and less useful. ## In short - **Refusal is information.** Seven reasons, and only three resolve by changing something. - **Persuading someone once costs you every future time.** - **If it goes badly: stop first, ask afterwards**, and stay. - **Log refusals and interruptions**, not just what went well. - **Whoever offers must be able to hear no**: otherwise this becomes about the equipment and not about the person. Q: What should you do when a patient refuses a virtual reality session? A: Understand the reason before responding. The most common are not having understood what it is, fearing losing sight of their surroundings, or it not being a good moment because of pain, nausea or a visitor. Only reasons of information, safety and content resolve by changing something; the rest resolve by accepting the refusal and offering at another time, or not offering again. Q: What if the first session goes badly? A: Stop immediately, without first asking whether the person wants to stop. Remove the headset, give orientation back by saying where they are and who is there, stay with them for the following minutes, log what happened and at what point, and do not offer again the same day. Q: Is it worth insisting with someone who refuses? A: No. Beyond respecting the person's decision, it has a known practical effect: someone talked into a session they did not want tends to refuse all subsequent ones. The real possibility of saying no is what sustains the offer over time. ### How long should a session last, and how often? URL: https://rver.pt/blog/duracao-frequencia-sessao-realidade-virtual/en/ Date: 20 August 2026 Everyone wants a number, and a number would suit everyone. The problem is the literature does not have one: it has ranges inherited from each study's logistics, and it is honest to say so before saying what we do. "How long should it last?" is among the first questions any team asks, and the honest answer starts with an admission: **there is no established dose of virtual reality**, in the sense that there is a dose of a drug. It is worth understanding why, because it changes how you decide. ## What the literature uses, and what that is In published work on virtual reality in health contexts, sessions usually run between **ten and twenty minutes**, with some shorter ones during procedures and some longer ones in rehabilitation. That is the range you will see quoted everywhere. What is almost never said is where that range comes from. It does not come from trials that compared durations to find the best one. It comes from **logistical decisions**: how long the procedure took, how much time the research team had, the battery life of the equipment, what someone judged a participant would tolerate. It is what fitted, not what was optimised. So when a supplier tells you "twenty minutes, twice a week", ask where that came from. It is an extrapolation from ranges in studies with different designs, different populations and different goals. We gathered the work in the [study library](/estudos/en/) precisely so that it can be checked rather than believed. ## Three situations, three different logics Grouping everything under "session duration" is the mistake. There are at least three cases and they are decided differently. **1. During a procedure.** Here duration is not a choice: it is the length of the procedure. It starts before (putting the headset on is already part of it) and ends when the procedure ends. Asking "how many minutes?" makes no sense: the answer is "as long as the cannulation, the dressing or the dialysis session takes". **2. As a moment of calm or stimulation.** Here there is a choice, and the practical rule teams converge on is short: **end before the person wants to end.** A session that finishes with someone asking for one more is the session that makes sure there is a next one. One that drags into tiredness is the one that gets refused next time. **3. In rehabilitation.** Here duration is subordinate to the exercise and to whoever is guiding it. The system does not decide, the professional's plan does, and fatigue is the real limit, not the clock. ## Frequency is a scheduling question, not a pharmacological one On "how many times a week", the honest answer is shorter still: **there is no evidence establishing an optimal frequency.** What exists is what the institution can sustain. And here is the most useful observation we have: **the frequency you keep beats the ideal frequency.** A care home doing two sessions a week for a year does more than one that plans five and gives up in the second month. The practical question is not "what is the best frequency?", it is "what is the highest frequency this team can keep up in February, with someone off sick?". ## Signals that end a session early Whatever was planned, the session ends when: - the person **asks** to stop, no negotiation, and this comes before all others; - signs of [discomfort or motion sickness](/blog/conforto-e-enjoo-realidade-virtual/en/) appear: pallor, sweating, complaints of dizziness, reaching for the chair; - the person **stops responding** to what is happening, or seems lost rather than engaged; - agitation is increasing rather than decreasing; - whoever is running it has a doubt. The doubt is enough. None of these is a failure. They are information, and they are worth more logged than remembered. ## What the log solves, and what it does not Since there is no reference dose, the only route is to look at what happens in your institution. Every session is [logged](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/): what ran, how long, when it was stopped. After a few months that is a series you can argue about: are this person's sessions systematically stopped at five minutes? Does this scenario hold attention longer than that one? **What this is not:** proof of effect. A log says what was done, not that it worked. A supplier presenting session counts as a clinical result is changing the subject: we have written about [what cannot be proven](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## In short - **There is no established dose.** The quoted 10–20 minutes is study logistics, not an optimum. - **During a procedure**, the duration is the procedure's. - **As a moment of calm**, end before the person wants to end. - **Sustainable frequency beats ideal frequency.** - **Stop signals always beat the plan**, and the doubt of whoever is running it is one of them. Q: How long should a virtual reality session last? A: There is no established dose. Published studies mostly use sessions of ten to twenty minutes, but that range reflects each study's logistics rather than an optimised duration. During a procedure the duration is the procedure's; as a moment of calm, the practical rule is to end before the person wants to end. Q: How often should sessions happen? A: There is no evidence establishing an optimal frequency. In practice the frequency a team can sustain over time is worth more than an ambitious one abandoned in the second month. The useful question is what rhythm is sustainable with the real team, including holidays and absences. Q: When should a session be stopped? A: Whenever the person asks, without negotiation; on signs of discomfort or motion sickness such as pallor, sweating or dizziness; if the person stops responding or seems lost; if agitation is increasing; or whenever whoever is running it has doubts. Stopping is not a failure and should be logged. ### The patient no longer communicates: is a session worth it? URL: https://rver.pt/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/en/ Date: 20 August 2026 It is the hardest question we get asked, and the one with the most dishonest commercial answers. It deserves an answer that admits what is not known, because the alternative is selling hope to someone deciding on another person's behalf. The question almost always arrives the same way. Someone with advanced dementia who no longer speaks, or someone in their last days. The family asks whether "that goggles thing" might do some good. And the team wants an honest answer. This is the area where hope is easiest to sell, which is why it demands the most care to write about. ## What changes when there are no words Three things at once, and it is the accumulation that makes this hard: - **There is no verbal consent.** The usual conversation (explain, ask, hear yes or no) stops being available. - **There is no account.** Nobody can say whether it was good, strange or frightening. The person's experience stays inaccessible to us. - **Observation is fallible.** We read an expression, a loosening of the shoulders, a smile. We may be reading it right. We may be reading what we want to see, and the risk is greatest precisely when we badly wanted it to go well. ## What the evidence says, and it is little Frankly: **research on virtual reality in advanced dementia and at end of life is thin.** The bulk of the dementia literature covers mild to moderate stages, with wellbeing, mood and [reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/) outcomes, and even there with small studies. For people who no longer communicate verbally, what exists is largely observational and does not support claims of benefit. **Anyone telling you there is evidence that this improves end-of-life quality is going well beyond what exists.** We gathered the work in the [study library](/estudos/en/), and the palliative and dementia themes are there with their counts on show, including when they are few. ## What stands in for consent With no informed consent in the usual sense, what exists is a combination worth naming: - **Authorisation from whoever represents** the person (family, legal representative) informed honestly, including the part about not knowing; - **Assent and dissent**: what the person expresses in the moment, without words. Turning the head away, reaching for the headset, frowning, tensing. This **counts as refusal** and is not negotiated; - **What was known about the person before.** Did they love the sea? Were they claustrophobic? Did they refuse devices? Biography is the best available source when the person can no longer answer, and it usually sits with the family. We have written about [consent](/blog/consentimento-informado-realidade-virtual-saude/en/) generally; the difference here is that dissent becomes the primary signal rather than an exception. ## The question that decides There is a question that separates caring from staging, and it is uncomfortable: > **Whose benefit are we looking for?** Sometimes the honest answer is: the family's. Seeing your mother smile at the sight of her home town is a good and legitimate thing **for the family**, and may be the only good thing that week. But it is different from saying it did your mother good, and the difference should be said out loud when deciding. We are not saying the family's benefit does not count. It does, and in palliative care the unit of care includes them. **We are saying it should be called by its name**, rather than dressed up as clinical benefit. And there is a clear limit on the other side: if the person shows discomfort and the session continues because the family wants to watch, it has stopped being care. ## If you go ahead, what makes a difference - **Short.** Much shorter than in other contexts. Minutes. - **Content from the biography**, not pretty content. Their place, not a generic beach. - **Someone trusted alongside**, talking, holding a hand. The familiar voice is part of the session. - **Position**: at end of life people are rarely sitting up. [Lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/) exists so the scene does not appear tilted to someone reclined or in bed. - **Stop at the first sign**, and the threshold here is lower than in any other context. - **Log what was observed** in the words of what was seen: "frowned", "breathing settled", not in conclusions like "enjoyed it". ## Where we stop Let us be explicit, because this is an area where the temptation to say more is strong: - **RVer does not assess comfort, pain or emotion.** There is no measurement of emotional state. What exists is the record of what the team observed and wrote. - **We have no evidence** of benefit in this population, and we will not claim any. - **We do not know** what the person is experiencing. Nobody does. What we can state is what the system allows: a scenario chosen by the team, short, stoppable remotely, with family present if that makes sense. Whether it makes sense is a clinical decision, belonging to the team and to whoever represents the person, taken case by case. ## In short - **Without words**, you lose consent, account and certainty: all three at once. - **The evidence in this population is thin** and supports no promises. - **Dissent is refusal**, and it is the primary signal. - **Ask whose benefit it is**, and call it by its name. - **If the person shows discomfort and it continues**, it has stopped being care. Q: Does virtual reality make sense for someone with advanced dementia who no longer speaks? A: It can, case by case, but without promises. Research in this population is thin and does not support claims of benefit: the bulk of the dementia literature covers mild to moderate stages with wellbeing and reminiscence outcomes. The decision is clinical, taken with whoever represents the person, and depends heavily on their biography. Q: How do you obtain consent from someone who cannot communicate? A: You do not, in the usual sense. What exists is authorisation from whoever represents the person, informed honestly including what is not known, plus assent and dissent expressed in the moment. Turning the head away, reaching for the headset, frowning or tensing count as refusal and are not negotiated. Q: What if the family asks and the person seems indifferent? A: It is worth asking openly whose benefit is being sought. The family's benefit is legitimate, particularly in palliative care where the unit of care includes them, but it should be called by its name rather than presented as clinical benefit. If the person shows discomfort and the session continues because the family wants to watch, it has stopped being care. ### Twenty years after 65, eight in good health: what to do with the gap URL: https://rver.pt/blog/anos-de-vida-saudavel-portugal-a-diferenca/en/ Date: 20 August 2026 Portugal is one of the oldest countries in the European Union, and the hardest indicator is not life expectancy, it is what is left after you subtract the healthy years. It is an uncomfortable number, and it is the number half the social care sector works in. There is a number in almost every presentation about ageing in Portugal: life expectancy has risen. That is true, and it is good news. There is a second number that shows up far less often, and it changes the whole conversation. In Portugal, **someone who reaches 65 has on average around twenty years of life ahead, and around eight of them in good health**. 2023 data points to close to 8.4 healthy years after 65, with women living more years overall and fewer of them in good health than men. Portugal is **below the European average** on this indicator, unlike its position on total life expectancy. The gap between the two numbers runs to about **twelve years**. That is not a statistical abstraction. It is twelve years per person, multiplied by more than two and a half million people aged 65 or over, close to a quarter of the resident population. ## Twelve years is where the sector lives It is worth being clear about which years we mean, because the answer defines who works inside them: - **[care homes and residential structures](/en/solucoes/lar-residencial/)**, where the person now lives; - **continuing care**, the [RNCCI](/blog/realidade-virtual-cuidados-continuados-rncci/en/), where function is recovered or stabilised; - **home support**, while the house still works; - **[palliative care](/en/solucoes/cuidados-paliativos/)**, when the goal stops being to prolong and becomes to comfort. None of these responses exists to add healthy years. They all exist to make the years that are not healthy **liveable**. That is a different mission, and it is frequently judged with the wrong indicators. ## What technology usually promises, and what it should Almost all technology sold to the ageing sector is sold on the **prevention** side: prevent falls, prevent decline, delay dependency. It is a legitimate market and, when it works, it is the best investment there is. But prevention talk has a side effect: **it leaves the people working in the twelve years without language**. A care home manager is not preventing much: they are caring for people who have already crossed that point. And when every piece of promotional material talks about preventing, what is left is the sense that caring well is a consolation prize. It is not. Improving a bad day is an outcome, not a rhetorical fallback. ## Where virtual reality fits, and where it does not Let us be direct, because that is the only way this is useful. **What RVer does not do:** - **it does not add healthy life years.** Nothing in the literature supports that, and we do not claim it; - **it does not prevent dependency, frailty or falls;** - **it does not replace exercise, physiotherapy, nutrition or company**, which are the interventions with the strongest evidence on the prevention side; - **it is not a public health intervention.** It is a system used in a session, with one person, supervised by whoever is caring for them. **What it does, and it is what we have:** immersive environments used inside those twelve years, as a non-pharmacological complement, decided by the clinical team: moments of calm, of [reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/), of distraction during an uncomfortable procedure, of [family presence from a distance](/blog/videochamadas-familia-realidade-virtual/en/). Every session is logged, which gives the team something it rarely has: a record of what was done and when. The published research in this area is mostly about **wellbeing, anxiety, pain and quality of life**, not longevity. We have gathered it, with the themes and counts on show, in the [study library](/estudos/en/). And where the evidence is weak, we say so there. ## The indicator institutions are missing If the mission is the quality of the years and not their quantity, indicators should follow. In practice, almost no institution measures what it does on that axis: it measures occupancy, incidents and care hours, which are operational indicators. We do not have a finished answer to this, and be wary of anyone who does. We have one observation: when a team starts **logging sessions** of any non-pharmacological activity, it gains for the first time a time series to argue about. That does not prove effect. It allows a conversation with data instead of impressions, and that is already more than existed. ## In short - **Around twenty years after 65, around eight in good health.** Portugal is below the EU average on this indicator. - **The gap is the working ground** of care homes, continuing care, home support and palliative care. - **Virtual reality does not shorten that gap.** It works inside it. - **Anyone promising you healthy years** with a headset is extrapolating. Q: What are healthy life years? A: It is an indicator estimating how many years a person can expect to live without activity limitations due to health problems. It differs from total life expectancy, which counts all years regardless of health status. In Portugal, at 65, life expectancy is around twenty years and healthy life expectancy is around eight. Q: Does virtual reality increase healthy life expectancy? A: There is no evidence supporting that claim, and we do not make it. Published research on virtual reality in health contexts focuses mainly on wellbeing, anxiety, pain and quality of life, not on longevity or prevention of dependency. Q: So what is it for in a care home or continuing care unit? A: As a non-pharmacological complement inside the years lived with limitation: moments of calm, reminiscence, distraction during procedures and family presence from a distance, always decided and supervised by the clinical team. Every session is logged, which gives the team a history of what was done. ### The AI Act: what changed on 2 August 2026 for AI in healthcare URL: https://rver.pt/blog/ai-act-saude-o-que-mudou-agosto-2026/en/ Date: 20 August 2026 Two dates changed this summer and almost nobody in healthcare pulled them apart. One brought obligations that already apply; the other postponed the heavy ones by two years. It is worth knowing which one your supplier is in. If you follow this from a distance, you probably came away thinking "the AI Act came into force in August 2026". That is half true, and the missing half is exactly the half that matters when you are buying software for a health service. Two things happened days apart, and they pull in opposite directions. ## The two dates **27 July 2026.** The so-called *Digital Omnibus* on AI (Regulation (EU) 2026/1744) entered into force. Among other things it set fixed deadlines for the high-risk obligations that were previously tied to the pace of technical standardisation, and **postponed them**. **2 August 2026.** The **transparency** obligations of Article 50 started to apply. These were not postponed: they are in force now. The result is a three-step calendar: | When | What | |---|---| | 2 Feb 2025 | Article 5 prohibitions and the AI literacy duty | | 2 Aug 2025 | General-purpose AI model obligations | | **2 Aug 2026** | **Transparency (Article 50)** | | 2 Dec 2027 | Annex III high-risk (stand-alone systems: hiring, credit, education) | | **2 Aug 2028** | **Annex I high-risk: AI embedded in already-regulated products, including medical devices** | It is the last step that gets misread. An AI system inside a medical device does not have to meet high-risk requirements this month: it has until **2 August 2028**. But two caveats are worth keeping in view. The deferral **lapses** if the system undergoes a significant design change. And **none of this touched the MDR**: the obligations of Regulation 2017/745 stayed exactly where they were. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## What transparency actually requires Article 50 is not about performance or clinical safety. It is about the person on the other side knowing what they are dealing with. It covers four situations: 1. **Direct interaction**: if you are talking to an AI system, you must be told, unless it is obvious. 2. **AI-generated content**: synthetic image, audio and video must be marked in a machine-readable way. 3. **Emotion recognition and biometric categorisation**: exposed people must be informed. 4. **Deepfakes and text on public-interest matters**: publishing AI-generated text to inform the public on matters of public interest must be disclosed. Point 4 has an exemption that is almost never quoted: **it does not apply where the text underwent meaningful human review and someone assumes editorial responsibility**. In other words, an article written with AI assistance and reviewed by a person who answers for it is, to the letter, outside the duty. The exemption is worth keeping in mind, because it changes the useful question to ask whoever is publishing. It is not "was this written with AI help?", the answer is increasingly yes, everywhere, and it will soon distinguish nobody. It is **who takes editorial responsibility for it?** On this blog the answer is the RVer team, for the same reason we publish [what we cannot prove](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/) about return on investment. ## Where this leaves RVer RVer is a [Class I medical device](/blog/dispositivo-medico-classe-1-realidade-virtual/en/) registered in EUDAMED and with INFARMED (Portugal). It has an [AI-assisted feature](/en/rver-ai/), and that feature does one thing: it **helps find a scenario in the library** based on the kind of moment: relaxation, settling agitation, memory, distraction, sleep, stimulation, orientation. It ranks the content and explains why it suggested it. What it does **not** do, and this is where the conversation becomes useful: - it does not prescribe; - it does not assess; - it does not diagnose; - it decides nothing on its own, and there is no way to make it decide. The choice always belongs to the clinical team. This is not a position of convenience adopted because of the regulation: it has been on the site since before it, and we set it out in [why AI is not ready to be the clinician](/blog/ia-nao-esta-pronta-para-ser-o-clinico/en/). ## The questions worth asking a supplier If you are evaluating clinical software with AI, three questions quickly separate those who thought about this from those who did not: - **Does your AI decide or suggest?** If it decides, and the product is a medical device, you are looking at Annex I and at 2028, and at a classification that may not be the one you were told. - **Where does the model run, and what leaves the institution?** That is a [GDPR](/blog/privacidade-rgpd-realidade-virtual-saude/en/) question before it is an AI Act one, and the two intersect. - **What design changes are planned?** Because a significant change makes the deferral lapse. ## What we do not know Worth saying plainly: **this is not legal advice.** We are a manufacturer, not a law firm. Parts of Article 50 are still settling in practice for small systems, and Commission guidance keeps arriving. If your institution needs a formal position, it has to come from someone who can sign it. What we can state is what we did on our side, which is public and checkable. ## In short - **2 August 2026:** Article 50 transparency applies. - **2 August 2028:** high-risk for AI inside medical devices: deferred, not cancelled, and the deferral lapses on significant design changes. - **The MDR did not change.** - **In RVer the AI suggests and the team decides.** Q: Does the AI Act already apply to my clinical software? A: It depends on the obligation. Article 50 transparency duties apply from 2 August 2026. High-risk obligations for AI embedded in already-regulated products, such as medical devices, only apply from 2 August 2028, following the Digital Omnibus that entered into force on 27 July 2026. Neither changed the MDR. Q: Does a medical device with AI automatically become high-risk? A: Not automatically, and the answer depends on what the AI does and how the product is classified. What changes the conversation is AI deciding rather than suggesting. In RVer the AI-assisted feature ranks and explains scenario suggestions from the library; it does not prescribe, assess or diagnose, and the choice always belongs to the clinical team. Q: Does text written with AI help have to be labelled? A: Article 50 requires disclosure of AI-generated text published to inform the public on matters of public interest, but exempts text that underwent meaningful human review with editorial responsibility assumed. The articles on this blog are reviewed by the RVer team, which assumes that editorial responsibility. ### Loneliness and social isolation: what technology solves, and what it does not URL: https://rver.pt/blog/solidao-isolamento-social-idosos-tecnologia/en/ Date: 20 August 2026 Two words used as synonyms that are not. One is measured by counting the people around someone; the other only that person can report. Confusing them is why so many well-meant programmes never move the needle. The report of the WHO Commission on Social Connection put numbers on something the social care sector already knew: **one in six people worldwide feel lonely**, and loneliness is associated with around **871,000 deaths a year**: close to a hundred an hour. The same report carries a finding that tends to catch people off guard. Against the picture almost everyone holds, **the highest levels of loneliness are not among the oldest**: they are among adolescents aged 13 to 17, at around 21%. Loneliness is not a disease of old age. What **is** disproportionate in later life is a different thing: **social isolation**, estimated to affect up to one in three older adults, and which in Europe sits alongside close to 20% of older people living alone. ## Two different things, and this is where programmes fail - **Social isolation** is objective. It can be counted: how many contacts, how often, what network. It can be measured from outside. - **Loneliness** is subjective. It is the distance between the contact a person has and the contact they would like. Only that person reports it. Someone can be in a full care home, with activities every day, surrounded by people, and be profoundly lonely. And someone can live alone in a village, see two people a week, and not feel lonely at all. This has a practical consequence that is widely ignored: **almost all technological interventions attack isolation**, because isolation is what can be counted. They add contacts. If the person's problem was loneliness, adding contacts may do nothing, and the programme will report success anyway, because it measured the wrong variable. ## What the evidence points to as strong Bluntly: the best-supported interventions are not technological. They are human contact programmes (group-based, with purpose, sustained over time) community connection, and what the literature files as psychological interventions where there is established distress. Contact with nature and with animals shows a positive signal across several studies. If your institution has to choose where to put money to attack loneliness, **start there**, not with a headset. We say that as a manufacturer of headsets. ## What virtual reality does in this conversation With that caveat made, there are two concrete points where a system like RVer touches the problem, and neither of them is "curing loneliness". **Family presence, from a distance.** During the session, the patient can be on a [video call with their family](/blog/videochamadas-familia-realidade-virtual/en/): they see and hear their relatives inside the experience, and on the other side the family follows in real time the scenario the patient is seeing, from a phone or a computer. For someone whose family is far away, emigrated, or unable to visit, this is not a generic additional contact: it is **the contact that was missing, with the right people**. It is the most requested feature among the people who use the system. **Reminiscence.** Taking someone to the place where they lived, to the local festival, to the sea they went to as a child. The dementia literature in this area is mostly about [wellbeing and reminiscence](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/), and what teams observe is not "less loneliness": it is conversation. The person talks, the carer hears things they did not know, and the relationship between the two shifts a little. That is social connection, even if the indicator has no name. ## Where it loses, in plain words - **A screen is not company.** A beautiful scene watched alone is a person alone watching a beautiful scene. - **A virtual reality session is individual.** It is not a group activity, and group activities are precisely among the best supported. Where a [Snoezelen room or a group programme](/blog/sala-snoezelen-ou-realidade-virtual-lares/en/) is working, that is not something to replace. - **There are no trials showing that virtual reality reduces loneliness** as a clinical outcome. There are small, promising studies on wellbeing and mood. Anyone presenting this to you as a loneliness intervention is going beyond what exists. - **RVer does not assess or diagnose** emotional states. It logs sessions. ## What to do with this on Monday If loneliness is a declared theme in your institution, three steps that cost nothing: 1. **Separate the two things** in what you already measure. Contacts per week is isolation. Asking the person whether they feel lonely is something else, and there are short validated scales for it. 2. **Look at who gets no visitors.** It is the most actionable list there is, and it usually lives in someone's head rather than being written down. 3. **Only then** ask which tools help, and require every supplier to tell you which of the two they are attacking. ## In short - **Loneliness and isolation are not the same**, and most programmes measure the second. - **Loneliness is not mainly an older person's problem**; social isolation is what weighs more in later life. - **The strongest interventions are human.** - **Virtual reality touches the problem at two points**: family at a distance and reminiscence, and does not replace presence. Q: What is the difference between loneliness and social isolation? A: Social isolation is objective and measured from outside: number and frequency of contacts, size of the network. Loneliness is subjective and only the person reports it: it is the gap between the contact they have and the contact they would like. Someone can be surrounded and feel lonely, or live alone and not feel lonely. Q: Does virtual reality reduce loneliness? A: There are no trials supporting a reduction in loneliness as a clinical outcome, and we do not claim it. Existing research focuses mainly on wellbeing, mood and reminiscence. The best-supported interventions against loneliness involve human contact and community connection. Q: So what does RVer do in this area? A: Two concrete things: it lets family be present by video call during the session, seeing in real time the scenario the patient sees, and it allows reminiscence sessions with familiar places, which tend to generate conversation between the resident and the carer. It replaces neither presence nor group activities. ### Whoever pays is not whoever saves: the problem that stalls health technology URL: https://rver.pt/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/en/ Date: 20 August 2026 There is a conversation that repeats: everyone agrees it makes sense, nobody says no, and the process dies. It is almost never about price. It is about where the money goes out and where it comes back. A health institution does not have a budget. It has dozens, with different owners, different rules and different incentives. It is obvious when said out loud, and ignored in almost every commercial pitch made to the sector. The result is a pattern we have seen often enough to describe with confidence: the department wants it, management agrees, the numbers add up, and the project does not move. Not because someone decided against it. Because **whoever has to pay is not whoever will save**, and nobody in the process has authority over both sides. ## The map Worth putting in two columns, because that is where the conversation changes. | Who pays | Where the saving lands | |---|---| | The buying department's budget | Anaesthesia and pharmacy (less sedation) | | | Theatre or scanner (room time, fewer rebookings) | | | Bed-days (length of stay) | | | Staff hours (less time settling, repeating, persuading) | | | Emergency department (avoided readmissions) | | | HR (turnover, absence) | Notice something: **the left column has one line and the right has six.** None of the six belongs to whoever signs the expense. And several are not even standalone budgets: they are costs nobody books as savings because they were never booked as costs. [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## A concrete case An imaging or radiotherapy department buys the equipment from its own capital budget. If the intervention reduces anxiety enough to avoid some sedations, the saving in drugs and anaesthetist time shows up **in the anaesthesia budget**, not theirs. If it reduces rebookings, the gain shows up in room productivity, measured by another department. The department head ends up in the absurd position of justifying spending whose benefit will be credited to colleagues. It is not ill will when they hesitate. It is the structure working exactly as designed. ## Why ROI decks fail The temptation is to add it all up and present one big number: "saves X a year". That number has no owner. Whoever reads it looks for their line and does not find it: they find an aggregate mixing six different people's budgets, and the predictable reaction is suspicion, not enthusiasm. A total nobody recognises as theirs reads as marketing, even when the arithmetic is right. We have written [the per-institution costing guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/) and [where the four cost levers are](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/en/). This article is about the step before: **who you hand the bill to.** ## What works Three routes, easiest first. **1. Do the sums in the currency of whoever pays.** If the budget is the department's, the argument has to close inside the department: staff time, rebookings, room capacity. Savings landing elsewhere get mentioned as a bonus, never as justification. An argument that needs the right-hand column to close is an argument that does not close. **2. Find the level above the silos.** Clinical management, the board, the executive: someone who sees both columns at once. It is the strongest route and the slowest, and it requires the department to already want it: nobody above sponsors something nobody below asked for. **3. Take the capital decision out of it.** If the obstacle is the capital budget rather than the merit, an annual licence model changes the nature of the expense and of the approver. The routes are in [how to fund it](/blog/financiamento-comparticipacao-realidade-virtual-saude/en/). ## What does not work - **Insisting on the aggregate total.** Repeating a number with no owner does not give it one. - **Asking the department to "convince" anaesthesia.** That is asking someone to do internal politics on a supplier's behalf. It does not happen. - **Promising savings that depend on third-party behaviour.** "If they avoid sedations" is a condition, not a result, and it depends on clinical decisions that are neither ours nor the buyer's. ## Where we do not help Frankly: **we cannot change your institution's budget structure, and we should not try.** We do not know who has discretion over what in your case, and a supplier who starts designing your internal politics is out of their lane. What we do is give you the costing split by budget instead of a total, so you can hand each person the line that is theirs. And tell you when the sums do not close in the payer's column, because in those cases it is better we both know before spending three months. ## In short - **One line pays, six lines save**, and they are not the same person. - **An aggregate total has no owner** and reads as marketing. - **The argument has to close inside the budget of whoever signs.** - **Without someone above the silos, or without the case closing below**, the project stalls without anyone ever saying no. Q: Why do projects everyone approves fail to move in a hospital? A: Often because the budget that pays and the budget where the saving lands are different. The department buys from its own budget, while gains appear in anaesthesia, pharmacy, bed-days or staff hours. Nobody in the process has authority over both sides, and the project stalls without anyone saying no. Q: How do you build the economic case in that situation? A: By closing the sums inside the budget of whoever signs (staff time, rebookings, room capacity) and mentioning other savings as a bonus, never as justification. Alternatively, take the decision to a level that sees several budgets at once, or change the nature of the expense through an annual licence model. Q: Is it worth presenting a total annual saving figure? A: Rarely. An aggregate total mixes several people's budgets and has no owner: whoever reads it looks for their line, does not find it, and reacts with suspicion rather than interest. A costing split by budget is harder to produce and far easier to approve. ### From yes to the first session: who actually has to approve inside a hospital URL: https://rver.pt/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/en/ Date: 20 August 2026 The question "who decides this?" almost never has a single answer. It has six, and the order you go through them decides whether the project starts in six weeks or dies waiting for a meeting nobody scheduled. There is a pattern in almost every process that stalls, and it is not price. It is this: someone in a department gets excited, asks for a quote, takes it to the board, and the process dies in a limbo where nobody said no and nobody is able to say yes. In a hospital, "approving" is not an act. It is a sequence of people with different powers, and none of them can stand in for the others. ## The six yeses **1. The department that will use it.** This is not a formality: it is the one approval nothing can replace. Equipment nobody on the shift wants to use is not saved by any signature above it. It is also where the concrete case gets defined: which patients, at what moment, with what goal. **2. The department or division management.** They answer for clinical practice and for one specific question: does this fit what we do, or is it one more thing for the team to do? Worth arriving here with [the flow already thought through](/blog/integrar-realidade-virtual-fluxo-clinico/en/), not with a brochure. **3. Nursing management.** In most departments, nursing is who will actually run the sessions. If nursing was not heard before the decision, it gets heard after, and by then it is a complaint. Their question is about time and about who does what, and there is [a good answer to give](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). **4. IT and the data protection officer.** Two roles, often two people, and the questions [are almost always the same eight](/blog/informatica-hospital-perguntas-realidade-virtual/en/): network, integration, where data sits, who the controller is, updates, continuity. The answer that unblocks this fastest is being able to say the system **runs on the local network and needs no integration** with the hospital system. **5. Infection control.** In Portuguese hospitals this is typically the GCL-PPCIRA. Equipment that touches the face of successive patients is their business, and the conversation is short if you bring a [written hygiene routine](/blog/higiene-seguranca-equipamento-realidade-virtual/en/) rather than a promise that "it wipes down". **6. Procurement.** It arrives last and everyone underestimates it. Here the question stops being clinical: it is budget cover, procedure type, single or multi-year. Worth noting that **the Portuguese public procurement framework is under revision in 2026**, with changes to procedure thresholds still settling: confirm the values in force with your institution's legal services rather than assuming them from memory, including ours. [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## The order that works The temptation is to start at the top, because that is where the signature that seems to matter lives. In practice the path of least resistance is almost always bottom-up: 1. **Department**: is there a concrete case and someone who wants it? 2. **Department management and nursing**: does it fit what we already do? 3. **IT, data protection, infection control**: in parallel, not in series. Three independent conversations that can run at once. 4. **Procurement and the board**: with the previous three already settled in writing. Reaching the board with the technical opinions already given transforms the decision: it stops being "should I authorise this?" and becomes "I am signing something the services have already validated". ## One document per stakeholder, not a dossier for everyone The most expensive and most avoidable mistake: sending the same thirty-page deck to six people. Each reads it looking for their question and does not find it. What tends to work: - **department and clinical management**: the use case, on one page; - **nursing**: the session flow, who does what, how long; - **IT and data protection**: architecture, data, controller; - **infection control**: the between-patients hygiene procedure; - **procurement**: the [specification](/blog/caderno-de-encargos-realidade-virtual-saude/en/) and the terms. ## Where it stalls, and it is not ill will - **No owner.** If the project does not have a name and a phone number inside the institution, it does not move. A supplier cannot be the owner. - **The informally authorised pilot.** Someone lends it, someone tries it, and when it goes well nobody knows how to turn that into a contract: because there was no process. A [useful pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/) is agreed in writing before it starts, even when it is free. - **The right question at the wrong time.** Infection control asked after the purchase is a problem. Asked before, it is ten minutes. ## Where we cannot help Bluntly: **we cannot create willingness inside your institution that does not exist.** If nobody in the department wants to run sessions, the project does not survive the first month, and we can hear that on a phone call. We also do not issue opinions: not on data protection, not on infection, not legal ones. We provide the technical answers so that the people who do issue them can do it quickly. ## In short - **There are six yeses**, and the first belongs to the department that will use it. - **Bottom-up**, with the three technical ones in parallel. - **One document per stakeholder.** - **No internal owner, no project**, and no supplier can fill that seat. Q: Who has to approve virtual reality in a hospital? A: In practice there are six approvals: the department that will use it, the department or division management, nursing management, IT together with the data protection officer, infection control (in Portuguese hospitals typically the GCL-PPCIRA) and procurement. None replaces the others. Q: Where should you start? A: With the department that will use it, not with the board. Without a concrete use case and someone willing to run it, signatures from above do not sustain the project. Conversations with IT, data protection and infection control can run in parallel, and the board should receive the decision with those opinions already given. Q: Does it need to integrate with the hospital IT system? A: No. The system works independently and runs on the institution's local network, with no need to integrate with the existing hospital system. This is usually the answer that unblocks the conversation with IT fastest. ### Where the equipment lives between sessions: the question never in the specification URL: https://rver.pt/blog/onde-vive-o-equipamento-realidade-virtual-hospital/en/ Date: 20 August 2026 Specifications ask for resolution, weight and battery life. None asks where the thing sleeps, who charges it and whose key opens the cupboard, and that is where usage is actually decided. We have seen well-chosen, well-funded and properly authorised projects stall for a reason that never appears in any proposal: **nobody had decided where the thing lived.** The equipment arrives, gets used enthusiastically for two weeks, and then enters a predictable cycle: it runs out of battery, someone puts it away "for safety" in a place only they know, the next shift cannot find it, and within a month it is in a drawer. There was no decision to abandon it. There was an absence of small decisions. Worth making them before delivery. There are five. ## 1. Where it charges It sounds trivial and is not. The real question is not "is there a socket?", it is **who plugs it in**. Shared equipment with nobody responsible for putting it on charge at the end of the day is always at 40% when it is needed. Institutions that solve this always do the same thing: charging becomes part of the **end-of-shift routine**, like any other check, and does not depend on someone remembering. On our side, each unit's battery is visible in the fleet from the browser, which turns "I think it was charged" into a percentage you can see before walking over to fetch it. [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## 2. Where it sleeps, and who holds the key A locked cupboard is the minimum, but the problem is rarely theft: it is **availability**. Equipment locked in an office that closes at 5pm does not exist for the night shift. The balance that tends to work: locked storage that is **accessible to every shift that will use it**, not to the person who bought it. Worth writing down who has access rather than letting it emerge. Preventing misuse does not have to be solved with the lock: the headset can be **PIN-locked**, so that outside a session run by the team it is not usable as a consumer device. That separates two questions that usually get stuck together: physical access and use. ## 3. Who moves it between departments This is where nearly all inter-department sharing fails. If two departments share the equipment and nobody defined who moves it, it stays wherever it is. In practice only two models work: - **a fixed home.** The equipment belongs to one department and the others come to fetch it, with a simple record of who took it; - **a trolley with an owner.** The equipment travels, but a person or role is responsible for knowing where it is. What does not work is symmetric sharing with no owner. It is not a goodwill problem: responsibility divided between two departments is nobody's responsibility. ## 4. Hygiene between patients This one is usually thought through, because infection control asks. So just the link to the [procedure](/blog/higiene-seguranca-equipamento-realidade-virtual/en/), and one logistical note: the cleaning materials must be **where the equipment is**, not at the other end of the corridor. A hygiene routine that requires a walk is a routine that decays. ## 5. Weekends, holidays and the person who leaves The honest test of a project: **does it work in the week the person who brought it in is on holiday?** If the answer is no, there is no project yet: there is an enthusiast. The fix is boring and effective: two trained people per shift instead of one, and the procedure written where the equipment is, not in an email from August. ## What the system solves, and what it does not **It solves:** seeing each unit's battery and state from the browser without walking over; locking use outside a session; running the session from a PC or tablet on the same network, which means whoever is driving does not need the headset in their hands. That, plus the [log of every session](/blog/acompanhamento-clinico-sessoes-realidade-virtual/en/), which also answers "was it used?" without relying on memory. **It does not solve:** none of this invents a place. It does not decide whose key it is, does not carry the equipment between floors and does not put anyone on charging duty. A supplier telling you the platform handles logistics is selling you something that does not exist: logistics is an institutional decision, and it is a ten-minute decision if taken before delivery instead of three months after. ## The ten-minute list Before the equipment arrives, write down answers to these five: 1. Which room does it live in, and which cupboard? 2. Who has access, on each shift? 3. Who puts it on charge at the end of the day, by role and not by name? 4. If shared, does it have a fixed home or an owner? 5. Where are the hygiene materials? Five lines taped to the cupboard door are worth more than any section of the specification. ## In short - **Equipment without an address ends up in a drawer**, and never by decision. - **Charging belongs in the end-of-shift routine**, not in good memory. - **Sharing without an owner does not work**: fixed home or trolley with an owner. - **If it fails during one person's holiday**, it is an enthusiast, not a project. Q: Where should virtual reality equipment be stored in a hospital? A: In locked storage that is accessible to every shift that will use it, not only to whoever acquired it. Equipment locked in an office that closes in the late afternoon does not exist for the night shift. It is worth writing down who has access rather than letting it emerge through use. Q: How do you stop it always being out of battery? A: By putting charging into the end-of-shift routine, assigned to a role rather than a specific person. In RVer each unit's battery is visible in the fleet from the browser, which lets you check before walking over instead of finding out at the moment of use. Q: Can two departments share the same equipment? A: They can, provided there is a fixed home or an owner. Either the equipment belongs to one department and the others fetch it with a record, or it travels on a trolley with a role responsible for knowing where it is. Symmetric sharing with no defined owner is the model that fails. ### What the health system measures, and why this stays invisible URL: https://rver.pt/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/en/ Date: 20 August 2026 A system does what it measures. Not out of cynicism: because measuring is the only way to account to whoever pays. The problem is what falls off the sheet, and what happens to the people working on that side. A health service accounts for itself in numbers, and the numbers are few and old: **average length of stay, occupancy rate, response times, output: appointments, surgeries, scans.** In Portugal, guaranteed maximum response times and production targets structure much of what a hospital has to report. None of these indicators sees whether someone was frightened. ## This is not a complaint about management Worth saying, because the easy criticism is unfair. These indicators exist for a good reason: they are **auditable**. They are counted the same way everywhere, do not depend on who records them, and allow comparison. A public system spending everyone's money needs exactly that. The problem is not that the indicators are bad. It is that they are **incomplete in a biased way**: what is easy to count gets in, what is hard to count stays out, and then it starts to look as though what stayed out does not exist. ## What stays out - Whether the patient **was frightened** during the scan. - Whether the hour before surgery was spent in panic or in calm. - Whether the person with dementia **spent the afternoon agitated** or settled. - Whether the family was present or left outside. - Whether someone was treated with **dignity** on the worst day of their life. None of this is an indicator. So none of it competes for budget, appears in a contract, or justifies an investment decision. ## The practical consequence This is where it stops being philosophy. An intervention that improves **only what is invisible** has no way to justify itself inside the system, even when it works. It is not rejected: it is **incomparable**, which in practice is worse, because it never even reaches the list where things are decided. It is the same family of problem as budget silos, described in [whoever pays is not whoever saves](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/en/): there the benefit exists but lands in the wrong pocket; here it exists and lands nowhere, because there is no line to put it on. And there is a nastier side effect: **the people working on the invisible side are left without language.** A palliative team, a care home, a service that cares well has no numbers that say so. It ends up defending its work with adjectives, against departments that defend theirs with tables. ## What can actually be counted We have no solution to the big problem, and be wary of anyone who does. We have three useful observations. **1. Counting what was done is possible, and it is more than existed.** Every session of any non-pharmacological intervention can be [logged](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/): when, with whom, how long, whether it was stopped. After months that is a time series. It does not prove effect. It allows a conversation with data instead of impressions. **2. Patient-experience instruments exist and are underused.** PREMs, patient reported experience measures, are the only family of indicators that looks at this side, and most institutions do not apply them. That is an institutional decision, not a technological limitation, and it is probably the most effective thing a management team can do here. **3. Always distinguish activity from outcome.** "We ran 340 sessions" is activity. It is not a clinical outcome, and presenting it as one is the mistake that most discredits people working on this side. We develop that in [“The ROI that cannot be proven”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## Where we stop Being specific, because this is where the industry behaves worst: - **RVer does not measure emotional state.** There is no wellbeing score, no comfort index, no mood inferred from anything. - **A supplier selling you a "wellbeing index" computed by the equipment is inventing an indicator**, and inventing it precisely because the market needs one. An invented number is worse than none, because it displaces the conversation and cannot be audited. - **We cannot turn comfort into an indicator.** Nobody can, for now. What exists is the record of what the team did and observed, in their words. ## In short - **The system measures what is auditable**, and has good reasons to. - **Comfort, fear and dignity are not indicators**, so they do not compete. - **An intervention purely on the invisible side is not rejected: it is incomparable.** - **Counting sessions is not measuring outcome**, and confusing the two discredits whoever does it. - **Distrust any wellbeing score** produced by a piece of equipment. Q: Which indicators structure hospital funding? A: Mostly auditable, comparable indicators: average length of stay, occupancy rate, response times and output volumes such as appointments, surgeries and scans. They exist for a good reason, they are counted the same way in any institution, but they do not capture patient experience. Q: Why do comfort interventions struggle to get funded? A: Because they mainly improve what the system does not measure. They are not rejected on analysis: they become incomparable, with no line on which to present the benefit, and so never reach the list where investment decisions are made. Q: Does RVer measure patient wellbeing or comfort? A: No. There is no wellbeing score, comfort index or inference of emotional state. What exists is the record of what the team did and observed, written by them. A supplier presenting a wellbeing index computed by the equipment is inventing an indicator. ### Immobility costs more than the illness that brought the patient in URL: https://rver.pt/blog/imobilidade-no-internamento-o-custo-de-estar-parado/en/ Date: 20 August 2026 A patient comes in with one thing and leaves worse from another. Loss of function during a stay is among the most expensive things that happen in a hospital and among the least visible in any report. There is a calculation almost no hospital makes, and it is among the heaviest. A patient is admitted for pneumonia, a fracture, a decompensation. The problem that brought them in is treated. And meanwhile something else happened: they spent days in bed, and the loss of function that causes can be larger and longer lasting than the acute episode. ## The numbers, with the caveats they deserve The bed-rest literature is consistent in direction and highly variable in magnitude, so ranges rather than certainties: - **Strength loss** of roughly 1% to 3% per day of bed rest, with higher figures reported in older people. - **Muscle mass loss** that accumulates quickly in the first days, and which several studies put in the order of several percent after a week in immobilised older adults. - **Recovery is not symmetrical.** It is frequently cited that each day of absolute bed rest may require up to two weeks of reconditioning to return to baseline. That last point changes the conversation. **It is lost in days and regained in weeks**, and what goes first is precisely the antigravity muscles: the ones for getting out of a chair, climbing a step, standing. Which are the ones that decide whether someone goes home or goes into an institution. ## Where this costs the system money The bill does not appear under "immobility". It appears scattered: - **More bed-days**, because discharge depends on function and not only on the acute problem; - **A worse discharge destination**: continuing care or an institution instead of home. It is the most expensive difference of all, and it is often permanent; - **Falls**, during the stay and in the following weeks, with what follows them; - **Readmissions**, with a patient who left frailer than the illness warranted; - **Care burden** shifted onto the family, which nobody books at all. And none of these lines belongs to the budget of the department where the patient lay still: which is exactly the problem described in [whoever pays is not whoever saves](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/en/). ## Why it is so hard to fix Not through ignorance. Everyone on a ward knows it is better to get the patient up. What is missing is **staff time**, the scarcest resource a hospital has, and mobilisation consumes a lot of it: two people, ten minutes, several times a day, for something that is not urgent today and whose benefit shows up two weeks later somewhere else. The second difficulty is adherence. Many patients do not want to. They are tired, in pain, cannot see the point, and guided exercise is boring in a way that helps nobody repeat it. ## Where virtual reality fits, with every caveat Let us be precise, because this is an area where it is easy to oversell. **What virtual reality does not do:** - **It mobilises nobody.** It does not get a patient out of bed. - **It does not replace a physiotherapist** or an early mobilisation protocol. - **On length of stay, the evidence is inconsistent.** Studies have measured it and the results do not agree, a meta-analysis in intensive care found no significant difference in stay, while the economic analyses showing savings *assume* that reduction as a premise of the model, one of them setting the threshold at 14.6%. - **The best-supported interventions for this problem** are mobilisation protocols and physiotherapy staffing. - **If you have to choose between a physiotherapist and a headset, choose the physiotherapist**, we say that as a manufacturer of headsets. **What it may do:** make guided movement more acceptable to those who refuse it. The hypothesis, and it is a hypothesis, is that exercise with a visible purpose gets repeated more often than exercise without one, and adherence is half the problem. We have written about [adherence to physiotherapy in older adults](/blog/realidade-virtual-fisioterapia-idosos-adesao/en/). **A regulatory caveat that cannot be skipped:** support for guided movement is **RVer Motion**, a module **in development and not covered by the Class I medical device registration**, which covers the base product. Anyone presenting the module as part of the registered device is misleading you. And for those who do not get up at all, what exists is a different thing and should not be confused with rehabilitation: comfort and presence, with [lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/) aligning the horizon for someone reclined. ## What to measure, if you really want to know Do not measure length of stay: it has too many causes and you will never attribute the difference. Measure what is closer: - **mobilisation sessions offered and completed**, with and without the system; - **refusals**, which is where an effect, if any, shows up first; - **function at discharge** with a simple, consistent instrument. None of these proves clinical effect. All of them tell you whether the thing is being used and whether adherence changed, which is what a pilot can answer: the rest is in [“The ROI that cannot be proven”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## In short - **Lost in days, regained in weeks**, and the standing muscles go first. - **The bill shows up in the discharge destination**, not under immobility. - **Virtual reality mobilises nobody** and replaces no physiotherapy. - **Where it may help is adherence**, and the module supporting it is in development and outside the registration. Q: How much strength is lost per day of bed rest? A: The literature points to losses in the order of 1% to 3% per day, with higher figures reported in older people, and the loss concentrates in the antigravity muscles: those used to rise from a chair and stand. It is frequently cited that each day of absolute bed rest may require up to two weeks of reconditioning to return to baseline. Q: Does virtual reality reduce length of stay? A: The evidence is inconsistent and we do not claim it. Studies have measured length of stay and the results do not agree, a meta-analysis in intensive care found no significant difference, while the economic analyses showing savings assume that reduction as a premise of the model. The best-supported interventions against hospital deconditioning are early mobilisation protocols and physiotherapy staffing. Where virtual reality may contribute is adherence to guided movement, which is part of the problem rather than its solution. Q: Is exercise support part of the registered device? A: No. Support for guided movement is the RVer Motion module, which is in development and not covered by the Class I medical device registration in EUDAMED and with INFARMED (Portugal), which covers the base product. Any presentation that merges the two is misleading. ### Do you need an ethics committee opinion to use virtual reality? URL: https://rver.pt/blog/comissao-de-etica-realidade-virtual-quando-e-preciso/en/ Date: 20 August 2026 It is one of the first questions to come up, and it usually arrives with the answer already formed, in either direction. Both certainties are wrong about equally often. Two answers circulate, and both are dangerous. One says "it is equipment, it is like buying an armchair, it needs nothing". The other says "it is technology with patients, it has to go to the ethics committee". Depending on the case either can be right, which is why the useful question is a different one. ## The question that separates everything **Are you caring for a patient, or producing knowledge?** That line decides it, not the fact that technology is involved. **Care.** Using a registered medical device, within its [intended purpose](/blog/dispositivo-medico-classe-1-realidade-virtual/en/), with a specific patient, because the team judges it does them good at that moment, is a clinical decision. The same kind as choosing to put music on, change the lighting or call the family. It does not, in itself, create a need for an ethics committee opinion. **Research.** The moment there is a **protocol**, a **knowledge objective** and data collection **beyond what care requires**, the category has changed. That is ethics committee territory, under the framework for clinical investigation, which for medical devices has specific rules under the MDR (Regulation (EU) 2017/745) and, in Portugal, involves the competent ethics committee. [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## What crosses the line without anyone noticing In practice almost nobody decides "let us do research". You slide into it. The most common triggers: - **deciding to publish.** A conference poster is dissemination of knowledge. If the data came from patients, the ethics question appears, even if the collection was done with something else in mind; - **allocating patients** to receive or not receive, in order to compare. That is study design, even when informal; - **applying scales** that would not otherwise be applied, or applying them at moments defined by a protocol rather than by care; - **using outside the device's intended purpose**; - **collecting data systematically** on a purpose-built form, for later analysis. None of these triggers is forbidden. They only change the process, and changing it after starting is where people get hurt. ## The pilot trap It is the most frequent case and worth stating plainly. A department runs a [pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/) to decide whether to buy. It went well. Someone says: "this would make a paper." And then it emerges that the data was collected without a research framework, without consent for that purpose and without an opinion. **An opinion cannot be obtained retroactively for data already collected as though none were needed.** Even retrospective use of routine data for publication usually requires an opinion from the institution's ethics committee and a lawful basis under the GDPR. Prevention is cheap and takes five minutes: **before the pilot starts, decide whether you will want to publish.** If the answer is "maybe", treat it as research from the outset. It is far easier to hold an opinion you never use than to produce data you cannot use. ## Consent is not the same thing Two consents live on different planes and should not be confused: - **consent for the session**: telling the patient what will happen, what they may feel and that they can stop at any moment. This always applies, and we have [covered it separately](/blog/consentimento-informado-realidade-virtual-saude/en/); - **informed consent for research**: specific, written, approved within the protocol. Having the first does not remove the need for the second. And the second does not replace the first. ## What the committee will ask If you go that route the questions are predictable, and preparing them speeds everything up: what is the design, who are the participants and how are they selected, what data is collected and why, what risks exist and how are they mitigated, how is consent obtained and recorded, who has access to the data and for how long, and what happens if a participant withdraws. Notice that almost all of them are about **data and people**, not about the technology. That is the most common preparation mistake: bringing a technical explanation of the equipment to a committee that wants to talk about participants. ## What we do not do **We do not issue ethics opinions, and be wary of any supplier who tells you confidently that "you do not need one".** We are not your institution's ethics committee, we do not know your protocol, and this is not legal advice. Whether your case is care or research is decided by the institution, and when in doubt by the committee itself, which usually answers a well-framed question quickly. What we do is give you what it will ask about the system: what it logs, where the data sits, what leaves the institution, and the intended purpose in writing. ## In short - **Caring is not researching**, and that is what decides. - **Care within the intended purpose** is a clinical decision. - **Publishing, allocating, applying scales by protocol** or collecting data systematically changes the process. - **Decide before the pilot** whether you will want to publish. - **When in doubt, ask the committee.** It is cheaper than the alternative. Q: Do I need an ethics committee opinion to use virtual reality with patients? A: If the use is care (a registered medical device, used within its intended purpose, by clinical decision of the team and for the benefit of that patient), it is a clinical decision and does not in itself create a need for an opinion. If there is a protocol, a knowledge objective and data collection beyond what care requires, it is research and becomes ethics committee territory. Q: I ran a pilot and now want to publish the results. Can I? A: Not without a framework. An opinion cannot be obtained retroactively for data collected outside a research context, and even retrospective use of routine data for publication usually requires an opinion from the institution's ethics committee and a lawful basis under the GDPR. If there is any chance you will want to publish, treat the pilot as research from the start. Q: Is consent for the session enough? A: No, they are different things. Informing the patient about the session, what they may feel and that they can stop at any time always applies. Informed consent for research is specific, written and approved within the protocol. One does not remove the need for the other. ### How to run a virtual reality pilot in a healthcare service URL: https://rver.pt/blog/piloto-realidade-virtual-hospital-como-correr/en/ Date: 16 August 2026 Almost every institution wants to try before deciding, and few define what trying means. That is why so many pilots end without a conclusion. Almost every institution wants to try before deciding. Few define what trying means, which is why so many pilots end without a conclusion, the equipment goes back in its box, and nobody can say why. A pilot is not "having the headsets here for a while". It is a question with a date for its answer. ## Before you start: write the question down A pilot has to be able to fail. If there is no result that would make the institution say "we are not going ahead", it is not a pilot: it is an extended demonstration. Write one sentence, and write it before the equipment arrives. For example: *"After eight weeks, we want to know whether the team can fit sessions into the routine without costing them time they do not have."* Notice what that sentence does **not** say. It does not say "we want to prove it reduces anxiety". An eight-week pilot in one service has no design, no size and no comparison group to answer that, and promising it does is the fastest route to a report nobody can use. [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## What a pilot really can answer These are **implementation** questions, and a pilot answers them well: - **Does the team use it?** The number one question, and the one that fails most pilots. - **How long does it actually take** to set up and run a session? - **Where does it jam?** Cleaning, charging, Wi-Fi, who fetches the headset, where it sleeps. - **Do patients accept it?** How many decline, how many stop midway, and why. - **Who takes ownership?** There is almost always one person who picks it up. Or there is not, and that is the answer. ## What a pilot cannot answer Worth saying up front, so there is no disappointment at the end: - **Clinical efficacy.** Without a comparison group, without randomisation and with dozens of sessions, there is no efficacy conclusion to draw. That is what trials are, and they are a different thing. - **Real financial return.** Eight weeks do not show annual savings. - **Long-term effect.** By definition. :::note Be wary of a supplier who proposes a pilot with clinical outcome objectives. Either they do not understand study design, or they do and are counting on you not to. ::: ## A design that works **Duration: six to eight weeks.** Less is not enough for the novelty to wear off; more and the pilot dissolves into routine without ever being assessed. **Scope: one service, not three.** A pilot spread across three wards produces three half-experiences and no conclusion. **People: names, not "the team".** Two or three designated people, trained before it starts. Equipment that is everyone's responsibility ends up in a cupboard: it is the most predictable pattern in this field. **A decision point in the calendar**, dated, before the pilot begins. Without that date the pilot does not end: it dissolves. ## What to measure, and how Few things, and simple ones: 1. **Sessions per week.** The curve says almost everything. If it rises and levels off, it entered the routine. If it rises and falls, it did not. 2. **Who ran them.** If it is always the same person, the service did not adopt it: one person did. 3. **Time per session**, including setup and cleaning. That is the number that decides whether it is sustainable. 4. **Refusals and interruptions,** with the reason in two words. 5. **One sentence from whoever ran it,** at the end of each week. Worth more than any dashboard. RVer records sessions and how each one went automatically, and the Companion app lets one person oversee several headsets, which reduces the effort of collecting points 1 and 3. The rest is conversation with the team. ## Before signing: the questions that remain At the end, three questions settle the decision: - **Did the session curve level off** at a rate that makes sense for the service? - **Did more than one person** run sessions comfortably? - **Is what jammed** solvable, or structural? If all three answers are good, the business case makes itself. If they are not, the pilot saved you a purchase, which is exactly what it is for. ## How we run ours The device arrives configured and training is included, the system runs without internet during a session, and sessions are recorded for the team to interpret. We do not promise a clinical outcome from a pilot, and if anyone on our side does, tell us. On who can run the sessions during a pilot, we wrote separately in [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). On what to ask before that, in [how to write a tender specification](/blog/caderno-de-encargos-realidade-virtual-saude/en/). Q: How long should a virtual reality pilot last? A: Six to eight weeks, in a single service. Less is not enough for the novelty to wear off and to see whether sessions really enter the routine; more and the pilot dissolves into daily work without ever being assessed. The essential part is putting the decision date in the calendar before it starts. Q: What should you measure in a virtual reality pilot? A: Sessions per week (the curve says almost everything), who ran them, time per session including setup and cleaning, refusals and interruptions with the reason, and one sentence from whoever ran it at the end of each week. A few simple things beat a complex dashboard nobody fills in. Q: Does a pilot prove that virtual reality works? A: No, and it is important not to promise that. Without a comparison group, without randomisation and with a few dozen sessions, there is no clinical efficacy conclusion to draw: that is what clinical trials are, and they are a different thing. A pilot answers implementation questions: does the team use it, how long does it take, where does it jam, do patients accept it. Q: What is the most common mistake in a pilot? A: Not designating named people. Equipment that is everyone's responsibility is nobody's and ends up in a cupboard: the most predictable pattern in this field. The second mistake is spreading the pilot across several services, which produces several half-experiences and no conclusion. ### Is virtual reality bad for you? Side effects, risks and contraindications URL: https://rver.pt/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/ Date: 16 August 2026 Families, nurses and clinical directors all ask it, and it deserves a straight answer: what is described, what is not, and the concrete situations that call for caution. The question always comes, and almost always in the same words: **is this bad for you?** Families ask before letting a parent try. Nurses ask before offering it to a patient. Clinical directors ask before signing a contract. It deserves a straight answer rather than a brochure. **Short answer:** for the large majority of people, a virtual reality session run by someone trained is well tolerated. The most common unwanted effect is motion sickness, it is temporary, and there are known ways to reduce it. There is a small, specific set of situations where caution or prior clinical assessment is advised: they are listed below, plainly. ## Motion sickness is the most common effect, and the most avoidable It is called cybersickness and it resembles travel sickness: nausea, dizziness, cold sweat, sometimes a headache. It appears when what the eyes see does not match what the inner ear feels. That is why **the type of content matters more than the hardware**. Real 360° video filmed from a fixed point, with no abrupt camera movement, is far less likely to provoke it than a computer-generated environment the user moves through. Short sessions, a seated person and the ability to stop at any moment do the rest. If it happens: take the headset off, stay seated, wait. It passes. ## What about the eyes? This is the most repeated fear and the one with the least established basis. What the literature describes is **temporary eye strain**: the same kind you get after hours at a computer. There is no established evidence today of permanent damage to eyesight from normal use of one of these displays. That said, it is still an area under study, particularly in children, which is exactly why the hardware manufacturer publishes its own [health and safety guidance](https://www.meta.com/legal/quest/health-and-safety-warnings/) and why age limits exist. ## Photosensitive epilepsy: the warning to take seriously A very small share of the population has seizures triggered by flashing lights or patterns. This warning is not specific to virtual reality, it comes from video games and television, but it applies. Anyone with uncontrolled epilepsy or a history of photosensitive seizures should not use it without prior clinical assessment. It is not a formality. ## Older people: the real risk is a fall, not the screen With older people, the concern is not the image: it is balance. Someone standing, with their field of view occupied, can become disoriented. The answer is simple and operational rather than technological: **seated, always accompanied**. It is also why a [lying-down mode](/blog/realidade-virtual-modo-deitado-acamados/en/) exists: so someone bed-bound or reclined can have the experience without standing up. ## Children and adolescents Hardware manufacturers set their own age limits, and there are visual development reasons behind them. In RVer's case, the published answer is that it **is not intended for children under 10**. ## Hygiene Equipment shared between patients needs a [cleaning routine](/en/ferramentas/higiene/) between sessions, with attention to the areas that touch skin. It is not an exotic risk: it is the same logic as any reusable clinical material. ## The situations where we advise caution These are published, and are the same ones on our [frequently asked questions page](/en/faq/): - a history of severe motion sickness or vestibular disorders; - uncontrolled epilepsy or photosensitive seizure disorders; - being unable to follow safety instructions due to severe cognitive impairment. When in doubt, the decision always rests with the responsible healthcare professional. The safety steps for each setting are in the [implementation guides](/en/guia/). :::note A published list of contraindications is not a sign that a product is dangerous. It is the opposite: it is the minimum to expect from anyone selling technology to be used with patients. Be wary of those who have none. ::: ## What changes when it is a registered medical device Registration makes nothing magic. What changes is concrete: there is technical documentation, there is a risk assessment, there is an identified and accountable manufacturer, and there is a formal route to report an incident: to the manufacturer and to [Infarmed](https://www.infarmed.pt/web/infarmed/entidades/dispositivos-medicos/colocacao-no-mercado). RVer's base product is registered in EUDAMED and with INFARMED (Portugal) as a Class I medical device, no. CDM 94571546 (Basic UDI-DI 56006195127RVERTZ), and bears the CE mark under MDR 2017/745. An entertainment app downloaded from a store has none of this: which does not make it dangerous, it makes it a different thing. ## In short 1. **Motion sickness**: the most common effect, temporary, much reduced by filmed content and a seated session. 2. **Eyes**: temporary strain is described; permanent damage is not. 3. **Photosensitive epilepsy**: the warning to take seriously. 4. **Older people**: the risk is a fall: seated and accompanied. 5. **Contraindications**: published, short and specific. RVer is used under the supervision of healthcare professionals or trained carers, as a non-pharmacological complement. It is not intended for self-administration and does not replace clinical assessment or judgement. Q: Is virtual reality bad for your eyes? A: What the literature describes is temporary eye strain, similar to hours at a computer. There is no established evidence today of permanent damage to eyesight from normal use of one of these displays. It remains an area under study, particularly in children, which is why hardware manufacturers publish their own guidance and set age limits. Q: What are the most common side effects of virtual reality? A: The most common is motion sickness (nausea, dizziness, sometimes a headache) which happens when what the eyes see does not match what the inner ear feels. It is temporary and passes after removing the headset. It is greatly reduced by 360° video filmed from a fixed point, short sessions and a seated person. Q: Is virtual reality safe for older people? A: In the large majority of cases yes, with one operational precaution: the session should be seated and always accompanied. With older people the relevant risk is not the image, it is balance: someone standing with their field of view occupied can become disoriented. A lying-down mode also exists for people who are bed-bound or reclined. Q: Who should not use virtual reality? A: Caution or prior clinical assessment is advised for anyone with a history of severe motion sickness or vestibular disorders, uncontrolled epilepsy or photosensitive seizure disorders, or an inability to follow safety instructions due to severe cognitive impairment. RVer is not intended for children under 10. When in doubt, the decision rests with the responsible healthcare professional. Q: Is cybersickness permanent? A: No. Motion sickness in virtual reality is temporary: nausea, dizziness or discomfort usually ease soon after taking the headset off and resting seated. If the symptoms do not go away, see a doctor. ### Who can run a virtual reality session with patients? URL: https://rver.pt/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/ Date: 16 August 2026 A care home wants to know if a care assistant can do it. A clinic wants to know if the physiotherapist must be in the room. Nobody wants to find out after buying. It is the question that always follows "how much does it cost", and it is almost never answered anywhere: **who, in practice, can put the headset on a patient and run the session?** A care home wants to know whether a care assistant can do it. A clinic wants to know whether the physiotherapist has to be in the room. A hospital wants to know who signs. And nobody wants to find out after buying. ## The short answer RVer's intended user is **healthcare professionals and trained carers**. The session is always accompanied. The system **is not intended for self-administration**: it is not something you leave with a patient and come back to later. Within that, who runs the session specifically is a decision for the institution, not the supplier. And there is a good reason for that. [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## Why the answer cannot come from the supplier A product's intended purpose defines the **type** of user. It does not, and cannot, define a service's staffing structure. Who may do what inside a healthcare institution depends on the professional framework of each role, on internal clinical governance, and on the responsibility of whoever runs the service. A device manufacturer answering "anyone can" would be saying something that is not theirs to say, and handing the risk downstream. What is the manufacturer's job is to be clear about three things: what it is for, who the intended user is, and what the product does not do. The rest is a clinical decision. :::note This is not legal advice, nor advice on professional scope. The decision about who runs sessions belongs to the institution's clinical leadership, which knows its own roles, protocols and responsibilities. ::: ## What running a session actually requires It is worth separating "running a session" from what people imagine. In practice, whoever runs it needs to: - **Choose the right content** for the moment and the person; - **Recognise the contraindications** and know when not to proceed; - **Read the signs of discomfort** (nausea, fatigue, disorientation) and stop; - **Clean the equipment** between patients; - **Know how to stop it remotely**, if managing more than one headset. None of this is an advanced clinical competence. It is equipment-specific training, included in the licence. ## What to decide before buying Three decisions worth more than any feature: 1. **Who the named people are.** Not "the team": names. Equipment that is everyone's responsibility is nobody's, and ends up in a cupboard. 2. **Who decides what is appropriate for each patient.** Choosing content for someone with advanced dementia is not the same as choosing for someone on dialysis. That decision has an owner. 3. **What gets recorded, and who reads it.** The session log is raw material for the team to interpret: it is not a report that decides anything on its own. ## One person can manage several headsets The Companion app opens in the browser on any PC or tablet on the same network, with nothing to install. Each headset appears as a card: pick the scenario, play, pause, assign the patient, and trigger a remote emergency stop. That changes the practical answer to the original question: you do not need one professional per headset. You need **someone responsible for the session**, who can be overseeing more than one at a time, provided the people are accompanied in the room. ## Does the medical device registration say anything about this? It says the essentials and nothing beyond them. The base product is registered in EUDAMED and with INFARMED (Portugal) as a Class I medical device, no. CDM 94571546 (Basic UDI-DI 56006195127RVERTZ), and bears the CE mark under MDR 2017/745. The documentation accompanying the registration identifies the **intended user** (healthcare professionals and trained carers) and excludes self-administration. What the registration does **not** do is tell a Portuguese hospital which of its professional roles may operate the equipment. That was never within the scope of a device registration, and be wary of anyone who tells you otherwise. The [user manual](/manual/en/) is public and says this in full, including the contraindications and the route for reporting a serious incident. ## In short - **Intended user:** healthcare professionals and trained carers. - **Never self-administration.** The patient is always accompanied. - **Who specifically:** the institution decides, not the supplier. - **Training:** included in the licence. - **One person, several headsets:** possible through Companion. Q: Do I need to be a therapist to use virtual reality with patients? A: RVer's intended user is healthcare professionals and trained carers, and the session is always accompanied. Who specifically runs it inside an institution is a decision for the clinical leadership, which knows the professional framework of its roles and its own governance; the supplier does not define it. Q: Can a care assistant run a session? A: The intended purpose covers trained carers, so it is not excluded at the outset. But the decision belongs to the institution: it depends on internal rules, the framework of each role, and who carries the clinical responsibility. A manufacturer answering "anyone can" would be saying what is not theirs to say. Q: Can the patient use it alone? A: No. The system is not intended for self-administration and the patient is always accompanied. It is not something to leave with a person and come back to later. Q: Do you need one professional per headset? A: No. The Companion app opens in the browser on any PC or tablet on the same network and shows each headset as a card: pick the scenario, play, pause, assign the patient, and trigger a remote emergency stop. You need someone responsible for the session, who can oversee more than one at a time, provided the people are accompanied in the room. ### Virtual reality or a tablet? What differs, and when the tablet wins URL: https://rver.pt/blog/realidade-virtual-ou-tablet-qual-a-diferenca/en/ Date: 16 August 2026 "A tablet with nature videos costs two hundred euros. Why would we buy this?" It is the most honest objection we get, and it deserves the full answer. It is the most honest objection we get, and it usually comes from someone who has had to justify a purchase before: *"a tablet with nature videos costs two hundred euros. Why would we buy this?"* The answer deserves to be given properly, including the part where the tablet wins. ## What physically differs There are three concrete differences, and none of them is a matter of opinion. **The field of view is occupied.** With a tablet, the person sees the screen and sees the room: the needle, the machine, the professional. With a headset, they see the scenario and nothing else. This is the central difference, and almost everything else follows from it. **The image responds to looking around.** 360° video follows head movement, so looking to the side shows what is to the side. On a tablet, turning your head shows you the wall. **The sound is spatial.** It comes from directions, not from a speaker in front. ## What that means in practice For procedures, occupying the field of view **is the point**, not a side effect. Someone afraid of needles who cannot see the needle is in a different situation from someone who sees it next to a screen. For bed-bound people, a tablet has to be held or propped, and it is always in the wrong place. A headset with a lying-down mode aligns the horizon with the tilt of the head: the image appears level even with the person at 30° or 90°. For reminiscence, being somewhere is not the same as seeing somewhere. Whether that difference translates into measurable benefit is another conversation, and it is the next one. ## What the evidence says about this specific comparison Little, and that needs saying. There is a fair amount of research on virtual reality in healthcare settings, and a fair amount on distraction as a strategy. **Studies directly comparing a headset with a tablet, in the same procedure and with the same content, are few.** So anyone guaranteeing that virtual reality is *x per cent* better than a screen is extrapolating. We do not claim it. Our [study library](/estudos/en/) is open precisely so you can see what exists and what does not. :::note The right question is not "which is better". It is "which is appropriate for this moment, in this service, with this person", and there are plenty of moments where the answer is the tablet. ::: ## When the tablet is the right answer Let us put it in writing, because it is true: - **When the person needs to keep seeing the room**: because losing the reference makes them anxious, because they need to communicate by gesture, or because the team needs to see their face. - **When the family wants to watch too.** A tablet is shareable; a headset is a one-person experience at a time. - **When there is a contraindication.** Severe motion sickness, vestibular disorders, uncontrolled epilepsy: the list is on our [FAQ page](/en/faq/). - **When the person simply does not want** their eyes covered. It happens, and it is reason enough. - **When the budget does not stretch.** A tablet with good content beats a headset nobody bought. ## What you buy besides the headset If the comparison is only "headset versus tablet", the tablet wins on price, every time. The honest comparison is between **a device and a system**: - content chosen for the clinical context, rather than a list of videos; - managing several headsets from one screen, with a remote stop; - a record of how each session went, for the team to interpret; - working without internet during a session; - team training, included; - an identified manufacturer, with technical documentation, a risk assessment and a formal route for reporting incidents. RVer's base product is registered in EUDAMED and with INFARMED (Portugal) as a Class I medical device, no. CDM 94571546 (Basic UDI-DI 56006195127RVERTZ), and bears the CE mark under MDR 2017/745. A tablet with a video app has none of this: which does not make it worse, it makes it a different thing. ## In short - **The physical difference is real:** the field of view is occupied, the image follows the head, the sound has direction. - **The difference in clinical outcome between the two is barely studied.** Anyone giving you a number is extrapolating. - **In several cases the tablet is the right choice,** and a supplier who never admits it is selling you something. - **What distinguishes them is not the headset**: it is what comes around it. If you are deciding between the two for a specific service, tell us the clinical moment. If the answer is the tablet, we will say so. Q: What is the difference between virtual reality and watching a video on a tablet? A: Three physical differences: with a headset the field of view is occupied and the person does not see the room, the 360° image follows head movement, and the sound is spatial. With a tablet the person still sees the screen and the room around it. For procedures, occupying the field of view is precisely the point; in other contexts it is a drawback. Q: Does virtual reality work better than a tablet? A: There is no solid basis for claiming that. There is research on virtual reality in healthcare and on distraction as a strategy, but studies directly comparing a headset with a tablet, in the same procedure with the same content, are few. Anyone giving you a percentage is extrapolating. Q: When is a tablet the better option? A: When the person needs to keep seeing the room, when the family wants to watch too, when there is a contraindication to the headset, when the person does not want their eyes covered, and when the budget does not stretch: a tablet with good content beats a headset nobody bought. Q: So what are you buying besides the headset? A: Content chosen for the clinical context, managing several headsets from one screen with a remote stop, a record of how each session went, working without internet during a session, training included, and an identified manufacturer with technical documentation, a risk assessment and a formal incident reporting route. ### Virtual reality and Parkinson's disease: what the research is looking at URL: https://rver.pt/blog/realidade-virtual-doenca-de-parkinson/en/ Date: 16 August 2026 We collected eight publications on virtual reality and Parkinson's. Six look at the same triad (balance, gait and falls), and what remains undecided says as much as what is known. Parkinson's disease is a neurodegenerative movement disorder. The best known motor signs are slowness, rigidity, resting tremor and postural instability, and it is the last of these that becomes the most limiting over time, because it is the one that brings the fear of falling. Physiotherapy and guided exercise are an established part of care. The question that keeps coming up is whether virtual reality adds anything to that work, and this is where it pays to separate what is being studied from what is settled. ## What the literature is looking at We have collected eight publications on Parkinson's in our [study library](/estudos/tema/parkinson/en/). Read together, what stands out is where the research concentrates: - **Benefits of Virtual Reality Balance Training for Patients With Parkinson Disease: Systematic Review, Meta-analysis** - **The Effectiveness of Virtual Reality in Improving Balance and Gait in People with Parkinson's Disease** - **Efeitos da realidade virtual no equilíbrio e marcha de indivíduos com doença de Parkinson: uma revisão sistemática** - **The Effectiveness of Virtual Reality Exercises to Reduce Fall Risk in Parkinson's Disease: A Literature Review** - **Precision intervention of virtual reality training for balance and gait in Parkinson's disease: a dose–response analysis** - **Effects of Virtual Reality in the Rehabilitation of Parkinson's Disease: A Systematic Review** - **Supporting Tremor Rehabilitation Using Optical See-Through Augmented Reality Technology** - **Designing Virtual Reality Assisted Psychotherapy for Anxiety in Older Adults Living with Parkinson's Disease** Six of the eight look at the same triad: **balance, gait and fall risk**. One asks about **dose** (how much, how often, for how long), which is the question a clinical team asks immediately after "does it work?". One steps away from the motor side and into **anxiety** in older adults with Parkinson's, a part of the disease that gets discussed less. And one addresses **tremor**, using augmented rather than virtual reality, which is a different technology. ## What that says, and what it does not It says there is a body of research organised around a concrete, well-defined problem: balance and falls. This is not a fashionable technology hunting for an application: it is the opposite, an old clinical need looking for tools. It does not say the matter is settled. Systematic reviews and meta-analyses exist precisely because individual studies disagree with each other, and the presence of a dose–response analysis in the list is the clearest sign that the parameters are still under discussion. And there is a distinction that often gets lost: **"virtual reality" is not one intervention.** A computer-generated environment with locomotion, a console game with a motion sensor, and real 360° video filmed from a fixed point are different things, with different risks and probably different effects. A review that pools all three is adding apples to oranges, and the good reviews say so. :::note These studies are about virtual reality as a technology. They are not clinical studies of RVer, they were not conducted with RVer, and they do not constitute a performance claim for the product. They are in the library because they are the context the product exists in, not because they validate it. ::: ## Where RVer sits in this Honestly: RVer's base product is a 360° video library for comfort, distraction, relaxation, reminiscence and guided activity. **It is not a balance rehabilitation programme for Parkinson's disease, and we do not claim it treats the condition or reduces falls.** RVer Motion (guided movement, recording repetitions and range per session) is a module **in development and not covered** by the Class I medical device registration, which covers the base product. Anyone calling it rehabilitation is running ahead of what exists. What the system does, and does well, is deliver content under the supervision of a healthcare team, with a record of how the session went for the team to interpret. The clinical decision belongs to whoever is in the room. ## For teams working with Parkinson's If you are considering virtual reality in a neurology service or a rehabilitation unit, three questions save time: 1. **Which kind of virtual reality?** Filmed video and computer-generated environments are not the same proposition, in risk or in effect. 2. **Which evidence is about this product**, and which is about the technology in general? They are different things, and a serious supplier distinguishes them. 3. **Who runs the session, and with what training?** The eight publications are in the [study library](/estudos/tema/parkinson/en/), there to be read directly. You do not have to take our word for it. Q: Does virtual reality help with Parkinson's disease? A: There is an organised body of research on the topic, concentrated on balance, gait and fall risk: we have collected eight publications in our study library. The matter is not settled: systematic reviews exist because individual studies disagree, and dose parameters are still under discussion. These are studies of virtual reality as a technology, not of RVer. Q: Does RVer treat Parkinson's disease? A: No, and we do not claim it does. RVer's base product is a 360° video library for comfort, distraction, relaxation, reminiscence and guided activity, used under the supervision of healthcare professionals. It is not a balance rehabilitation programme and makes no claim to reduce falls. Q: What does research on Parkinson's and virtual reality study most? A: Balance, gait and fall risk: six of the eight publications we collected address this triad. One analyses dose (how much, how often, for how long), one addresses anxiety in older adults with Parkinson's, and one addresses tremor using augmented reality, which is a different technology. Q: Are all forms of virtual reality the same in these studies? A: No, and it is a distinction that is frequently lost. A computer-generated environment with locomotion, a game with a motion sensor, and real 360° video filmed from a fixed point carry different risks and probably different effects. A review that pools them is adding different things together, and the good reviews flag it. ### Do you need consent to use virtual reality with a patient? URL: https://rver.pt/blog/consentimento-informado-realidade-virtual-saude/en/ Date: 16 August 2026 A question that arrives late and should arrive early, usually with the equipment already on the table and a clinical governance meeting in the calendar. It is a question that arrives late and should arrive early: **do you need consent to put a virtual reality headset on a patient?** Whoever asks usually already has the equipment on the table and a clinical governance meeting in the calendar. It is worth arriving with the answer ready. :::note This is not legal advice. The decision on the form of consent belongs to the clinical leadership and the institution's own framework. What follows is what experience shows teams weigh up. ::: ## Start by classifying what you are doing The question that precedes consent is: **what is this, within your protocol?** If the session is understood as a comfort and occupation activity (like putting on music, reading aloud, or watching a film with someone) it is in one category. If it is understood as part of an intervention plan with defined objectives, it is in another. The form of consent follows that classification, not the other way round. Many institutions resolve this by placing sessions inside an existing general care consent. Others prefer a specific record. Both are defensible positions; what is not defensible is never having decided. ## What makes this different from putting on a film One thing, and it is concrete: **the headset occupies the field of view**. The person stops seeing the room. That is the difference that justifies explaining beforehand, even where the institution concludes no signature is needed. Someone who did not understand what was about to happen and suddenly cannot see the room is having a different experience from the intended one. In practice, three sentences do it: **what you will see, how long it lasts, and that you can stop whenever you want.** ## The right to stop matters more than the signature More than a signature, what protects is the power to interrupt. - Does the person know they can say "take this off me" and that it happens immediately? - Is there someone in the room to hear it? - Can the team stop it remotely if the person cannot ask? With RVer the session is always accompanied and the Companion app has a remote emergency stop. That does not replace the explanation beforehand: it backs it up. ## When the person cannot consent This is the most frequent case in care homes and in advanced dementia, and it is where teams hesitate most. The usual framing combines three things: authorisation from whoever has legitimacy to decide, the **assent** of the person in the moment (meaning accepting, not resisting, not showing discomfort) and continuous reading of signs by whoever is running the session. Refusal does not have to be verbal. Removing the headset, turning the head away, becoming agitated: all of that is refusal, and is treated as such. A session that continues against signs like these has no consent at all, whatever has been signed. ## The contraindication check comes first It is not consent, but it belongs to the same conversation and happens first. Caution or prior clinical assessment is advised for anyone with a history of severe motion sickness or vestibular disorders, uncontrolled epilepsy or photosensitive seizure disorders, or who cannot follow safety instructions. The list is on the [FAQ page](/en/faq/) and in the [manual](/manual/en/). ## What about consent for data? This part is simpler than feared, because **no personal patient data leaves the headset**. What is sent is per-device usage statistics (which content played, on which headset, when) which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server. The institution is the data controller for its patients' data. Whoever writes the consent text will be grateful for that paragraph: there is no need to seek authorisation to transfer clinical data that is not transferred. ## A workflow that tends to work 1. **Before:** check contraindications. 2. **Before:** explain in three sentences: what you will see, how long, you can stop. 3. **During:** someone in the room, watching for signs. 4. **After:** record that the session happened, like any other activity. 5. **Once, at the start:** decide which category this falls into in your protocol, and write it down. The fifth point is the only one that needs a meeting. The other four are routine. On who can run the sessions, we wrote in [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). On safety and contraindications, in [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). Q: Is informed consent required for a virtual reality session? A: It depends on how the institution classifies the session in its protocol: a comfort and occupation activity, or part of an intervention plan. Many institutions fold it into an existing general care consent; others prefer a specific record. Both are defensible. The decision belongs to clinical leadership, and what is not defensible is never having decided. Q: What should you explain to the person beforehand? A: Three sentences are enough: what you will see, how long it lasts, and that you can stop whenever you want. What distinguishes this from putting on a film is that the headset occupies the field of view and the person stops seeing the room: that difference justifies explaining beforehand even where no signature is required. Q: What if the person cannot consent, for example in advanced dementia? A: The usual framing combines authorisation from whoever has legitimacy to decide, the assent of the person in the moment (accepting, not resisting, not showing discomfort) and continuous reading of signs by whoever is running the session. Refusal does not have to be verbal: removing the headset, turning away or becoming agitated is refusal and is treated as such. Q: Is consent needed for data in virtual reality? A: The data part is simpler than feared, because no personal or clinical patient data leaves the headset. What is sent is per-device usage statistics, which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server. ### How to write a tender specification for virtual reality in healthcare URL: https://rver.pt/blog/caderno-de-encargos-realidade-virtual-saude/en/ Date: 16 August 2026 Buying in a hospital is not choosing a product: it is writing a document. And the decision is made in that document, long before any bids arrive. Buying inside a public hospital is not choosing a product: it is writing a document. And the decision is made in that document, long before any bids are on the table. The problem is that virtual reality in healthcare has no standard specification yet. The result is tender documents asking for the wrong things: screen resolution instead of declared intended purpose, number of games instead of regulatory framing, and then a clause demanding a "certified therapeutic solution" that no honest supplier can meet, because it does not exist. This is the skeleton we would use. Not to favour us: to force whoever answers to tell the truth. ## 1. Start with the purpose, not the hardware The question that orders everything else is **what this will actually be used for in this service**. Comfort during a procedure is not the same as cognitive stimulation in a care home, and neither is the same as supporting guided exercise. Ask the bidder for the product's **declared intended purpose** as it appears in the technical documentation, and not the list of applications in the brochure. They are different documents and they sometimes say different things. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## 2. Regulatory framing: ask for what is verifiable This is where tender documents slip most. Three formulations that work: - **"State whether the product is a medical device and, if so, its class, registration number and competent authority."** A registration number can be checked; the word "certified" cannot. - **"State whether it bears the CE mark and under which regulation."** - **"State whether a notified body was involved and, if so, which one."** That last one is the most useful and almost never appears. For a Class I device that is non-sterile and has no measuring function **there is no notified body**. A bidder who answers that question with a notified body number is either in a higher class or making it up. Either way, you learned something. Also ask for the **EU Declaration of Conformity** and the **device label** as annexes. Any serious manufacturer hands those over. :::note Do not write "solution certified as a therapeutic medical device". That category does not exist, and the clause either excludes everyone or forces someone to lie in order to answer. ::: ## 3. Separate the base product from the modules Many systems are modular, and not every module is in the same regulatory state. One line handles it: > "State which components of the system are covered by the medical device > registration and which are not." If the answer is "all of them", ask for the document. ## 4. Data: where it lives, and what leaves the device Three closed questions, with no room for prose: - What patient data is collected, if any? - What leaves the device, to where, and on what lawful basis? - Does the system work without an internet connection during a session? The last is operational and regulatory at once: a service with patchy Wi-Fi cannot depend on streaming, and a system that runs offline has less exposed surface. ## 5. Contraindications and safety Ask for the **list of contraindications** and the **procedure for reporting serious incidents**. A supplier with neither has not thought about it, and that is the most useful information a tender response can give you. ## 6. Operation: who uses it, with what training - Who is the intended user? - Is training included? Is it on site? - Can one person manage several headsets at once? - Who chooses the content for each patient? ## 7. Total cost, not unit price Ask for three-year cost with everything in it: licence, headsets, content, updates, replacements, support and training. And ask explicitly **what happens at the end of the contract**: if the equipment becomes unusable, that is part of the price. ## 8. Evidence: separate the two things One clause separates the serious from the rest: > "State what published evidence exists about THIS product and what evidence is > about the technology in general, clearly distinguishing the two." Most suppliers only have the second. There is nothing wrong with that: as long as they say so. ## What not to ask for - **Resolution, field of view and pixel counts.** It is the same handful of headsets on the market; specifying this distinguishes nobody and excludes solutions by accident. - **Number of scenarios.** A hundred bad ones are worth less than twenty appropriate ones. - **Certifications that do not exist.** See above. ## If you want to check our own answers What we would answer is public: RVer's base product is registered in EUDAMED and with INFARMED (Portugal) as a Class I medical device, no. CDM 94571546 (Basic UDI-DI 56006195127RVERTZ), and bears the CE mark under MDR 2017/745, with no notified body, because for a Class I non-sterile device without a measuring function there is none. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are **not** covered by that registration. The contraindications are on the [FAQ page](/en/faq/), the scope of the registration is in [science and regulation](/en/ciencia/), and the [user manual](/manual/en/) is open. If you are writing a tender document and would like someone to read it before it goes out, we will tell you what is impossible to comply with, even when the clause would favour us. On the question that separates suppliers when someone claims savings, see [the ROI nobody can prove](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). Q: What should a tender specification for virtual reality in healthcare contain? A: The product's declared intended purpose, verifiable regulatory framing (is it a medical device? which class? which registration number? which authority? was a notified body involved?), which components are covered by the registration, what data leaves the device, whether it works offline, the contraindications, the incident reporting procedure, who the intended user is, and total cost over three years. Q: Can I require a "solution certified as a therapeutic medical device"? A: You should not, because that category does not exist. Medical devices have registrations, classes and CE marking. For a Class I device that is non-sterile and has no measuring function there is not even a notified body. Such a clause either excludes every bidder or forces someone to answer incorrectly. Q: How do I confirm a supplier really is a medical device? A: Ask for the registration number and the competent authority, and ask for the EU Declaration of Conformity and the device label as annexes. A registration number can be checked with the authority; the word "certified" can be checked against nothing. Also ask whether a notified body was involved: the answer tells you a lot. Q: What is not worth asking for in a virtual reality tender? A: Resolution, field of view and pixel counts: it is the same handful of headsets on the market, it distinguishes no bidder and excludes solutions by accident. Number of scenarios, because a hundred bad ones are worth less than twenty appropriate ones. And certifications that do not exist. ### Accessibility: which patients can actually use virtual reality URL: https://rver.pt/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/ Date: 16 August 2026 After price, this is always the question. The answer splits three ways: what is no obstacle, what calls for care, and where the answer really is no. When a service evaluates virtual reality, the question that usually follows price is this: **can our patients actually use it?** It is a good question, and the honest answer splits three ways: there are limitations that are no obstacle at all, limitations that call for care, and limitations that mean the answer is no. It is worth knowing which is which before buying. ## Nothing to operate The most common confusion comes from video games: people assume controllers, buttons and manual dexterity. RVer's base library has none of that. It is 360° video, and **the team chooses and drives**, from the Companion app in the browser. The person wearing the headset does not have to operate anything: they watch and listen. That resolves a large set of situations at once: tremor, arthritis, hemiparesis, amputation, reduced strength, or simply not knowing how to use technology. None of them prevents a session. The RVer Motion, RVer Neuro and RVer Exposure modules do use controllers and movement: they are a different proposition, they are in development, and they are not covered by the medical device registration. The base library is not. ## Reduced mobility and bed-bound patients **Seated is the recommended mode for everyone**, not only for people with difficulty. The relevant risk in a session is not the image: it is someone standing losing their balance with their field of view occupied. For people bed-bound or reclined there is a lying-down mode, which aligns the horizon of the experience with the tilt of the head. The image appears level with the person at 30° or 90°: in bed, in a dialysis recliner or in a dentist chair. It applies to every scenario in the library, with no need for content filmed specially. Wheelchair: nothing particular, it is a seated session. ## Communication You do not need to speak to take part. There are no verbal instructions to follow and no answers to give. That makes the session accessible to people with aphasia, dysarthria, or who simply do not communicate verbally. **But it places a demand on the team:** if the person cannot say "take this off me", whoever is in the room has to read the signs (agitation, hands going to the headset, turning away) and the app allows a remote stop. Combining the two resolves it. Neither alone is enough. ## Vision and hearing Here it pays to be blunt, because this is where too much gets promised. **Low vision:** it depends entirely on the degree and type. The screen is very close to the eyes and large in the visual field, which helps some people, but it is not a vision aid and should not be sold as one. Testing with the person is the only way to know. **Blindness:** the experience is visual. Spatial audio exists, but it would be dishonest to present this as a proposition for someone who cannot see. **Deafness or hearing loss:** the scenario remains, with one layer fewer. Several scenarios work well without sound. **Prescription glasses:** a practical question worth resolving at installation, with the team, rather than on the day of the first session. ## Cognition The base library requires no understanding of rules and no tasks to complete: watching a beach has no instructions. That is why it works with people with moderate cognitive impairment, and reminiscence is one of the most frequent uses in care homes. The limit is written in the contraindications and is about safety, not comprehension: **anyone unable to follow safety instructions** due to severe cognitive impairment should not use it without prior clinical assessment. ## When the answer is no For honesty, and because it is short: - a history of severe motion sickness or vestibular disorders; - uncontrolled epilepsy or photosensitive seizure disorders; - inability to follow safety instructions due to severe cognitive impairment; - children under 10; - and, most important of all, **anyone who does not want to**. Covering your eyes is not neutral for everybody, and refusing is a complete answer. The list is on the [FAQ page](/en/faq/) and in the [manual](/manual/en/). :::note A note on language: "accessible" does not mean "for everyone". It means the avoidable barriers have been removed and the remaining ones are written down. That is what can be promised. ::: ## In short | situation | answer | |---|---| | No manual dexterity, tremor, hemiparesis | No problem: the team drives | | Wheelchair, reduced mobility | No problem: seated session | | Bed-bound or reclined | Lying-down mode | | Aphasia, no verbal communication | Possible, with the team reading signs | | Low vision | Case by case; test | | Blindness | Not the proposition | | Hearing loss | No problem | | Moderate cognitive impairment | One of the most frequent uses | | Severe cognitive impairment with safety risk | Prior clinical assessment | On risks and contraindications in full, see [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). On who runs the session, see [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). Q: Do you need to use controllers for a virtual reality session? A: Not with RVer's base library. It is 360° video and the team chooses and drives, from the Companion app in the browser: the person wearing the headset watches and listens, they operate nothing. That resolves tremor, arthritis, hemiparesis, amputation, reduced strength or simply not knowing how to use technology. Q: Can a bed-bound person or wheelchair user use virtual reality? A: Yes. Seated is in fact the recommended mode for everyone, because the relevant risk is someone standing losing balance with their field of view occupied. For people bed-bound or reclined there is a lying-down mode, which aligns the horizon of the experience with the tilt of the head, at 30° or 90°. Q: Can someone with aphasia or who does not speak take part? A: Yes: there are no verbal instructions to follow and no answers to give. But it demands more of the team: if the person cannot ask to stop, whoever is in the room must read signs such as agitation, hands going to the headset or turning away, and the app allows a remote stop. Q: Can someone with low vision or blindness use it? A: Low vision depends entirely on degree and type: the screen is very close and large in the visual field, which helps some people, but it is not a vision aid and should not be presented as one: testing is the only way to know. For someone who is blind, the experience is visual and it would be dishonest to present it as a proposition. ### The ROI nobody can prove, and what to measure instead URL: https://rver.pt/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/ Date: 16 August 2026 "Saves X euros per patient" is the sentence an informed buyer tests first, and almost always the first to fall. The conclusion is not that there is no return: it is that it gets measured somewhere else. One sentence appears in almost every commercial deck for virtual reality in healthcare, with different numbers attached: *"saves X euros per patient"*. It is the sentence an informed buyer tests first, and it is almost always the first to fall. This article is part of the [ROI guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/). It is worth understanding why, because the conclusion is not "there is no return". It is that **the return has to be measured in your own house**, and there is a correct way to do it. ## The real state of the economic literature In October 2026, our public library held **130 studies** on virtual reality in healthcare settings. Of those, **eight** are about cost and return, and even those come from very specific contexts: paediatric imaging without sedation, post-operative pain, a mental health programme in the UK. Eight out of a hundred and thirty is not an accident of our selection. It is the state of the field: clinical research on virtual reality is abundant, economic research is scarce. Anyone presenting a savings figure as settled is generalising from very little. ## Why the numbers do not transfer Even when an economic study is good, three things stop its number from being yours: **1. The population is not the same.** A trial in paediatric imaging measures children who, without virtual reality, would be sedated. If in your service those children are not sedated, the saving the study calculates does not exist for you: not because the technology fails, but because the avoided cost was never there. **2. The comparator is not the same.** "Saves against what?" decides the whole result. Against nothing is easy. Against the distraction a nurse already provides with conversation, a tablet or a parent in the room, it is a different conversation, and that is the honest comparison. **3. The payer is not the same.** A study from the public payer's perspective counts different things from one taken from the hospital's, and both count different things from a private care home's. A saving that lands in a national budget may never land in yours. ## What to do instead of believing the number Measure. A three-month pilot answers better than any brochure, as long as you decide **beforehand** what you are going to count. Four metrics are enough: 1. **Sessions delivered per week**: the only one that says whether the thing actually entered the routine. A solution nobody uses returns zero, whatever the literature says. 2. **Who took part who did not before.** This is the most defensible value in a care home or any service with group activities: reaching the people who were left out. 3. **Real staff time per session.** Timed, not estimated. It is the true cost and it is always higher than the first estimate. 4. **Refusals and interruptions.** How many said no, how many took the headset off early. It says more about fit than any satisfaction survey. None of these four is a clinical metric, and that is deliberate: a pilot answers implementation questions well (does the team use it? where does it jam?) and **does not answer clinical efficacy at all**, however much you are promised otherwise. ## How to write this into a tender If you are preparing a tender, the question that separates suppliers is this: > "List the studies supporting the saving you claim, with population, > comparator and payer perspective." Those who have them, show them. Those who do not answer with success stories and testimonials: a perfectly legitimate answer, as long as it is not presented as economic evidence. :::note We do not claim savings ourselves. What we state is what can be verified: what the equipment does, what gets recorded, how much staff time it consumes, and where an institution's arithmetic usually closes. The Class I registration covers the base product and is not, and never was, an efficacy argument. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. The eight cost studies are under [Cost and return](/estudos/tema/custos-e-roi/en/) in the public library, alongside the other 122. On running the pilot, see [how to run a pilot in a health service](/blog/piloto-realidade-virtual-hospital-como-correr/en/). On a care home's arithmetic, see [what it returns in a care home](/blog/roi-realidade-virtual-lar-de-idosos/en/). Q: Are there studies proving savings with virtual reality in healthcare? A: There are few, and from very specific contexts: paediatric imaging without sedation, post-operative pain, a mental health programme. In our library they were eight out of 130 studies in October 2026. Clinical research is abundant; economic research is scarce, and a savings figure presented as settled is generalising from very little. Q: Why does a study’s saving not apply to my service? A: Three reasons: the population may differ (if your patients would not be sedated, the avoided cost does not exist), the comparator may differ (saving against nothing, or against the distraction your team already provides?) and the payer perspective may differ: a saving in a national budget may never appear in yours. Q: What should a three-month pilot measure? A: Sessions delivered per week, who took part who did not before, real staff time per session (timed, not estimated), and refusals or interruptions. None is a clinical metric: a pilot answers implementation questions and does not answer clinical efficacy. ### What does it return in a care home? The ROI a hospital does not calculate URL: https://rver.pt/blog/roi-realidade-virtual-lar-de-idosos/en/ Date: 16 August 2026 The hospital arithmetic (sedation avoided, theatre time) does not exist in a care home. The variable that decides it is a different one, and you probably know it by heart. Almost everything written about the return on virtual reality in healthcare was written with a hospital in mind: sedation avoided, theatre time, shorter procedures. In a care home, none of that exists. There is no theatre, no anaesthetist, no procedure to shorten. A care home's arithmetic is different, and simpler, as long as you start with the right variable. ## The variable that dominates: occupancy In a care home, the difference between a good month and a bad one is rarely in the costs. It is an empty bed. An unfilled place is a whole monthly fee that does not come in, every month it stays that way. Which is why the useful question is not "how much does this equipment save?", but: > **Does this help fill a place, or hold on to a family comparing two homes?** If the answer is yes once a year, the arithmetic closes itself with your own monthly fee: no other lever needed. If it is no, none of the other lines will justify the service. That is not a promise: it is where the decision is made. A family visiting three homes in the same month decides on visible differences, and what you can show during a visit counts. ## The second line: staff time The individual activity has a real, measurable cost: **the time of whoever runs it.** Allowing about five minutes to choose the scenario and fit the headset, plus ten of session, that is fifteen minutes per resident. With one person, that means twelve to sixteen sessions a week without undoing the rest of the plan. Multiplied by your team's real hourly cost, it is a number that comes off your payroll, not ours. The relevant comparison is not with "doing nothing": it is with the activity that would otherwise fill that slot. ## The third: what you already pay for and would now be covered Look at what already leaves the budget and could be covered: - outside entertainment booked once a week; - stimulation materials bought piecemeal every year; - building work postponed for a room that does not exist (this is where the comparison with a [multisensory room](/blog/sala-snoezelen-ou-realidade-virtual-lares/en/) comes in); - overtime on rainy days, when the outing is cancelled and an afternoon has to be invented. ## The fourth: what you can show without manual work An automatic record of what was done, with whom and for how long. It is not a direct saving: it is clinical-director time no longer spent reconstructing memory for a family, an audit or an activity report. ## A six-line model Fill it in with your own figures. We do not publish numbers we do not control, and the ones that matter here are all yours: | Line | What to fill in | |---|---| | 1. Average monthly fee | the value of one place, per month | | 2. Unfilled places | average over the last 12 months | | 3. Staff hourly cost | of whoever will run the sessions | | 4. Sessions per week | 12 to 16 is the pace with one person | | 5. Existing cost | outside entertainment and materials now covered | | 6. Cost of the service | annual service with headsets included, per month | The arithmetic that matters is: **(1) × (probability of holding a place) + (5) − (3 × hours) − (6)**. If line 1 is large enough, and in a care home it almost always is, the rest of the model is detail. ## What you cannot count Do not count on reduced medication, fewer falls or clinical improvement. We have no trials supporting that for our product, and putting any of those lines into a tender builds a case that does not survive the first hard question. What you can count is what you measure in the house: sessions delivered, who took part who did not before, real staff time, and what the family says on the next visit. :::note Virtual reality in a care home is a comfort, stimulation and wellbeing activity, run by trained professionals or carers. It is not treatment, it does not replace clinical assessment or prescribed therapy, and no line of this model should be presented as a clinical benefit. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. This is one of the three sums in the [ROI guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/), and how RVer is used in a care home is in [care homes](/en/solucoes/lar-residencial/). On where the sessions fit in the week, see [a care home activity plan](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). On the hospital-side arithmetic, see [where the saving is](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/en/). Q: How do you calculate the ROI of virtual reality in a care home? A: Start with occupancy: an unfilled place is a whole monthly fee, every month. Then staff time per session (about fifteen minutes per resident), the costs you already carry that would now be covered, and the cost of the solution. The six-line model in this article uses only the institution’s own figures. Q: Can I count on savings in medication or fewer falls? A: No. There are no trials supporting those lines for our product, and putting them in a tender builds a case that does not survive the first hard question. Count what you measure in the house: sessions delivered, who started taking part, real staff time. Q: How much staff time does each session cost? A: About five minutes to choose the scenario and fit the headset, plus ten of session. With one person running them, twelve to sixteen sessions a week fit without undoing the rest of the activity plan. ### Sundowning in dementia: what the team can change in the environment URL: https://rver.pt/blog/agitacao-fim-da-tarde-demencia-sundowning/en/ Date: 16 August 2026 At five in the afternoon the house changes. Before talking about activities there is a physical checklist to rule out, and then three things in the environment that usually matter more than anything new. At five in the afternoon the house changes. Someone calm all day stands up, looks for the door, asks for their mother, wants to go home. The afternoon shift knows this better than anyone. ## What is sundowning **Sundowning** is the name for a pattern where restlessness, confusion and anxiety rise in the late afternoon and evening in people with dementia. The word comes from *sundown*. It is also called sundown syndrome or late-day confusion. It is not a diagnosis and it has no single cause. What exists is a set of things that tend to contribute, and some of them are within reach of whoever is in the room. ## First, what is not behaviour Before changing the environment, rule out the physical. A good share of what reads as agitation is something else showing itself: - **pain** nobody named, especially in people who no longer describe it; - **needing the toilet**, constipation, urinary retention; - **hunger or thirst**: dinner is still far off; - **infection**, urinary in particular, which in older adults often appears as confusion before it appears as fever; - **medication effects**, including recent changes. This list comes first, always. And any decision about medication belongs to the clinical team: nothing below replaces it. ## Then, the environment Late afternoon brings three things together: the light drops, the noise rises (shifts changing, visitors leaving, a television on) and the body is tired. Teams that manage to bring agitation down almost always work on these points: - **Light.** Switch it on before it gets dark, not after. The abrupt shift from light to dark is the most cited trigger. - **Noise.** Fewer sources at once. A television nobody is watching is noise, not company. - **Routine.** The same thing, at the same time, by the same person where possible. Predictability does more than any new activity. - **Caffeine and long naps** late in the day: both show up in the guidance. - **A task with meaning.** Folding towels, setting the table, tending a plant. Occupying is not entertaining. ## Where a calm scenario fits This is where what we build comes in, and it is worth being exact about what it is and is not. A 360° video scenario (a beach at dusk, a garden, a familiar village) is **one more calm-environment option**, alongside music, photographs and conversation. What is different about it is that it occupies the field of view: the room with the shift-change noise stays outside for a few minutes. Three things need saying plainly: 1. **The published research on virtual reality in dementia is mostly about wellbeing, engagement and reminiscence, not about sundowning specifically.** We have no trials saying it resolves sundowning, and that is not our claim. 2. **It is not for everyone.** Someone already very agitated will not accept anything on their head, and insisting makes it worse. The useful window is usually *before* the peak, not during it. 3. **The session is always accompanied** and stops whenever the person wants. Covering someone's eyes is not neutral when they are disoriented. In practice, teams that use this late in the day do it early, around four, and keep it short: five to ten minutes, seated, with someone alongside. ## A checklist for the afternoon shift 1. Rule out pain, toilet, hunger, thirst and infection. 2. Turn the lights on before it gets dark. 3. Cut the number of noise sources. 4. Keep the same sequence every day. 5. Offer a meaningful task, or a calm environment, **before** the peak. 6. Record what happened and at what time: that is what reveals the pattern. Point 6 is the one usually missing. Without a record, every shift starts from scratch and nobody knows whether yesterday's attempt worked. :::note None of this is treatment and none of it replaces clinical assessment. A persistent change in behaviour deserves medical review: it may be pain, infection or a medication effect. Decisions about therapy belong to the clinical team. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. On use in dementia, see [reminiscence, calm and moments of presence](/blog/realidade-virtual-demencia-alzheimer/en/). On who can use the equipment, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). Q: What is sundowning? A: It is the name given to the pattern where restlessness, confusion and anxiety rise at the end of the day in people with dementia. It is not a diagnosis and has no single cause, and the first step is to rule out pain, needing the toilet, hunger, infection and medication effects. Q: Does virtual reality solve late-day agitation? A: That is not our claim. Published research on virtual reality in dementia is mostly about wellbeing, engagement and reminiscence, not sundowning specifically. A calm scenario is one environment option among others, and it is used before the peak of agitation, not during it. Q: How long should a late-afternoon session last? A: Short. Teams using it at this hour do so around four in the afternoon, seated, for five to ten minutes, always with someone alongside and stopping as soon as the person wants. ### Snoezelen room or virtual reality? What each one does in a care home URL: https://rver.pt/blog/sala-snoezelen-ou-realidade-virtual-lares/en/ Date: 16 August 2026 Is the room worth building, or does virtual reality replace it? They do not do the same thing, and the choice is decided by the space you have and by who never leaves their room. Almost every care home we talk to has heard of a Snoezelen room, and many have considered building one. The question we get is nearly always the same: **is the room worth it, or does virtual reality replace it?** The honest answer is that they do not do the same thing, and the choice depends less on the technology than on your space, your team and who your residents are. ## What a Snoezelen room is A Snoezelen (or multisensory) room is a fixed space set up to stimulate the senses in a controlled way: soft light and bubble tubes, ambient sound, textures, scents, sometimes a water bed or a vibrating chair. The person goes in, someone chooses what is switched on, and a member of staff stays with them. The principle is the same one behind virtual reality in healthcare settings: **a controlled, accompanied environment for comfort and stimulation**, and not a self-administered therapy. ## What each one does better The room wins at everything involving the body. Touch, temperature, vibration, weight, smell: none of that goes through a headset. For someone who will not tolerate anything on their head, or who responds mainly to touch, the room is the right answer. And it is shareable: two or three people can be in there together. Virtual reality wins on three concrete things: - **It needs no room.** It goes to the bedroom, the armchair, the day room. In a building where every square metre is spoken for, that is not a detail. - **It changes scenery without building work.** A beach today, a village tomorrow, the grape harvest in autumn. The room keeps whatever was installed. - **It leaves a record.** What was done, with whom and for how long, without anyone transcribing it by hand. And there is a difference that usually decides it: the room requires bringing the person to it. Those who are bedbound, in isolation, or who do not leave their room late in the day rarely make it there. ## What each one costs We will not publish figures we do not control, but the **shape** of the cost is different and worth understanding: | Criterion | Snoezelen room | Virtual reality | |---|---|---| | Investment | building work and fixed equipment | equipment and subscription | | Space | a permanent room | none | | Changing the environment | new purchase or building work | new content | | Reaches the bedroom | no | yes | | Tactile stimulation | yes | no | | Several people at once | yes | one at a time | ## Four questions before deciding 1. **Do you have a room to give up permanently?** If not, the question ends here. 2. **How many residents never leave their room?** The bigger that number, the more weight belongs to the option that travels. 3. **Who will sit with the sessions?** Both need someone alongside. A solution nobody has time to use is no solution. 4. **What do you need to record?** If you have to show what was done (to a family, to the clinical director, in an audit), it helps if it writes itself. :::note **Neither one is a treatment.** They are comfort and stimulation environments, used under the supervision of the care team. They do not replace clinical assessment or any prescribed therapy, and decisions about the care plan always belong to the team. ::: ## They can also coexist The homes where this works best did not choose: they use the room for people who respond to touch and movement, and virtual reality for those in their rooms or those who like going places. Two tools in the same box, with different costs and different limits. If you are starting with one, start with the one that answers the problem you have today, and not the one that impresses visitors. RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. On who can use the equipment, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). On use in dementia, see [reminiscence, calm and moments of presence](/blog/realidade-virtual-demencia-alzheimer/en/). Q: Does virtual reality replace a Snoezelen room? A: No. The room stimulates touch, temperature and movement, none of which goes through a headset, and it holds more than one person at a time. Virtual reality reaches the bedroom, changes environment without building work and records the session. Many homes end up using both. Q: Which is better for people with dementia? A: It depends on the person, not the diagnosis. Someone who responds to touch and movement gets more from the room; someone who responds to places and stories does better with scenarios. Neither is a treatment, and both are used with a professional alongside. Q: Do I need a dedicated room for virtual reality? A: No. The equipment is used wherever the person is: in bed, in an armchair, in the day room. It is the practical difference most often raised by homes that have a room and cannot get half their residents into it. ### The eight questions hospital IT will ask about virtual reality URL: https://rver.pt/blog/informatica-hospital-perguntas-realidade-virtual/en/ Date: 16 August 2026 The service wants it, management is open, and the process reaches IT. That is where many projects die, not through rejection, but waiting for answers nobody prepared. There is a predictable moment in adopting any technology in a hospital: the service wants it, management is open to it, and the process reaches IT. That is where many projects die, not through rejection, but by waiting for answers nobody prepared. It pays to anticipate the questions. They are almost always the same eight. ## 1. "Will this connect to our network?" The question behind it is: **how much new surface does this add for me?** Two things get confused here. One is whether the equipment needs internet **during a session**: if it does, a Wi-Fi drop interrupts a patient midway, and that is a clinical problem before it is an IT one. The other is whether a management application runs on the local network. With RVer, content playback runs entirely on the headset and needs no internet during a session. The Companion app opens in the browser on any PC or tablet **on the same local network**, with nothing to install and nothing going through the cloud. [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## 2. "Does it need integration with our systems?" This is the question IT dreads most, because integration means a project, and a project means months. The right answer, when it is true, is *no*. RVer runs independently and requires no integration with hospital systems. That means no interface to build, no identifier mapping and no dependency on a team already over capacity. If a supplier tells you it "integrates with everything", ask how long it takes and who pays. ## 3. "What patient data does it store?" The question to ask is not "are you GDPR compliant", everyone says yes. It is **what specific data leaves the device, to where, and on what basis**. With RVer, no personal or clinical patient data leaves the headset. What is sent is per-device usage statistics (which content played, on which headset, when) which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server. This has a practical consequence IT will like: **if no personal data leaves, the associated risk is far smaller**, and the impact assessment gets simpler. ## 4. "Who is the data controller?" The institution. RVer is supplied to healthcare institutions, which are responsible for their patients' data. That is the answer the data protection officer needs to hear, and it should be written into the contract, not into a conversation. ## 5. "What if the company disappears?" A legitimate question, rarely asked in time. The answer hinges on one thing: **does the system work offline?** If it does, the supplier disappearing switches nothing off: each headset carries on playing the library installed on it. If it does not, you are buying a dependency, and that belongs in the risk assessment. ## 6. "Who does the updates, and when?" What matters is whether updates are mandatory, whether they can be deferred, and whether any of them force a service outage window. On equipment that runs offline, an update is a planned operation, not an interruption. ## 7. "Is this a medical device? Does that change anything for us?" It changes three things IT should know about: - There is **technical documentation and a risk assessment** that can be requested. - There is an **identified, accountable manufacturer**. - There is a **formal route for reporting serious incidents**: to the manufacturer and to the competent authority. RVer's base product is registered in EUDAMED and with INFARMED (Portugal) as a Class I medical device, no. CDM 94571546 (Basic UDI-DI 56006195127RVERTZ), and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. ## 8. "Who manages the accounts?" There are no user accounts for patients. Device settings sit behind a protected menu clients cannot reach, and configuration is done at installation. Fewer accounts is less surface. :::note A good way to test a supplier: ask for these eight answers **in writing, before** there is a meeting with IT. Anyone who has them ready has been through this. Anyone who improvises will improvise after the purchase too. ::: ## A summary to paste into an email - **Offline** playback; no internet during a session. - Management app in the **browser, local network**, no installation, no cloud. - **No integration** with hospital systems. - **No personal or clinical patient data leaves the headset.** - Data controller: **the institution**. - **Class I medical device registered in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546), CE-marked (MDR 2017/745)**; modules not covered. - No patient accounts; protected settings. On the security of the platform itself we wrote separately in [“The state of security on the RVer platform”](/blog/nis2-o-estado-da-seguranca-na-plataforma-rver/en/), and on data protection in [privacy and GDPR](/blog/privacidade-rgpd-realidade-virtual-saude/en/). Q: Does virtual reality need integration with the hospital IT system? A: In RVer's case, no. The system runs independently and requires no integration with hospital systems: there is no interface to build and no identifier mapping. Management is done through an application that opens in the browser on any PC or tablet on the same local network, with nothing to install. Q: What patient data leaves the headset? A: No personal or clinical patient data leaves the headset. What is sent is per-device usage statistics (which content played, on which headset, when) which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server. Q: Does virtual reality work without internet in a hospital? A: Content playback runs entirely on the headset and needs no internet during a session. This matters for two reasons: a Wi-Fi drop does not interrupt a patient midway, and a system that runs offline keeps working even if the supplier disappears. Q: Who is the data controller? A: The healthcare institution. The system is supplied to hospitals and clinics, which act as data controllers for their patients' data. It should be written into the contract, and it is the answer the data protection officer needs to have. ### A care home activity plan: where virtual reality fits (and where it does not) URL: https://rver.pt/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/ Date: 16 August 2026 It is not a group activity, it does not replace company and it does not save you the coordinator. That said, it fits exactly the gaps a group plan never covers. A care home's activity plan is built out of constraints: one activities coordinator for sixty residents, a room that is also the dining room, rainy days when nobody goes out, and a third of the residents who join nothing in a group. This is a practical note on where virtual reality fits into that plan, and, just as plainly, where it does not. ## Where it does not fit Worth starting here, because it is what prevents buying badly. - **It is not a group activity.** One person at a time, with someone alongside. If the problem is filling Wednesday afternoon for twenty people, this does not solve it. - **It does not replace company.** Nobody should end up more isolated because of it. It is a short, accompanied session, not a way to park someone alone. - **It is not continuous entertainment.** Long sessions tire people and lose their effect. What we see working is five to fifteen minutes. - **It does not save you the coordinator.** Someone picks the scenario, fits the headset and stays with the person. ## Where it does fit It fits exactly the gaps the group plan does not cover: **People who join nothing.** There is always a set of residents who refuse group activities: shyness, hearing loss, dislike of noise. A ten-minute individual session in an armchair is a way in for someone who never appears in the day room. **People who do not leave their room.** Bedbound, in isolation, recovering from a fracture. This is the group an activity plan usually loses entirely, and it is where something that travels makes the most difference. There is a lying mode for people who are reclined. **Rainy days and August.** The cancelled outing, the week half the team is on holiday. An activity that depends on neither weather nor transport takes pressure off the calendar. **Conversation that starts from a place.** Seeing the grape harvest, a familiar beach or a village tends to open conversation better than a direct question. The activity does not end when the headset comes off: often that is when it starts. **Moments with family.** A visitor who does not know what to say has a subject: choosing the place, watching the reaction, talking about it afterwards. ## A realistic week Not a plan to copy: the shape that tends to work when it is added to what already exists: | Day | Morning | Afternoon | |---|---|---| | Monday | group exercise | 4 individual sessions (bedrooms) | | Tuesday | craft workshop | outing, or scenarios indoors if it rains | | Wednesday | music | 4 individual sessions (new residents) | | Thursday | table games | family visits, session for two | | Friday | service / conversation | 4 individual sessions (bedbound) | Twelve to sixteen sessions a week, with one person running them. At five minutes to choose and fit, plus ten of session, it fits into an afternoon without undoing the rest. ## What to record Two columns solve almost everything: **who** and **what**. Who took part, which scenario, how long, and a line about the reaction. It serves three things a clinical director needs: showing families what was done, learning what works with each person, and answering an audit without reconstructing anyone's memory. In RVer that record is automatic: what was watched, on which device and for how long. What is not recorded is any clinical data about the resident: that never leaves the headset. :::note Virtual reality in a care home is a comfort, stimulation and wellbeing activity, run by trained professionals or carers and never self-administered. It is not treatment, it does not replace clinical assessment or prescribed therapy, and the decision to include it in each resident's plan belongs to the team. ::: ## Three questions before putting it in the plan 1. **Who will run it?** Without a name and a time slot, it does not happen. 2. **Who goes first?** Start with the people who join nothing: that is where it shows. 3. **How will you know it worked?** If it is not recorded, in three months the answer is an opinion. RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. On who can run the sessions, see [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). On bedbound residents, see [lying mode](/blog/realidade-virtual-modo-deitado-acamados/en/). On the arithmetic that justifies this to management, see [what it returns in a care home](/blog/roi-realidade-virtual-lar-de-idosos/en/). Q: Is virtual reality a group activity? A: No. It is an individual session of five to fifteen minutes, always with someone alongside. It reaches people who do not join group activities and those who never leave their room, and it does not replace company or group animation. Q: How many sessions fit into an afternoon? A: Allowing about five minutes to choose the scenario and fit the headset, plus ten of session, four sessions fit into an afternoon without undoing the rest of the plan. Twelve to sixteen a week is the pace we see with one person running them. Q: Who can run the sessions in a care home? A: Trained professionals or carers: activity coordinators, care assistants, nursing staff, depending on how the institution organises the activity. It is never self-administered, and who specifically runs it is the institution’s decision. ### NIS2: where RVer stands, and what stays with the institution URL: https://rver.pt/blog/nis2-o-estado-da-seguranca-na-plataforma-rver/en/ Date: 9 August 2026 NIS2 changed one thing for healthcare institutions: your suppliers' security became your business. Here is where RVer stands, and the split of responsibilities we propose. NIS2 is now one of the first items in any conversation with a healthcare IT department. Rightly so: the directive widened the set of entities in scope, raised the technical bar, and, the part that changes daily practice most, **made entities accountable for the security of their supply chain**. Which means: the moment an RVer headset enters an in-scope institution, RVer's security posture stops being only our concern. It becomes an item in your file. This article answers the question the way it is usually asked: *where does RVer stand?* ## The position, in two sentences The RVer platform **meets the applicable technical requirements** of the regime. Part of NIS2, however, is **organisational rather than technical**, and that part belongs to no supplier: it belongs to the institution. On those, what we do is **recommend, document and support**. That distinction is the most useful thing we can bring to the meeting, and it is the rest of this article. [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## On our side: the technical measures For obvious reasons we do not publish configurations, versions or implementation detail: describing the lock in public works against the point. In general terms, and this is what the documentation we hand over states: - **Data is encrypted**, in transit and at rest. Backups are encrypted too, and the recovery key does not live in the same infrastructure it protects. - **Strong authentication is mandatory** on all administrative access, with a second factor. No convenience exceptions. - **Least privilege by role**: each user sees and does only what their function requires. - **Audit logging** of access, changes and sensitive operations: who, when and what. - **Protection against abusive access attempts**, with automatic lockout. - **Infrastructure and data in EU jurisdiction**, backups included. - **Updates and security fixes** applied under a controlled procedure, with a rollback path. None of this is sold as a badge. It is the baseline we consider the minimum for putting equipment inside a healthcare institution. ## Patient usage data does not leave the headset In practice, this is the answer that settles half of every security meeting. **No patient usage data leaves the headset.** The session record, the activity statistics, the readings attached to a person: all of it stays on the headset and inside the institution's perimeter. It is not sent to RVer, it feeds no dashboard of ours, and it does not exist on our side. What does travel is two things, and only two: 1. **Technical information for updates and remote support** of the equipment: device status, versions, fault diagnosis. This is what keeps a fleet current without sending someone to every room. 2. **Aggregated data about how the product behaves**, which we use to improve it: what is slow, what fails, where. Neither category includes the clinical content of a session or readings attached to an identified patient. The practical effect for your data protection officer is simple: **the institution is the controller** of that data, and RVer holds no copy of it. The risk surface that would otherwise have to be assessed, negotiated and monitored... never comes into existence. ## On your side: what NIS2 does not let you delegate This is the part that sometimes catches institutions off guard. A substantial share of NIS2 is not about technology, it is about governance. And no supplier on the market can discharge it for you: - **Management body accountability**: the board answers for the measures, and has to know them. - **Risk analysis and the organisation's own security policy.** - **Access management and account lifecycle**: who joins, who leaves, who no longer needs it. We provide the tools; the policy is yours. - **Incident response plan and notification duties**, with tight deadlines and a defined recipient. - **Business continuity and recovery**, including the tests that prove the plan works. - **Training and awareness** for the people who use the systems. - **Supply chain risk management**: in which we are one of the items to assess. On these points, what RVer does is **suggest and support**: we provide the recommendations that apply to our equipment, we document our own measures for your supplier assessment process, and we maintain a defined channel for reporting incidents involving our product. ## What we hand over for your file When an institution asks us for security documentation, what follows is: - a description of the technical measures applied to the product and the platform; - the location and jurisdiction of the data, backups included; - which categories of data leave the headset, and, above all, which do not; - the retention and deletion policy; - the channel and deadlines for reporting security incidents; - configuration recommendations for the institution's side (network, accounts, device management). It is material written to be attached to your process, not read as marketing. ## Why this matters to whoever signs Equipment that forces a security exception costs far more than its list price. It costs meetings, it costs an opinion, and it costs risk carried by someone who signs their name to it. RVer's position was built for the opposite case: **patient data that does not leave, encryption by default, mandatory strong authentication, EU jurisdiction, and an audit log that answers "who did what"**. What remains sits on the right side, the institution's own governance, and we say so up front, rather than letting it surface in an audit. The RVer platform's base product is a Class I Medical Device registered in EUDAMED and with INFARMED (Portugal), with session records handled in line with the GDPR. In a shorter, more practical form for a meeting: [the eight questions hospital IT asks](/blog/informatica-hospital-perguntas-realidade-virtual/en/). Q: Is RVer NIS2 compliant? A: The platform meets the applicable technical requirements of the regime: encryption in transit and at rest, mandatory strong authentication on administrative access, least privilege, audit logging, protection against abusive access attempts, and data in EU jurisdiction. Part of NIS2 is organisational (governance, incident response, training, supply chain management) and belongs to the institution; on those, RVer recommends, documents and supports. Q: What patient data leaves the headset? A: None. The session record, usage statistics and readings attached to a person stay on the headset and inside the institution's perimeter. What travels is technical information for updates and remote support of the equipment, and aggregated product-behaviour data used to improve the service, with no clinical session content and no readings attached to an identified patient. Q: Is the data encrypted? A: Yes, in transit and at rest, backups included. For security reasons we do not publish configurations, versions or implementation detail; the description of the measures is provided to institutions for their supplier assessment process. Q: Where is the data hosted? A: On infrastructure in EU jurisdiction, including backups, which are encrypted as well. Q: Which NIS2 duties stay with the institution? A: The organisational ones: management body accountability, risk analysis and security policy, access management and account lifecycle, incident response and notification duties, continuity and recovery, staff training, and supply chain risk management. No supplier can discharge these for an institution; RVer provides the recommendations that apply to its equipment and the documentation of its own measures. Q: What security documentation do we receive? A: A description of the technical measures, the location and jurisdiction of data and backups, which categories of data do and do not leave the headset, the retention and deletion policy, the channel and deadlines for reporting incidents, and configuration recommendations for the institution's side. ### What the clinical team sees in an RVer session record URL: https://rver.pt/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/en/ Date: 8 August 2026 The question comes up in almost every meeting: as a clinician, what data do I actually get out of this? The honest answer has two halves: what we record, and what we deliberately do not do. There is a question that comes up in almost every meeting with a clinical team, usually early in the first conversation: *what data do I actually get out of this?* It is the right question. And it deserves an answer in two halves: because what RVer records matters no more than what RVer, by design, refuses to do with it. ## The rule that governs everything else RVer's base product is a **Class I Medical Device** registered in EUDAMED and with INFARMED (Portugal). That class is not an administrative footnote: it is what draws the boundary around what the system may do. Under the European framework, health software falls, very broadly, into three bands: - **Not a device**: wellness and lifestyle, with no medical purpose. - **Class I**: has a medical purpose, but **provides no information used for diagnostic or therapeutic decisions**. - **Class IIa or above**: provides information that feeds those decisions, or monitors physiological processes. RVer is registered in the middle band, and that is where it intends to stay. A system that scored, compared against norms, flagged deviations or suggested courses of action would be supplying information for a clinical decision, a different device, in a different class, with a different conformity assessment and a different price for institutions. So the internal rule is simple and not up for negotiation: **RVer records; the team reads.** ## What the Companion app records The Companion app is the panel the team uses to set up, follow and close each session. Every session leaves an objective record: - **who**: the patient assigned to the headset for that session; - **when**: date, start time and actual duration; - **what**: the content chosen, and what was actually played; - **how it ended**: completed, interrupted, or ended by the team; - **history**: the same patient's sequence of sessions over time, so consistency and adherence are visible. In practice this replaces *"how did it go yesterday?"* with a record that depends on neither memory nor report. ## With a movement module active When a headset has a movement module active, the record gains one more layer: **hand position readings** and, where the module applies, **leg position readings**. From those come repetition counts, range of movement and per-session performance. It is worth being literal about what this is: **these are position readings in space**: movement numbers produced by the headset's sensors. They are not clinical measurements, they are not normalised against any population, they carry no thresholds, no grading and no judgement of any kind. They are raw material for the team to look at. :::note RVer Motion and RVer Neuro are modules under development, **not yet** covered by the Class I Medical Device registration, which covers the base product: the RVer video library. The base product bears the CE mark under MDR 2017/745. ::: [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## The scales are yours, and that is how it has to be This is usually the part that settles the conversation. RVer **provides no assessment instruments**. It ships no built-in scales, does not administer them, does not score them and does not interpret them. What the platform provides is the **field and the timeline**: alongside the session record, the clinician logs the instrument they themselves chose, applied under their own rules and weighed by their own judgement. The difference is the whole point: the instrument is the clinician's, the application is the clinician's, the reading is the clinician's. RVer's job is to make sure that record is stored, dated, attached to the right patient and there when the team needs it. This is not a limitation dressed up as a virtue. It is what separates a system that helps a team organise its own work from a system that claims a clinical reading it has no business making. ## What RVer does not do So that nothing is left ambiguous, and because this is what teams need to be able to tell their own management and quality functions, RVer does **not**: - score, grade or assign levels; - compare the patient against norms, populations or reference values; - flag deviations, raise clinical alerts or signal decline; - suggest courses of action, exercises or therapeutic adjustments; - assess function, capacity or status; - diagnose, screen or triage. RVer **is not a diagnostic device** and does not replace any clinical assessment or the team's decision. ## Where the data stays A patient's session record **stays on the headset and inside the institution**. It is not sent to RVer, it feeds no dashboard of ours, and it does not leave your perimeter. The institution is the controller of that data under its own GDPR framework; RVer keeps no copy of it. What does travel is something else: technical information needed for updates and remote support of the equipment, and aggregated data about how the product behaves, which we use to improve it. None of that includes the clinical content of a session or the readings attached to a patient. ## The short version, for the next meeting RVer gives the clinical team an **objective, dated record** of what happened in each session, and, with a movement module active, hand and leg position readings. It also gives the clinician the right place to keep their own instruments alongside that record. What it does not give is a reading. That is, and will remain, the team's. Q: What session data can the clinical team see? A: The patient assigned to the headset, the date, start time and actual duration, the content chosen and actually played, whether the session was completed or interrupted, and the patient's session history over time. With a movement module active, hand and, where applicable, leg position readings are also recorded: repetitions, range and per-session performance. Q: Does RVer assess, score or diagnose? A: No. RVer records session activity and, when the applicable module is active, position readings. It does not score, grade, compare against norms, flag deviations, suggest courses of action or diagnose. It is not a diagnostic device and does not replace any clinical assessment or the team's decision. Q: Can I use my own scales inside the platform? A: Yes, and the clinician owns them end to end. RVer provides no assessment instruments, does not administer them, does not score them and does not interpret them; it provides the field and the timeline so the clinician can log, alongside the session record, the instrument they chose and applied under their own judgement. Q: Why doesn't RVer give automatic interpretations or suggestions? A: Because the base product is registered as a Class I Medical Device. Software that provides information used for diagnostic or therapeutic decisions falls into a higher class, with a different conformity assessment. Holding that line is deliberate: the platform records, the clinical reading belongs to the team. Q: Does patient usage data leave the headset? A: No. The session record stays on the headset and inside the institution, which is the controller of that data. What travels is technical information for updates and remote support of the equipment, and aggregated product-behaviour data used to improve the service, with no clinical session content and no patient-attached readings. Q: Are the movement modules covered by the medical device registration? A: Not yet. The Class I Medical Device registration in EUDAMED and with INFARMED (Portugal) covers the base product: the RVer video library. RVer Motion and RVer Neuro are modules under development, not yet covered by that registration, and the base product bears the CE mark under MDR 2017/745. ### When a service asks for something that does not exist yet URL: https://rver.pt/blog/quando-um-servico-pede-algo-que-ainda-nao-existe/en/ Date: 6 August 2026 In a product that is one thing, anything you add you add for everyone. In a platform of modules, a specific request can be built for the service that made it. A therapy lead describes the session she runs on Thursday mornings, with a particular group, in a particular way, and then asks whether the headset can do that. Sometimes it already can. Sometimes it cannot, and in most software that is the end of the conversation. The request goes on a list. It competes with every other request from every other customer, and if it ever ships, it ships to everyone, eighteen months later, in a version that has been sanded down until it fits the average. That is not a failure of goodwill. It is what happens when a product is one thing. Anything you add, you add for all of it. RVer is not one thing. It is a base plus modules, and that changes the answer. ## What a module actually buys RVer is a native platform for the Meta Quest 3, running entirely on the device. No accounts, no login, no cloud dependency: patient data does not leave the building. Capability is packaged as modules, licensed and enabled per device: - **RVer**: the base immersive 360° video library - **RVer Motion**: guided movement activities - **RVer Neuro**: cognitive activities Because capability lives in modules rather than fused into a single application, something new does not have to be built for everybody in order to exist. It can be built for a use case: one kind of session, one population, one way a team prefers to work. It can be built for a single client. It can be enabled on one device, in one room, if that is where it belongs. So the therapy lead is not asking us to change a product that every other service depends on. She is asking for a module. That is a much smaller, much more answerable question. ## The services that did not ask for it never see it This part matters more than it sounds. Software that accumulates everything anyone ever wanted becomes heavy for the people who use it daily. A care assistant starting a session before lunch should see the handful of things her service actually does, not a menu carrying another institution's requirements. Modules keep that true. A device carries what its service enabled and nothing else. Growth in the platform does not become clutter on the headset, and staff are never trained around features that were meant for someone else. It also means a bespoke module is not a fork. Everything sits on the same base, managed the same way, updated the same way. One fleet, whatever mix of capability is running on it. ## And it arrives without anyone travelling Modules are switched on remotely, and both the app and its content update over the network. A decision taken on Tuesday is live on the fleet. No reinstall, no engineer in the corridor, no headsets boxed up and sent away. When a module a service already has gains new activities, they simply appear. That is how the most recent release reached the fleets already running it: in their in-development versions, RVer Motion and RVer Neuro gained new activities, and the movement data RVer Motion produces for the clinician became more detailed. Nothing was installed by hand, and no hardware changed. The commercial side of this (paying only for the modules you enable, on only the devices you enable them on) we wrote about separately, in [why modular software suits a healthcare institution](/blog/software-modular-vantagens-saude/en/). Here the point is narrower: what the architecture makes possible to build, not what it makes cheaper to buy. ## What this is, and what it is not RVer Motion is a movement tracking and exercise aid. RVer Neuro is cognitive activities with a session activity log. Both are modules in development and are not covered by the Class I medical device registration, which covers the base product. Both assist a clinician: neither replaces one, and neither makes a clinical decision. What adapts here is commercial and operational: which capability is enabled, on which devices, in which room. The clinical judgement stays where it was. ## Where the roadmap comes from Further modules are in development, and the honest answer to where they came from is: services asked. That is only workable because a good idea for one institution does not have to become a change for every institution. The request that would be too specific for a monolithic product (too small, too particular, too much one team's way of working) is exactly the request a modular platform can say yes to. If your service has one of those, we would rather hear it than not. On designing that experiment so it ends in a decision, see [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/). Q: Can capability be built for a single service? A: Yes. Because capability is packaged as modules, something new can be built for one use case, for one client, or enabled on a single device, without changing what other services use. Q: Do other services then see that module? A: No. A device carries only the modules its service enabled. Growth in the platform does not add clutter to a headset that never asked for it. Q: Does enabling a module require installing anything on the headsets? A: No. Modules are switched on remotely, and both the app and its content update over the network: no site visit and no new hardware. Q: Does a bespoke module create a separate version of the app? A: No. It sits on the same base, managed the same way and updated the same way. It stays one fleet. Q: Does patient data leave the building? A: No. RVer runs entirely on the Meta Quest 3, with no accounts, no login and no cloud dependency. ### Stroke and virtual reality: what the evidence shows (and what it does not) URL: https://rver.pt/blog/avc-realidade-virtual-o-que-diz-a-evidencia/en/ Date: 3 August 2026 We gathered six recent systematic reviews and meta-analyses, including the 2025 Cochrane review, to understand what virtual reality does, and does not do, in rehabilitation after a stroke. After a stroke, around 80% of survivors are left with some degree of upper limb motor impairment. Rehabilitation works, but it is slow, it demands repetition at high volume, and it depends on something hard to guarantee in practice: that the person completes more therapy time than they can tolerate in a conventional gym. That is precisely where virtual reality has been studied. We gathered six recent systematic reviews and meta-analyses (including the reference Cochrane review, updated in 2025) to answer a simple question: **what does the evidence show, and what does it not yet show?** ## The biggest benefit comes from adding, not replacing This is the most consistent finding, and the easiest to overlook. The [Cochrane review](https://pmc.ncbi.nlm.nih.gov/articles/PMC12178777/) (Laver et al., 2025) finds moderate- to low-certainty evidence that VR is slightly more beneficial than alternative approaches for upper limb function, balance and activity limitation. But it stresses that the benefit is clearest when VR is **added to usual care**, increasing total therapy time, rather than replacing it. The correct reading is not "VR beats the physiotherapist". It is that VR makes more rehabilitation dose possible, and dose matters. ## For gait and balance, the evidence is solid [Corbetta et al.](https://pubmed.ncbi.nlm.nih.gov/26093805/) (2015), covering 15 randomised trials and 341 participants, found that substituting some or all of conventional rehabilitation with VR-based rehabilitation produced significant improvements in **walking speed, balance and mobility**. Added to conventional therapy, the mobility benefit held. ## For the upper limb, the effect is broad, and timing matters The largest review in the set, [Soleimani et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11127427/) (2024), screened 11,834 studies and included 55, with 2,142 patients. VR outperformed conventional therapy on upper limb motor function, functional independence, quality of life, spasticity and dexterity. Two practical parameters emerge: - interventions longer than **six weeks** produced better results; - **starting within six months** of the stroke optimised outcomes. [Villarroel et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11973539/) (2025) adds two useful notes: gains are most pronounced in the acute and subacute phases, and **combining VR with conventional therapy beat VR alone**. Notably, whether the software was a commercial game or a purpose-built rehabilitation application did not change outcomes. ## Where the evidence still disagrees: immersion There is no consensus here, and it would be dishonest to pretend otherwise. [Soleimani](https://pmc.ncbi.nlm.nih.gov/articles/PMC11127427/) concluded that fully immersive VR produced the **greatest** gains in gross motor function, with non-immersive approaches better for fine dexterity. But the network meta-analysis by [Zhang et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11996652/) (2025), with 34 trials and 1,704 participants, ranked the modalities differently: Microsoft Kinect was most effective for upper limb motor function, followed by Nintendo Wii and non-immersive VR, and **head-mounted immersive devices showed no statistically significant difference** against conventional therapy. And [Kenea et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11943060/) (2025), on immersive VR, found statistically significant improvements on the Fugl-Meyer scale and the Box and Block Test which, in the authors' own words, **did not reach clinical significance thresholds**. :::note A statistically significant difference is not automatically a difference the patient feels. That is a distinction worth demanding of any health technology supplier, including us. ::: ## And cost? These studies do not answer that Worth stating plainly: **none of these six reviews measured cost, time to discharge, or return on investment.** They measure motor function, balance, dexterity, independence and quality of life. Economic evidence on VR in healthcare does exist, but it concerns mainly pain and inpatient stays, not stroke. The question "does VR make stroke rehabilitation cheaper?" remains, honestly, open, and be wary of anyone who tells you otherwise without citing a study. ## What this means in practice Read together, the pattern is reasonably clear: 1. **VR is a complement, not a substitute.** The gain comes mainly from more therapy dose, under clinical supervision. 2. **Start early and sustain it.** First six months, programmes beyond six weeks. 3. **Modality matters and is still contested.** Anyone claiming otherwise is selling, not citing. 4. **The economic case is not yet made** for stroke specifically. RVer is a virtual reality system designed to be used **under the supervision of healthcare professionals**, as a non-pharmacological complement to existing rehabilitation programmes, never as a replacement for medical care. The guided-movement module, [RVer Motion](/en/modulos/motion/), is in development and not covered by the Class I registration, which covers the base product. The six reviews cited are linked throughout the article, and the other references are under [rehabilitation](/estudos/tema/reabilitacao/en/) in the library: five have free full text on PubMed Central and the sixth has a free abstract on PubMed. You do not have to take our word for it: read the sources. The same exercise, done for another neurological condition: [virtual reality and Parkinson's disease](/blog/realidade-virtual-doenca-de-parkinson/en/). Q: Does virtual reality replace physiotherapy after a stroke? A: No. The most consistent finding of the 2025 Cochrane review is that the benefit is clearest when VR is added to usual care, increasing total therapy time, rather than replacing it. It is a complement used under clinical supervision. Q: When should VR be introduced in stroke rehabilitation? A: Soleimani et al. (2024) found that starting within six months of the stroke optimised outcomes, and that programmes longer than six weeks produced better results. Villarroel et al. (2025) found gains most pronounced in the acute and subacute phases. Q: Is immersive VR better than non-immersive VR? A: The evidence is contradictory. Soleimani et al. (2024) found the greatest gross motor gains with fully immersive VR, but the network meta-analysis by Zhang et al. (2025) found no statistically significant difference for head-mounted immersive devices. It remains an open question. Q: Does virtual reality make stroke rehabilitation cheaper? A: None of the six reviews examined measured cost, time to discharge or return on investment. Economic evidence on VR in healthcare exists, but it concerns mainly pain and inpatient stays, not stroke specifically. ### Companion app: control the VR headsets remotely, with nothing to install URL: https://rver.pt/blog/app-companion-controlo-remoto-realidade-virtual/en/ Date: 20 July 2026 The promise of Virtual Reality for clinical use is that the patient relaxes while the team stays in control. The Companion app is the piece that makes that control simple: from the browser, with nothing to install. ## Who controls the session? In well-designed Virtual Reality therapy, the patient simply watches and relaxes. Choosing the scenario, adjusting the volume and deciding when to stop is the **team's** job, and not the patient's, who is often frail, cognitively impaired or simply resting inside the experience. The challenge is practical: how does one person control a headset on someone else's head, across the room, and how do they manage several at once, on a ward or in a care home? That's what the Companion app is for. [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## One browser, one fleet Companion opens in the **browser** on any PC or tablet on the same Wi-Fi network. There's nothing to install, configure or update: the address is shown in the headset's own app. Each headset appears as a **card** on screen, and from there the clinician: - picks the scenario and plays or pauses; - skips ±10 seconds; - adjusts **volume and brightness** remotely; - assigns the patient to the session; - triggers an immediate **emergency stop**. One person can run a whole fleet of headsets from a single screen, useful when several sessions are running at once. :::note Everything runs on the **local network**. Companion doesn't depend on the internet or cloud accounts, and no patient data leaves the device, GDPR-compliant by default. ::: ## Why "nothing to install" matters In a healthcare service, every new piece of software is a request to IT, an approval, a maintenance burden. By running in the browser, Companion avoids all of that: it works on any PC or tablet already in the service, with no integration into hospital systems and no installation. The team starts using it the same day. ## RVer's role Companion is part of RVer, a Class I Medical Device (base product, registered in EUDAMED and with INFARMED (Portugal), EU MDR 2017/745). The philosophy is always the same: technology amplifies the clinical team, it doesn't replace it. The patient lives the experience; the team stays in control, from the first tap to the emergency stop. Managing several headsets from one screen changes the answer to [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). Q: How does the team control the Virtual Reality headsets during a session? A: Through the Companion app, which opens in the browser on any PC or tablet on the same Wi-Fi network, with nothing to install. Each headset appears as a card: pick the scenario, play or pause, adjust volume and brightness, assign the patient and trigger a remote emergency stop. Q: Do you need to install software to use Companion? A: No. Companion runs in the browser at the address the headset's own app shows. There's nothing to install, configure or update, and it works on any PC or tablet on the network. Q: Can I manage several headsets at once? A: Yes. Each headset appears as a card on the same page, so a single person can control and monitor a whole fleet from one screen. Q: Does Companion send data to the cloud? A: No. Everything runs on the local network, with no dependency on the internet or cloud accounts. No patient data leaves the device, in line with GDPR. ### Lying-down mode: Virtual Reality for bed-bound patients URL: https://rver.pt/blog/realidade-virtual-modo-deitado-acamados/en/ Date: 20 July 2026 Most Virtual Reality experiences assume the patient is upright. Many aren't. Lying-down mode makes the immersive experience possible for people who spend the day in bed, with less discomfort and without special content. ## The problem of lying down in a world built for sitting up Virtual Reality for Clinical Use shows real 360º video: a beach, a forest, a familiar place. The heart of the experience is the horizon: when it's level, the brain relaxes and accepts the scene. When it's tilted, discomfort, and often motion sickness, follows. The problem is that most systems assume the person is sitting or standing. In a **bed-bound or reclined patient**, the head sits at 30º, 45º or even 90º from vertical. The horizon looks tilted, the world looks crooked, and the session becomes uncomfortable for exactly the people who would benefit most. ## What lying-down mode does RVer's lying-down mode aligns the horizon of the experience with the patient's **actual head angle**. The headset's normal re-centre only handles which way you face and is gravity-aligned: it can't do this. RVer goes further: it tilts the whole world (video, menus and panels) to the angle the person is in. The result: the image looks level at any tilt, and **every 360º scenario works** with no need to film "lying-down" versions. Each angle is effectively a new variation of the same content. :::note Lying-down mode is enabled per session and turns off automatically at the end. While active, it hides the movement and cognition modules, a bed-bound patient isn't doing guided exercise, keeping the interface simple for the team. ::: ## Where it makes a difference - **Palliative care:** escape, comfort and reminiscence for those who no longer leave the bed. - **Post-operative:** distraction and relaxation in the first hours and days, without sitting the patient up. - **Dialysis and long treatments:** filling reclined-chair hours in a calming way. - **Dentist chair and procedures:** easing anxiety in positions that aren't upright. In all of these, the goal is the same: bringing a moment of calm to people whose position would otherwise leave them out of conventional Virtual Reality. ## RVer's role RVer is a Class I Medical Device (base product, registered in EUDAMED and with INFARMED (Portugal), EU MDR 2017/745). It doesn't replace clinical care, but it complements it, as a non-pharmacological option and under the team's supervision. Lying-down mode is one of the ways it makes that therapy reachable for as many patients as possible, whatever position they're in. Lying-down mode is one piece of a bigger picture: [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). On reaching people who never leave their room, see [a care home activity plan](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). Q: Does Virtual Reality work with bed-bound patients? A: Yes. RVer's lying-down mode aligns the horizon of the experience with the tilt of the head, so the image looks level even with the patient at 30º, 45º or 90º: in bed, in a reclined chair, during dialysis or post-op. It applies to every 360º scenario and is enabled in the settings. Q: Does lying-down mode reduce motion sickness? A: It removes one of the main causes of discomfort in Virtual Reality: a misaligned horizon. By following the head's tilt, it keeps the image stable and natural. As always, start with short sessions and stop if dizziness or discomfort appears. Q: Do you need special content to use lying-down mode? A: No. The same 360º video works at any angle: 0º, 30º, 45º or 90º. There's no need to film lying-down versions: each tilt is a variation of the existing content. Q: Which clinical settings benefit most? A: Palliative care, post-operative recovery, dialysis, long treatments in a reclined chair, and procedures in non-upright positions. In all of them, the goal is comfort and distraction for patients who can't sit up. ### ICU delirium: can Virtual Reality help prevent it? URL: https://rver.pt/blog/realidade-virtual-delirium-cuidados-intensivos/en/ Date: 20 July 2026 Delirium affects a significant share of intensive care patients and is linked to worse outcomes. The best prevention strategies are non-pharmacological, and that's where Virtual Reality draws interest. ## What delirium is and why it matters in the ICU Delirium is an acute state of confusion, with altered attention and awareness that fluctuates through the day. In the Intensive Care Unit (ICU) it is frequent and is associated with longer stays, higher mortality and long-term cognitive sequelae. Several features of the ICU itself feed it: **sleep deprivation**, constant noise and light, immobilisation, the absence of time cues and separation from family. Many of these factors are environmental, and therefore potentially modifiable without medication. ## Why non-pharmacological prevention is central Drug-based approaches to delirium have limited efficacy and risks of their own. So the most recommended prevention bundles are **non-pharmacological**: reorient the patient in time and place, promote sleep, reduce harsh stimuli, mobilise early and bring family closer. This is the territory where Virtual Reality for clinical use fits as a research hypothesis. The idea isn't to treat established delirium, but to act on the environmental factors that favour it. ## Where Virtual Reality might contribute - **Orientation and normality:** calm, recognisable scenarios (a garden, a sunny day, a familiar place) restore cues in a disorienting environment. - **Reducing sensory deprivation:** replacing, for short periods, the ceiling and the alarms with a pleasant, controlled stimulus. - **Relaxation and sleep:** experiences designed to calm can support the wind-down to rest. - **Family presence:** a video call inside the experience brings distant relatives closer, one of the known protective factors. :::note The evidence here is still being built: there are promising studies and strong clinical interest, but large trials are lacking. Virtual Reality should be seen as a **complement under investigation**, integrated into the prevention bundle, never as a substitute for the unit's protocol. ::: ## Caution and clinical judgement The critical patient demands extra care. Use should always be supervised, with short sessions, strict hygiene between patients and attention to signs of discomfort. The decision to use it, and in whom, rests with the responsible team. ## RVer's role RVer is a Class I Medical Device (base product, registered in EUDAMED and with INFARMED (Portugal), EU MDR 2017/745) and a non-pharmacological, complementary option. In settings like the ICU, its value is in giving the team one more safe, controllable tool to act on the environment: one of the few allies in delirium prevention that doesn't involve another drug. Q: Does Virtual Reality treat delirium? A: No. Virtual Reality does not treat established delirium. It is studied as a non-pharmacological prevention strategy, acting on environmental factors that favour delirium: disorientation, sensory deprivation, anxiety and isolation. It should be part of the unit's prevention bundle, under clinical supervision. Q: Is there evidence that it works in the ICU? A: The evidence is still being built: there are promising studies and strong clinical interest, but large trials are lacking. Virtual Reality should therefore be seen as a complement under investigation, not a proven intervention nor a substitute for the protocol. Q: Is it safe to use with critical patients? A: It should be used with extra care: always supervised, with short sessions, strict hygiene between patients and attention to signs of discomfort. The decision to use it, and in which patients, always rests with the responsible team. Q: How can Virtual Reality help with prevention? A: By reintroducing orientation cues, reducing sensory deprivation, supporting relaxation and sleep, and bringing family closer through a video call: acting on modifiable environmental factors without additional medication. ### Virtual Reality in long-term integrated care in Portugal URL: https://rver.pt/blog/realidade-virtual-cuidados-continuados-rncci/en/ Date: 20 July 2026 In long-term integrated care units, time is long and the goal is twofold: recover function and preserve quality of life. Virtual Reality for Clinical Use serves exactly those two sides. ## A different setting from the acute hospital Portugal's National Network for Long-Term Integrated Care (RNCCI) spans convalescence, medium-stay rehabilitation and long-stay maintenance units. Unlike the acute hospital, stays here are measured in **weeks or months**, and the patient is often of advanced age, with reduced mobility and many identical days ahead. This setting changes what you ask of technology. It's not a one-off intervention but **accompanying a journey**: rehabilitating, stimulating and comforting, session after session, without overloading a team that is already stretched. ## The three areas where Virtual Reality fits **1. Rehabilitation and adherence.** Motor recovery in these units depends on repetition, and repetition depends on motivation. Turning exercises into scenarios and gentle games helps the patient stay engaged over weeks, with objective movement data for the team. **2. Cognitive stimulation.** In patients with cognitive decline or after a stroke, regular stimulation is part of the plan. Reminiscence scenarios (familiar places, past eras) and cognitive exercises give the team another structured tool. **3. Comfort and wellbeing.** Long days take their toll. A calming session (a beach, a forest, a sunset) breaks the monotony, reduces anxiety and lifts mood, without reaching for more medication. :::note RVer is a **non-pharmacological, complementary** option. It doesn't replace the rehabilitation plan, medication or clinical judgement: it adds to them, under the unit team's supervision. ::: ## Simple for a stretched team The decisive factor in long-term care is operational. RVer is built for teams with no time for complicated technology: it boots in kiosk mode with one tap, runs 100% offline (the whole library available, no internet needed), and the team controls everything through the Companion app in the browser. Installation and training are included. ## Cost and funding A single device serves many patients over time, which spreads the cost per session. For institutions, it's worth framing the investment within the funding lines and support available for innovation and quality in healthcare: something our team helps map case by case. In short: through the combination of long stays, rehabilitation and comfort, long-term care units are one of the settings where Virtual Reality for clinical use best shows its value. Q: Is Virtual Reality suitable for long-term care units? A: Yes. Long stays and the twin goal of rehabilitating and comforting make these units a natural setting for Virtual Reality for clinical use: it supports rehabilitation adherence, cognitive stimulation and wellbeing, session after session, as a non-pharmacological, complementary option. Q: Do you need technical staff to operate the equipment? A: No. RVer boots in kiosk mode with one tap, runs 100% offline and is controlled by the team through the Companion app in the browser. Installation and training are included, with no technical knowledge required. Q: Does it work with patients with very limited mobility? A: Yes. Beyond seated sessions, lying-down mode lets you use Virtual Reality with bed-bound or reclined patients, aligning the image with the person's position. Q: How is the cost justified in a unit? A: One device serves many patients over time, which lowers the cost per session. Our team helps frame the investment within the funding lines and innovation support available to the institution. ### RVer Motion: guided movement in Virtual Reality, with every session recorded URL: https://rver.pt/blog/rver-motion-reabilitacao-com-realidade-virtual/en/ Date: 17 July 2026 Guided movement works when the patient does the exercises, and keeps doing them. RVer Motion is the RVer module that makes that movement guided, recorded and, above all, motivating. Guided exercise has a well-known problem: it rarely fails for lack of exercises: it fails for lack of **consistent repetition**. The patient knows what to do, but home exercises are boring, hard to record and easy to abandon. And with no objective record, the team is left relying on self-report, not always reliable, to know what happened between sessions. **RVer Motion** was designed to target exactly that. ## A coach that demonstrates, a patient who follows along At the heart of the module is a calm 3D coach that demonstrates each exercise. The patient does not have to read instructions, interpret menus or remember the sequence: they see the movement and follow along. That simplicity is deliberate: it removes the cognitive barrier and keeps the patient focused only on the gesture. As the patient moves, the app **automatically counts the repetitions** and logs the movement. What used to be "do three sets of ten" becomes a real, recorded number, session after session. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## Exercise that feels like play Between guided sessions, RVer Motion includes a set of **gentle mobility games** and **seated virtual cycling**. Each game works a kind of movement (range, reach, coordination, balance) but to the patient it feels like a game. That difference is what sustains adherence. Someone who wants to come back tomorrow does more repetitions than someone who feels they are fulfilling an obligation. And because everything is adjustable, the same module serves someone starting out and someone already further along. ## From movement to a record Every recorded movement becomes an **objective log for the team to review**. Instead of asking "how did it go?", the team opens the session log and sees what happened: repetitions, range, per-session performance, consistency. It is a record of the activity: reading it is always the team's job. The seated mode also aligns the experience with the tilt of the head, which makes the module usable by people who cannot stand: in bed, in a reclined chair or during other care. ## Local, safe and integrated RVer Motion runs **locally on the device**, without relying on an internet connection, and is enabled per device. It is part of the RVer platform, whose **base product** is a Class I Medical Device registered in EUDAMED and with INFARMED (Portugal), with session logging in compliance with GDPR. **RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration.** The module records session activity: it does not assess, grade or diagnose, and does not replace any clinical assessment or the team's decision. It does what technology should do in a healthcare institution: **take work off the team and return a useful record**, while keeping the person moving. Q: What is RVer Motion? A: It is the guided-movement module of the RVer system. A 3D coach demonstrates each exercise while the patient follows along, and the app automatically counts repetitions and records the movement: repetitions, range and per-session performance. It includes gentle mobility games and seated virtual cycling, adjustable per patient. It runs locally and does not replace clinical judgement. Q: Is RVer Motion covered by the medical device registration? A: No. The Class I medical device registration in EUDAMED and with INFARMED (Portugal) covers the base product: the RVer video library. RVer Motion and RVer Neuro are modules in development, not covered by that registration. The base product bears the CE mark under MDR 2017/745; the modules are not covered by that registration. Q: Does RVer Motion assess or diagnose? A: No. The module records session activity: repetitions, range and performance, with no grading, thresholds or norms. It does not assess, grade or diagnose, and does not replace any clinical assessment. Reading the log is always the team's job. Q: Does it need internet or a complex installation? A: No. RVer Motion runs locally on the headset, without relying on an internet connection, and is enabled per device in the settings. Installation and team training are included. ### Virtual reality in hospitals: what studies say about length of stay URL: https://rver.pt/blog/realidade-virtual-hospitais-mundo-tempo-internamento/en/ Date: 17 July 2026 From the United States to South Korea, some hospitals use virtual reality in care. What published studies observed, what that says about length of stay, and what nobody knows yet. In recent years, hospitals in several countries (from the United States to the United Kingdom, from South Korea to Brazil) have started using virtual reality for clinical use in some departments. One question comes up early in any conversation with management: **does it shorten hospital stays?** The honest answer is that the evidence on length of stay is limited and depends heavily on context. This article summarises what published studies looked at, what they found, and what nobody can yet claim. ## Where virtual reality is already used in hospitals Published reports cluster in a few departments: paediatrics (needle procedures, dressing changes, imaging), oncology (long treatment sessions), orthopaedics and rehabilitation, burns, intensive care and preparation for surgery. In almost all of them, virtual reality comes in as a **complementary, non-pharmacological approach**, alongside usual care and under the team's supervision, not as a substitute for analgesia, sedation or clinical assessment. Some departments use it routinely; in others it never went beyond the pilot. Both happen, and both tell you something. ## What makes a hospital stay last longer Length of stay does not depend only on the illness. It is also driven by: - **poorly controlled pain and anxiety**, before and after procedures; - **immobility and loss of strength**, especially in long stays; - **delirium and disrupted sleep**, common in intensive care and in frailer patients; - **complications and infections** that arise along the way; - and factors that are not clinical at all: waiting for a test, for transport, for a place in continuing care or for support at home. At most, virtual reality may touch some of the first. It does not touch the last at all, and in many hospitals those are what add the most days. ## What studies have observed - **Pain and anxiety during procedures.** This is where the evidence is most abundant. Randomised trials and systematic reviews have observed lower reported pain and anxiety during procedures, in children and adults, with immersive distraction. Virtual reality can help manage pain and anxiety, but effects vary with the procedure, age and content, and some studies found no difference. - **Sleep and agitation.** Small studies, mostly in intensive care, have explored calm immersive environments for sleep and agitation. The results are preliminary and do not support firm conclusions. - **Mobilisation.** There are rehabilitation studies using exercise in virtual reality, with mixed results. In RVer, guided exercise corresponds to **RVer Motion**, a module **in development and not covered by the** Class I medical device registration, which covers only the base product. - **Length of stay.** Few studies measure it as a primary outcome. Those that do come from specific settings with small samples, and the results are not consistent. A calmer procedure does not automatically translate into an earlier discharge. ## What is not known yet :::note It is not known whether virtual reality reduces length of stay in general, or by how much. There is no basis for promising freed beds, fewer drugs or a financial return in any particular department. In our public library, only **eight** studies are about costs and return, all from very specific settings, and their figures do not transfer to another hospital: the population, the comparator and who pays are all different. ::: We explain this in more detail in [“The VR ROI nobody can prove”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). The conclusion is not that there is no value. It is that value has to be measured in your own department, with metrics decided before you start. ## What a manager can measure Rather than starting from a savings figure, a well-designed pilot answers implementation questions: how many sessions happen per week, how much staff time they take (timed, not estimated), how many patients decline or stop early, and in which departments the tool actually becomes routine. A pilot does not demonstrate clinical efficacy and should not be presented as if it did. See [how to run a pilot in a healthcare service](/blog/piloto-realidade-virtual-hospital-como-correr/en/). ## Where RVer fits RVer is a virtual reality system for clinical use whose base product, the 360° video library, is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and CE-marked under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and not covered by that registration. Nor is the registration an efficacy claim. It runs offline, does not depend on hospital IT systems and does not collect patients' clinical data. It is always used with a professional present, with patients aged 10 to 100. It does not prescribe, assess or diagnose, and it does not replace usual care. The studies are in the [public library](/estudos/en/), including those with weak or neutral results, and what the registration covers is set out in [Science and regulation](/en/ciencia/). :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: Q: Does virtual reality reduce length of stay? A: It is not known in general. Few studies measure length of stay as a primary outcome, they come from specific settings, and the results are not consistent. The strongest evidence concerns pain and anxiety during procedures, and even there effects vary. Q: Which hospital departments use virtual reality? A: Published reports cluster in paediatrics, oncology, orthopaedics and rehabilitation, burns, intensive care and preparation for surgery, always as a complement to usual care and under the team's supervision. Q: Can a hospital know in advance how much it will save? A: No. There are few economic studies (eight in our public library) and their figures do not transfer to another hospital, because the population, the comparator and who pays are different. What a pilot can measure is sessions per week, staff time and refusals. Q: Does RVer replace analgesia, sedation or clinical assessment? A: No. RVer is a complementary, non-pharmacological approach, always used with a professional present. It does not prescribe, assess or diagnose. The Class I medical device registration covers the base product, the 360° video library, and is not an efficacy claim. ### RVer Neuro: cognitive stimulation in Virtual Reality URL: https://rver.pt/blog/rver-neuro-cognicao-com-realidade-virtual/en/ Date: 16 July 2026 Paper worksheets trigger disengagement and refusal. What if the activity that stimulates were also the one people want to repeat? Paper worksheets work, but they carry a known cost: they are monotonous, they trigger disengagement and, often, refusal. The person feels they are being put to the test, and gives up. Cognitive stimulation ends up happening less often than the team would like. RVer Neuro starts from a simple idea: what if the exercise were something people want to repeat? ## Seven exercises, in a calm virtual room The module brings together seven Virtual Reality activities across different cognitive domains: - **Number Trail**: attention and set-shifting - **Block Sequence**: working memory - **Focus Catch**: sustained attention and impulse control - **Visual Search**: selective attention and visual scanning - **Shape Match**: spatial reasoning in 3D - **Shopping List**: memory - **Spatial Memory**: spatial memory and orientation The patient controls each task with the two hand controllers and head movement. Immersion removes distractions from the room and makes the task engaging, which helps most with people who struggle to hold attention on a paper sheet. Almost nothing depends on reading: the items are 3D objects. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## An activity log, and a human decision As the patient works through it, the session log streams live to the team's dashboard. No manual transcription, no waiting for the session to end. :::note **What the log is, and is not.** Activity counts and times: how many items, in how long, with what errors. There is no grading, no thresholds, no norms and no comparison against reference values. The module **does not assess, grade or diagnose**, and does not replace any clinical assessment. It is a stimulation and activity-logging aid, for wellbeing purposes. ::: ## Why Virtual Reality helps here The difference is not the task itself: it is how the task is experienced. In a calm virtual room, without the competing stimuli of a real one, the person focuses on the activity rather than on their own performance. 3D mental rotation, for one, is only possible in a three-dimensional environment. Difficulty is set by the team. Only Block Sequence adapts to the patient during the activity. ## Local, private, integrated RVer Neuro runs locally on the headset, with no cloud, and is enabled per device. It is part of the RVer platform, whose base product is a Class I Medical Device registered in EUDAMED and with INFARMED (Portugal). RVer Neuro is a module in development, not covered by that registration. No patient data leaves the headset, which keeps everything under the institution's control and GDPR-compliant. The Neuro module is **in development**, via clinical partnership. RVer Neuro does not aim to replace any professional. It aims to give the team an activity people enjoy doing, and a record of what happened in the session, without the manual work. Q: What is RVer Neuro? A: It is the cognitive stimulation module of the RVer system. It brings together seven Virtual Reality activities (attention, working memory, spatial reasoning, visual search and memory) controlled with the two controllers and head movement. The session activity log streams live to the team's dashboard. Q: Does RVer Neuro assess or diagnose? A: No. The module logs session activity: counts and times, with no grading, thresholds, norms or comparison against reference values. It does not assess, grade or diagnose, and does not replace any clinical assessment. It is a stimulation and activity-logging aid, for wellbeing purposes. Q: What stage is the Neuro module at? A: The Class I medical device registration in EUDAMED and with INFARMED (Portugal) covers the base product: the RVer video library. RVer Neuro is a module in development, developed via clinical partnership, not covered by that registration. The base product bears the CE mark under MDR 2017/745; the modules are not covered by that registration. Q: Does it need a cloud connection? A: No. RVer Neuro runs locally on the headset, with no cloud, which keeps data under the institution's control and GDPR-compliant. ### Why modular software is better for a healthcare institution URL: https://rver.pt/blog/software-modular-vantagens-saude/en/ Date: 15 July 2026 The question is not 'which software has the most features?'. It is 'which software lets me use only the ones I need, and add the others when they make sense?'. That is where the modular model wins. Buying software for a healthcare institution is usually an uncomfortable decision. Traditional options ask you to decide **today** what you will only know **tomorrow**: which features you will need, at what volume, for which services. You pick a large package "to be safe", and pay for half of things you never use. Or you pick a small package, and a year later you have to replace everything. A **modular system** solves this dilemma differently: you start with the base and add capabilities when the need is real. ## Pay for what you use In a modular model, the base platform delivers the essentials and each extra capability is a module you enable when it makes sense. The institution does not fund idle features: the cost tracks usage. In RVer's case, the base covers the immersive experience: it helps manage pain and anxiety, and brings comfort. Those who need guided movement enable **RVer Motion**; those who need cognitive activities enable **RVer Neuro**. Those who do not need them, do not pay. RVer Motion and RVer Neuro are modules in development, not covered by the Class I medical device registration, which covers the base product. ## Enable per device, not per whole contract Fine-grained modularity brings a second advantage: modules are enabled **per device**. A physiotherapy service can have Motion active on its equipment, while the geriatrics service uses Neuro on theirs: all on the same platform, with no parallel contracts. This lets you trial a new capability on one ward before extending it to the whole institution. Small, reversible decisions, instead of a single expensive commitment. ## Grow without migration projects The biggest hidden cost of monolithic software is not the licence: it is **migration**. Every time you need something new, there is a project, downtime, repeated training and risk. In a modular system, growing means enabling the next module. The base is the same, the team already knows it, and the new capability comes in without interrupting what already works. ## Continuous improvements, no effort from the institution Because everything sits on a common base, **software and content updates reach all modules at the same time**, automatically. The institution does not manage versions or contract upgrades: the system improves on its own, and every improvement benefits all active modules. ## One base, many possibilities A good modular system is not a collection of loose programs. It is **a registered, secure base** on which specific capabilities sit. In RVer, that base is a Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal), running locally and complying with GDPR, and those guarantees hold, whatever the active modules. For a healthcare institution, this translates into a simple advantage: **start with what you need today, confident that what you need tomorrow is already one click away**, without starting from scratch. On the infrastructure side, the questions this raises are in [“The eight questions hospital IT asks”](/blog/informatica-hospital-perguntas-realidade-virtual/en/). Q: What does it mean for a system to be modular? A: It means the base platform works on its own and that additional capabilities (such as motor rehabilitation or cognitive stimulation) are enabled as independent modules, per device, when the institution needs them. You do not have to buy everything at once, nor replace the system to add a function. Q: Does a modular system cost more overall? A: Usually not. You pay for the base and add modules according to real usage, which avoids paying for features you never use. For larger volumes there is adapted pricing, but the logic is always to align cost with use. Q: What if we need a new capability later? A: You enable the corresponding module, with no migration project and no downtime. In RVer's case, modules like Motion (rehabilitation) and Neuro (cognition) are enabled per device in the settings. Q: Does modularity compromise security or compliance? A: No. In a good modular architecture, all modules share the same registered base and the same security and privacy rules. In RVer, the platform is a Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal), runs locally and complies with GDPR, regardless of the active modules. RVer Motion and RVer Neuro are modules in development, not covered by the Class I medical device registration, which covers the base product. ### Where the saving is: the four cost levers in hospitals and clinics URL: https://rver.pt/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/en/ Date: 14 July 2026 The saving is not a property of the technology: it is a property of your service. There are four places it can be, each with a condition. If none applies, it is not there. *Updated 16 August 2026.* "Where is the saving?" is the right question, and it deserves an answer that is not an invented number. The honest answer is that **the saving is not a property of the technology: it is a property of your service**. There are four places it can be. If none of them applies to your house, it is not there, and it is better to know that before signing. This page is part of the [ROI guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/) and covers the [hospital and clinic](/en/solucoes/hospital/) side. For a care home the arithmetic is different, and it is in [what it returns in a care home](/blog/roi-realidade-virtual-lar-de-idosos/en/). ## Lever 1: Procedures that today require sedation This is the lever with the highest unit cost: a sedated procedure consumes drugs, anaesthesia time, recovery monitoring and often an escort who loses a day. The literature studying this works mostly in paediatric imaging and short procedures with distraction. **The condition for a saving is simple: those people would genuinely have been sedated.** If your service already does most scans without sedation, the avoided cost does not exist: not because distraction fails, but because there was no expense to avoid. ## Lever 2: Procedure time and interruptions A calm patient cooperates, moves less, forces fewer repeats. Where this counts is in rooms whose cost per minute is high and whose schedule is the constraint: imaging, dentistry, wound care. The question to ask is: **how many minutes per session, how many sessions a day, and what does a minute of that room cost?** Without those three figures, any estimate is talk. ## Lever 3: Missed appointments, cancellations and walk-outs This is the most underestimated one. An appointment that does not happen because the person did not turn up, or panicked at the door, costs the whole slot. In MRI and in dentistry, fear is a recognised cause of non-attendance. Here the sum is easy to do with data you already hold: non-attendance rate, cost of the slot, and the share of that rate attributable to anxiety or claustrophobia. ## Lever 4: Adherence in long programmes In rehabilitation the problem is rarely the first session: it is the tenth. A programme abandoned halfway consumes resources without producing the outcome that justified the spend. What the rehabilitation literature most often reports is **adherence and engagement**: more sessions completed, not necessarily a better clinical result. ## The fifth, which is not a saving Patient experience, differentiation, family satisfaction, appeal to staff. It is real value and it often decides the purchase, but it is not an avoided-cost line, and presenting it as one in a tender weakens the rest of the argument. ## A model that holds up For each lever that applies to your service: > **unit cost avoided × real frequency × probability of avoiding it** The third term is the one almost everyone forgets, and it is what separates a defensible estimate from a brochure. If you cannot estimate the probability, measure it: that is exactly what a pilot is for. | Lever | Applies if… | |---|---| | Sedation | the patients in question would be sedated | | Room time | the room minute is expensive and the schedule is the constraint | | Non-attendance | the no-show rate has an identifiable anxiety cause | | Adherence | there are long programmes with known drop-out | ## Before using any of these numbers Figures published in other countries and other systems **do not transfer**: the population, the comparator and who pays for what all change. It is explained in [“The ROI nobody can prove”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/), and it is the recommended read before writing any saving into a document someone will assess. How to measure what is yours is in [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/). :::note Nothing on this page is a clinical efficacy claim or a promise of savings. These are levers to verify in each service, with that service's own data. The Class I registration (EUDAMED and INFARMED) covers the base product and concerns regulatory conformity, not performance. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. Q: Does virtual reality really reduce the need for medication? A: The literature on distraction analgesia and sedated procedures studies that question, but a saving only exists if those people would genuinely be sedated in your service. If scans already happen without sedation, there was no cost to avoid. We make no claim of medication reduction for our product. Q: How do I calculate the return for my institution? A: For each lever that applies: unit cost avoided × real frequency × probability of avoiding it. The third term is the one almost everyone forgets and what separates a defensible estimate from a brochure. If you cannot estimate it, measure it in a pilot. Q: What evidence exists on savings? A: Little, and very specific: in October 2026, of the 130 studies in our public library, eight concern cost and return, in contexts such as paediatric imaging without sedation and post-operative pain. Their numbers do not transfer directly to another service, because the population, the comparator and who pays what all change. Q: Does patient experience count as a saving? A: No. Experience, differentiation and satisfaction are real value and often decide the purchase, but they are not an avoided-cost line. Presenting them as savings in a tender weakens the rest of the argument. ### How to choose a virtual reality for clinical use solution: a checklist for healthcare institutions URL: https://rver.pt/blog/como-escolher-realidade-virtual-terapeutica/en/ Date: 9 July 2026 A decision guide for clinical and management leads: the criteria that actually matter when choosing virtual reality for clinical use, and what to get in writing before you sign. Choosing virtual reality for clinical use for a healthcare institution is not choosing a headset. It is choosing **content, workflow, data security and support**: the technology is merely what carries all of that. This guide gathers the criteria that actually matter and shows how to test before you decide. ## Start with the clinical problem, not the technology The most common mistake is to start with "what device should I buy?". The right question is **"what clinical problem do I want to solve?"**: - Distraction and pain management during procedures? - Reducing pre-operative anxiety, or anxiety in settings like haemodialysis and oncology? - Cognitive stimulation and reminiscence for older people or people with dementia? - Supporting motor rehabilitation and adherence to physiotherapy? - Relaxation and wellbeing in long-term or palliative care? Once the goal is defined, everything else follows. A solution that is excellent for pain management may be irrelevant for cognitive stimulation, because what changes is not the headset, it is the **content and the framing**. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## Essential criteria (checklist) Use this list to grade any vendor. If you are still getting to grips with the concept, start with [what is virtual reality for clinical use](/blog/o-que-e-realidade-virtual-terapeutica/en/); the Portuguese framing is in [clinical virtual reality in Portugal](/blog/realidade-virtual-terapeutica-portugal/en/). - **Validated, appropriate content.** Is there a library built for healthcare, not just generic games? Is the content suitable for the patient profile (geriatrics, paediatrics, mental health, palliative care)? - **Ease of use for staff.** Can a nurse start a session in seconds, with no technical training? If it is complicated, it will not be used. - **Works without internet.** In care homes and homes, the network fails. Content should live on the device and sessions should run offline (it is the criterion that decided [RVer's headsets](/en/equipamento/)). - **Hygiene and durability.** Is the equipment easy to clean and disinfect between patients? Does it withstand intensive use in a clinical setting? - **Data security and GDPR.** What data is collected, where is it stored, and how is GDPR met? Demand clear answers. - **Clinical follow-up.** Can you record sessions and track use over time, to integrate into the care plan? - **Regulatory framing.** What is the declared intended purpose and framing (for example, a Class I medical device with CE marking)? - **Support and training.** Is there initial staff training and ongoing support, or does the vendor disappear after the sale? - **Total cost.** What is the real cost (device, licences, content, support, replacements), not just the sticker price? And how it is paid for: funding and procurement routes are in [How to fund and procure](/en/aquisicao/). > The best solution is not the one with the most features. It is the one your team will actually use, every week, without friction. ## Questions to ask the vendor Bring these to the first meeting: 1. What evidence supports using this content for my clinical goal? 2. How does a typical session work, start to finish, from the team's perspective? 3. What happens when there is no internet? 4. How do you handle patient data and GDPR compliance? 5. What is the regulatory framing of the solution? 6. What training and support are included? 7. What does the start look like: who configures, who trains the team, and how long does it take? ## Red flags Be wary when you see: - **Promises of guaranteed results.** Virtual reality for clinical use is a complementary tool, used under supervision, not a miracle cure. - **Marketing over clinical substance.** Lots of enthusiasm, little clarity about content, evidence and framing. - **Dependence on internet** in settings where the network is unreliable. - **Vagueness about data and GDPR.** - **No ongoing training or support.** ## How to test before you decide: the pilot Do not roll out across the institution without starting with one service. A good pilot is **short, bounded and measurable**: - **One service, one goal.** Pick one setting and one concrete clinical goal. - **A defined period.** For example, 4 to 8 weeks. - **Success criteria up front.** Staff adoption, ease of use, patient feedback, workflow integration. - **Involve the people who will use it.** The view of frontline nursing staff is worth more than any sales demo. At the end of the pilot you have real data to decide, not a salesperson's impression. ## In short Choosing virtual reality for clinical use is, above all, a decision about **content, people and process**, not hardware. Start with the clinical problem, evaluate with the checklist, ask the right questions, recognise the red flags, and test with a pilot. That is how you adopt clinical technology your team actually uses and that makes a difference for patients. Before comparing suppliers, it helps to know which safety questions to ask: [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). If the choice goes through a tender, the same reasoning as a specification is in [how to write a tender specification](/blog/caderno-de-encargos-realidade-virtual-saude/en/). Q: What should I evaluate first when choosing virtual reality for clinical use? A: Start with the clinical problem you want to solve (pain management, anxiety, cognitive stimulation, rehabilitation), not the technology. The right solution is the one that answers that goal with appropriate content, is easy for your team to use, and fits into your existing workflow. The headset is the last criterion, not the first. Q: Does the solution need to work without internet? A: In many settings, yes. Care homes, long-term care units and home settings often have weak or no connectivity. A solution where the content lives on the device and sessions run offline is more reliable in those scenarios. Always confirm this point with the vendor. Q: Is virtual reality for clinical use a medical device? A: It depends on the product's intended purpose. Solutions with a therapeutic purpose may be classed as a medical device (often Class I in the EU), which implies CE marking and conformity requirements. Ask the vendor for the regulatory framing in writing. Q: How do I start without involving the whole institution? A: With a short, bounded pilot: one service, one clinical goal, a defined period (for example 4 to 8 weeks), and success criteria agreed up front: staff adoption, patient feedback, ease of use. Q: What red flags should I look for in a vendor? A: Promises of guaranteed clinical results, no validated clinical content, vagueness about data protection and GDPR, dependence on stable internet in settings without a network, and lack of training or ongoing support. Marketing over clinical substance is the main red flag. ### Clinical virtual reality in Portugal: where it is used, the rules and how to procure it (2026) URL: https://rver.pt/blog/realidade-virtual-terapeutica-portugal/en/ Date: 9 July 2026 The state of virtual reality for clinical use in Portugal in 2026: where it already applies, what the evidence says, the regulatory framing, and a practical path to start. Virtual reality for clinical use has moved from a future promise to a tool in active use in healthcare settings. In **Portugal**, adoption has grown gradually and pragmatically. This guide summarises where it is already used, what the evidence says, the regulatory framing, and how a Portuguese institution can start. The definition and the mechanism are in [what is virtual reality for clinical use](/blog/o-que-e-realidade-virtual-terapeutica/en/); the criteria for comparing vendors, in the [selection checklist](/blog/como-escolher-realidade-virtual-terapeutica/en/). ## Where it is already used in Portugal Adoption happens mostly in settings where **immersion** helps capture attention, reduce anxiety or stimulate cognition: - **[Care homes and residential facilities for older adults](/en/solucoes/lar-residencial/).** Cognitive stimulation, reminiscence of familiar places, wellbeing and reducing isolation. - **Hospitals and clinics.** Distraction and pain management during procedures, pre-operative anxiety, support in oncology and haemodialysis. - **Rehabilitation and physiotherapy.** Supporting adherence and engagement in motor programmes. - **Home and long-term care.** Relaxation, wellbeing and remote support, including in places without good internet. In all these cases, virtual reality is a **complementary tool**, applied under the supervision of healthcare professionals and integrated into a care plan, never a substitute for treatment. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## What the evidence says International research has shown encouraging results for using virtual reality as a **non-pharmacological** approach, particularly in: - **Pain management** through immersive distraction during procedures. - **Anxiety reduction** in clinical and pre-operative settings. - **Cognitive stimulation and wellbeing** in care homes and in dementia. - **Rehabilitation support** for motor function and adherence. At the same time, honesty matters: evidence varies by application, and virtual reality works best as a **complement** to good clinical practice, not in isolation. A serious institution communicates the benefits without exaggerating them. > The useful question is not "does virtual reality work?", but "for what goal, with which patients, and integrated into what care?". ## Framing: medical device and GDPR Two regulatory questions matter in Portugal, both aligned with the European framework: - **Medical device.** If the solution has a declared therapeutic purpose, it may be classed as a medical device, often **Class I** in the EU, with CE marking. In Portugal, the competent authority is **INFARMED** ([what Class I means](/blog/dispositivo-medico-classe-1-realidade-virtual/en/)). Always ask the vendor for the framing in writing. - **GDPR.** Health data is sensitive data. You need a clear legal basis and purpose, data minimisation, security, and transparency with patients and families. Solutions where data stays controlled and content runs locally simplify compliance. ## Funding and costs There is no single, universal reimbursement for virtual reality for clinical use; funding depends on the context, and the routes that exist in Portugal today (operating budget, cooperation agreements, corporate giving, foundation awards, municipal councils) are in [How to fund and procure](/en/aquisicao/). In practice, what matters most for the decision is: - The **total cost** (device, content, licences, training and support) not just the sticker price. - The **return** in staff time saved, patient wellbeing and service differentiation. - Starting with a **small pilot** to generate real data before extending to other services. ## How a Portuguese institution can start A practical path, from simplest to broadest: 1. **Define the clinical goal.** A concrete problem: pain, anxiety, cognitive stimulation, rehabilitation. 2. **Choose one service.** A setting where the goal is clear and the team is motivated. 3. **Run a pilot.** A few weeks, with success criteria defined up front. 4. **Confirm the framing.** Regulatory (medical device) and data (GDPR). 5. **Involve the team.** The frontline staff who use it decide real adoption. 6. **Evaluate and decide.** Only then scale, based on data and not impressions. ## In short In Portugal, virtual reality for clinical use is in growing, practical adoption: in care homes, hospitals, clinics and home care. Done well, it is a complementary tool, under supervision, with clear regulatory and data framing. The recommended path is always the same: **start small, measure, and only then scale**. Q: Is virtual reality for clinical use already used in Portugal? A: Yes. Portuguese institutions (care homes, hospitals, clinics and home care services) have been adopting virtual reality for clinical use as a complementary tool, mainly for pain and anxiety management, cognitive stimulation, wellbeing and rehabilitation support. Use is always under the supervision of healthcare professionals. Q: Is virtual reality for clinical use considered a medical device in Portugal? A: It can be, depending on the product's intended purpose. Portugal applies the European medical device framework: a solution with a therapeutic purpose may be classed as a medical device (often Class I), with CE marking and conformity requirements. INFARMED is the national competent authority. Q: How is GDPR met when using virtual reality in healthcare? A: Health data is sensitive data under GDPR. In practice this means collecting only what is needed, defining a legal basis and purpose, ensuring security and access control, and being transparent with patients and families. Solutions where data stays controlled and content runs locally make compliance easier. Q: How much does it cost to adopt virtual reality for clinical use in a Portuguese institution? A: Cost depends on the model: device, content, licences, training and support. More important than the sticker price is the total cost and the return in staff time, patient wellbeing and service differentiation. It is recommended to start with a small pilot to evaluate before scaling. Q: How can an institution in Portugal start using virtual reality for clinical use? A: By starting small: choose a concrete clinical goal, one service, and run a pilot of a few weeks with defined success criteria. Involve the team that will use it, confirm the regulatory and data framing, and only then decide on wider adoption. ### Seated virtual cycling: VR bike rides that frail patients can do too URL: https://rver.pt/blog/realidade-virtual-ciclismo-sentado-reabilitacao/en/ Date: 4 July 2026 VR cycling with no bike, no pedals and without leaving the chair: gentle cardio that frail patients can do too, with objective data for the clinician. Asking a frail patient to do cardio is often asking the impossible: limited mobility, poor balance, low motivation. **RVer Virtual Cycling** solves the equation differently: an immersive bike ride, done **always seated**, that works the legs and delivers gentle cardio with no bike and no pedals, without ever leaving the chair. Virtual Cycling is part of **RVer Motion**, a module in development, not covered by the Class I medical device registration, which covers the base product. ## A ride through the countryside, from the chair The patient rests or straps a VR controller on each thigh and starts pedalling. That motion drives a first-person ride through a **bright 3D countryside**: winding road, tree-lined avenue, sunlit hills. The world never physically moves them: the horizon stays level, with no jolts, which lowers the risk of the nausea that usually keeps frail users away from virtual reality. On-screen, in real time, are **speed, distance and cadence (RPM)**. An instructions card and a GO button let anyone start on their own, with no menus or complicated reading. ## The team sees movement data. The patient sees a ride This is where Virtual Cycling differs from a fitness app. While the patient enjoys pedalling through the countryside, the **physiotherapist's companion app** receives live, over the local network: - distance covered; - average and max speed; - cadence (RPM); - session duration; - **left/right leg symmetry**: the bilateral balance of effort. It turns a pleasant ride into objective information the team can follow over time. ## Built for patients, not for cyclists VR cycling is not new, but the usual solutions require a real bike and smart trainer and are built for fit cyclists. **RVer Virtual Cycling** is the opposite: - **seated** and comfortable, with a level horizon; - driven only by the **controllers on the legs**, no gym equipment; - **simple**: no accounts, no menus, one button to start; - **local and private**: runs on the headset itself, no cloud; - built for **frail, deconditioned or cognitively impaired patients**. ## Part of RVer Motion Virtual Cycling joins the other **RVer Motion** activities: the guided 3D coach (Gym Room) and the mobility games (Orb Slice, Reach Pop, Balloon Pop, Rhythm Reach). All share the same philosophy: movement the patient wants to do, recorded for the team to review. RVer Motion and RVer Neuro are modules in development, not covered by the Class I medical device registration, which covers the base product. :::note **Important note:** RVer Virtual Cycling is an **exercise and movement-tracking aid for wellness purposes**, used under the supervision of healthcare professionals. It is not a diagnostic device and does not replace clinical assessment. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It runs on affordable standalone headsets, is simple for teams to operate, and collects no patient clinical data. Riding through the countryside, seated, with effort turning into data: that is how Virtual Cycling makes cardio possible, and desirable, for the people who need it most. Q: What is RVer Virtual Cycling? A: It is a seated indoor VR cycling activity, part of the RVer Motion movement module. The patient rests or straps a controller on each thigh and pedals; that motion drives a first-person ride through a 3D countryside. It is designed for patients of all ages, frail ones included, with comfort and safety first. Q: How does seated VR cycling work without a bike? A: No bike or pedals are needed. The patient stays seated and uses a VR controller on each leg; the pedalling motion is detected and moves the virtual ride forward. Speed, distance and cadence (RPM) appear on-screen, and a GO button lets anyone start unaided. Q: What does the therapist see? A: The physiotherapist's companion app receives live, over the local network, the distance covered, average and max speed, cadence, duration, and left/right leg symmetry. The patient sees a bike ride; the clinician sees movement data to track progress over time. Q: Is it safe for older or frail patients? A: Yes. The activity is always done seated, with a level horizon and no forced camera motion, which lowers the risk of nausea. It suits frail, deconditioned or cognitively impaired people, always under team supervision. It is an exercise and wellness aid, not a diagnostic device. ### What is virtual reality for clinical use? A complete guide for healthcare professionals URL: https://rver.pt/blog/o-que-e-realidade-virtual-terapeutica/en/ Date: 3 July 2026 Virtual reality for clinical use: what it is, how it works and where it applies in healthcare, a clear guide for anyone considering it. The term "virtual reality" makes many people think of video games or entertainment. In healthcare, the concept is different, and it is important to start there. **Virtual reality for clinical use** is a clinical tool, not a pastime. This guide explains what it is, how it works and where it applies. ## What it actually is Virtual reality for clinical use is the **use of immersive virtual reality environments as a complementary tool in healthcare**. The patient wears a headset that transports them into a virtual environment (a calm beach, a forest, a guided scene) with a concrete clinical goal: helping to manage pain and anxiety, stimulating cognition, supporting rehabilitation or inducing relaxation. What sets it apart from entertainment is not the technology, it is the **purpose and the framing**: applied with a therapeutic goal, under the supervision of healthcare professionals, integrated into a care plan. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## How it works The mechanism relies on how the brain responds to an engaging sensory experience: - **Attention capture**: immersion occupies the senses and shifts focus away from pain or fear. This is the principle of therapeutic distraction. - **Emotional regulation**: calm environments and guided breathing techniques help lower activation and anxiety. - **Active stimulation**: guided tasks and movements can support cognitive and motor functions in rehabilitation (in RVer, these are modules in development, outside the Class I registration). > Immersion does not "trick" the patient: it creates an experience engaging enough to change what the brain focuses on. ## Where it applies in healthcare The range is broad and growing as [evidence](/estudos/en/) accumulates: - **[Pain management](/blog/realidade-virtual-gestao-da-dor/en/)** during procedures (dressings, punctures, wound care). - **Anxiety** pre-operative, in oncology, in haemodialysis, in imaging. - **Paediatrics**: distraction from fear and pain in children (in RVer's case, from age 10). - **[Geriatrics and dementia](/blog/realidade-virtual-demencia-alzheimer/en/)**: cognitive stimulation, reminiscence, calm. - **Rehabilitation** motor and neurological. - **Mental health**: relaxation, stress management, phobias. - **Palliative care**: comfort and escape. ## What it is NOT Worth being explicit to avoid misunderstandings: - **It is not a video game**: the goal is clinical, not recreational. - **It does not replace treatment**: it is complementary, never an alternative to medical care. - **It decides nothing on its own**: any use and any clinical decision rest with the healthcare team. :::note **Important note:** virtual reality for clinical use is a **complementary** and **non-pharmacological** approach, used under the supervision of healthcare professionals and integrated into the care plan. It does not replace diagnosis, medication or clinical decision. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It brings together a content library designed for clinical use, is simple for teams to operate, works with content stored on the device itself, without depending on internet, and collects no patient clinical data. Understanding what virtual reality for clinical use is marks the first step to using it well: as a clinical tool serving the team, not as a gadget. The next step depends on where you are: the Portuguese picture in [clinical virtual reality in Portugal](/blog/realidade-virtual-terapeutica-portugal/en/), the [checklist for choosing](/blog/como-escolher-realidade-virtual-terapeutica/en/) a solution, and use in each setting in [Solutions](/en/solucoes/). Q: What is virtual reality for clinical use? A: It is the use of immersive virtual reality environments as a complementary tool in healthcare: for pain distraction, anxiety management, cognitive stimulation, rehabilitation or relaxation. It differs from entertainment by being applied with a clinical goal, under the supervision of healthcare professionals and integrated into a care plan. Q: How does virtual reality for clinical use work? A: The patient wears a headset that places them in an immersive virtual environment. That engagement captures attention and alters perception: for example, shifting focus away from pain or fear, inducing relaxation, or stimulating cognitive and motor functions through guided tasks. The effect relies on how the brain responds to an engaging sensory experience. Q: Does virtual reality for clinical use replace medical treatment? A: No. It is a complementary, non-pharmacological approach, used in addition to clinical care and always under the supervision of the healthcare team. It does not replace diagnosis, medication or any clinical decision. Q: Where is virtual reality used in healthcare? A: In varied settings: pain management during procedures, pre-operative anxiety, oncology, haemodialysis, paediatrics, geriatrics and dementia, motor rehabilitation, mental health and palliative care, among others. The specific use always depends on the clinical team's assessment. ### Fear of the MRI scan: how virtual reality helps with claustrophobia during the exam URL: https://rver.pt/blog/realidade-virtual-ressonancia-magnetica-claustrofobia/en/ Date: 3 July 2026 Claustrophobia causes MRI scans to be delayed, abandoned or repeated. Virtual reality helps prepare the patient before they enter the machine. A significant share of MRI scans are delayed, abandoned or repeated for a reason that has nothing to do with the machine: **the patient cannot bear being inside it**. The narrow tube, the intense noise, the obligation to stay still for minutes: for anyone prone to claustrophobia, it is a hard scenario to endure. ## Why the MRI scares people so much An MRI brings together, at the same time, several classic anxiety triggers: - **Enclosed, narrow space**: the direct trigger of claustrophobia. - **Required stillness**: any movement ruins the image, which raises the tension. - **Loud noise**: the machine is noisy and unpredictable. - **Loss of control**: being confined and waiting, unable to leave freely. In more sensitive patients, the result can be a panic attack that forces the exam to stop, with costs in time, repetition and delayed diagnosis. ## Where virtual reality comes in Virtual reality for clinical use acts mainly **before** the exam, in preparation: - **Prior relaxation**: calm environments and breathing techniques help the patient arrive less activated. - **Familiarisation**: reducing the surprise effect of what is about to happen makes the experience more predictable and less threatening. - **Distraction and focus**: shifting attention from anticipated fear to a pleasant stimulus. > The goal is not to trick the patient: it is to give them tools to better tolerate a necessary exam, avoiding interruptions and repeats. ## The value for the imaging service Every interrupted exam is lost machine time, an appointment to redo and a delayed diagnosis. Helping the patient complete the exam first time has direct clinical and operational value. A calmer patient is also a more still patient, and better-quality images. :::note **Important note:** virtual reality for clinical use is a **complementary** approach, used under the supervision of healthcare professionals. It does not replace clinical assessment or any decision about sedation, which always rests with the healthcare team. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. Simple to operate between exams, comfortable for the patient, and with content stored on the device itself, it works without depending on internet, it supports the preparation of anxious patients while collecting no patient clinical data. Preparing the patient before they enter the machine is often the difference between a completed exam and a lost one. Q: Why are so many people afraid of MRI scans? A: An MRI combines several anxiety triggers: a narrow, enclosed space, the required stillness for long minutes, the loud noise of the machine, and a sense of loss of control. In people prone to claustrophobia, this can cause panic attacks that lead them to abandon the exam. Q: How can virtual reality help with an MRI scan? A: Virtual reality for clinical use is mainly used in preparation: calm environments and relaxation techniques help the patient arrive less anxious, and prior familiarisation reduces the surprise effect. The goal is for the patient to tolerate the exam better and avoid interruptions, always under the team's supervision. Q: Does virtual reality replace sedation for an MRI? A: It does not replace it, nor is it a decision made by the technology. It is a complementary, non-pharmacological approach that, in some patients, may reduce the need for sedation. Any clinical decision always rests with the healthcare team. ### Virtual reality physiotherapy: turning exercise into something patients want to do URL: https://rver.pt/blog/realidade-virtual-fisioterapia-idosos-adesao/en/ Date: 3 July 2026 In elderly physiotherapy, the hard part is not prescribing the exercise: it is getting it done. Virtual reality changes that equation. Any physiotherapist working with older adults knows the real obstacle. It is not designing the exercise plan: it is getting it done, regularly and with the right technique. **Adherence is the hardest problem in geriatric physiotherapy.** Repetitive exercises, with no immediate reward, done alone at home, are easy to abandon. The 3D coach, rep counting and games described below belong to **RVer Motion**, a module in development, not covered by the Class I medical device registration, which covers the base product. ## Why adherence fails Rehabilitation exercise tends to be everything that demotivates: - **Repetitive**: the same sets, no variation or stimulus. - **No feedback**: the patient sees no tangible progress. - **Solitary**: done at home, with no supervision or reliable counting. - **Boring**: nothing invites you to repeat it tomorrow. The result is familiar: too few reps, sloppier technique, and progress the therapist cannot measure objectively. ## What virtual reality changes Virtual reality attacks the problem through motivation. Instead of counting reps alone, the patient enters an environment where movement has purpose and immediate reward: - **Guided 3D coach**: a virtual instructor demonstrates each exercise; the patient just copies along. The app counts the reps automatically. - **Movement games**: slice orbs from the air, pop balloons, reach for targets. Simple, no instructions, designed to make movement feel like play. - **Visible progress**: real-time score and metrics give the patient the sense of advancement that keeps them repeating. > The patient sees a game. The therapist sees rehabilitation. That is the key to adherence. ## Movement that is also data The difference from a plain video game is measurement. While the patient has fun, the system records **reach, range of motion, speed and consistency**: turning exercise into information the clinician can review. Less manual counting for the team, objective progress for the physiotherapist. And because it is built for frail patients, it works **seated-safe by default**, with no menus or reading, comfort-first: usable by frail and cognitively impaired patients. :::note **Important note:** this is an exercise-support and movement-tracking aid for wellness and motivation: **not a diagnostic device**. The plan, the prescription and supervision always rest with the physiotherapist. ::: ## The role of RVer Motion **RVer Motion** is the guided-movement module of RVer, designed for clinics, rehabilitation centres and care homes. It combines a 3D coach with automatic rep counting and a suite of mobility games: all seated-safe, simple, and team-adjustable (rep targets, difficulty, reach zones). It runs entirely on the headset, with no accounts or cloud. RVer Motion and RVer Neuro are modules in development, not covered by the Class I medical device registration, which covers the base product. The best rehabilitation is the one the patient actually does. Making exercise desirable is the shortest path to adherence. In a population where balance and the fear of falling are the central problem, see [virtual reality and Parkinson's disease](/blog/realidade-virtual-doenca-de-parkinson/en/). Q: How can virtual reality help with physiotherapy for older adults? A: Virtual reality turns prescribed exercise into guided, playful movement. A 3D coach demonstrates each exercise and the patient copies along; simple mobility games make movement enjoyable. At the same time, the system measures reach, range and speed, giving the therapist an objective record of progress. The main effect is on adherence: people want to repeat it. Q: Is it safe for frail or cognitively impaired patients? A: Yes, when designed for it. A solution suited to frail patients should be seated-safe by default, with no menus or reading, and comfort-first. That makes it usable by frail and cognitively impaired patients, always under the supervision of the physiotherapy team. Q: Does virtual reality replace the physiotherapist? A: No. It is an exercise-support and movement-tracking tool, for wellness and motivation. The plan, the prescription and supervision remain with the physiotherapist. The technology measures and motivates; the clinician decides. ### Which virtual reality headset for healthcare? Quest 3, Pico 4 and Apple Vision Pro compared URL: https://rver.pt/blog/comparar-headsets-realidade-virtual-saude/en/ Date: 2 July 2026 Quest 3, Pico 4 or Apple Vision Pro? For a healthcare setting, the choice is decided less by the spec sheet and more by daily operation. When a healthcare team decides to adopt virtual reality for clinical use, the technical question comes up early: **"which headset do we buy?"**. The three most common answers are the Meta Quest 3, the Pico 4 and the Apple Vision Pro. But the right comparison is not the one made in tech stores. In a clinical setting, the criteria are different. :::note October 2026 update: for RVer, the first criterion is now storage. The library is already close to 300 GB, and the Pico 4 Ultra only comes with 256 GB. The full comparison, eleven headsets spec against spec, is at [Why the Meta Quest 3](/en/equipamento/). And in RVer the headsets are ours: the institution does not buy them. ::: ## What actually matters in healthcare In a clinic, care home or at-home setting, the headset is not used by an enthusiast for hours: it is used by several patients, by several professionals, often many times a day. What weighs is **repeated operation**: - **Hygiene**: how quickly it wipes down and disinfects between patients. - **Weight and comfort**: tolerable for older adults, children or frail patients. - **Preparation time**: seconds, not minutes, between uses. - **Autonomy**: works without cables and without a PC alongside. - **Robustness**: survives intensive use and moving between rooms. The spec sheet that impresses in a demo counts for little if the device is heavy, awkward to clean or slow to prepare. ## Quick comparison | Criterion | Meta Quest 3 | Pico 4 | Apple Vision Pro | |---|---|---|---| | Type | Standalone | Standalone | Standalone | | Price | Affordable | Affordable | High | | Weight | Light | Light | Heavier | | Visual quality | Very good | Very good | Excellent | | Ease of hygiene | High | High | Medium | | Fit for repeated healthcare use | High | High | Lower | > For most healthcare settings, an affordable standalone headset wins not by being the most powerful, but by being the one the team can use in minutes, patient after patient. ## Why standalone wins All three devices are standalone: the computer is built in, no cables or PC. That is half the battle in healthcare: less setup, more mobility between beds, rooms and homes. The **Apple Vision Pro** offers superior image quality, but its price and weight make it less practical for the repeated bedside use healthcare demands. The **Quest 3** and **Pico 4** hit the balance: light, affordable, easy to clean and quick to prepare. ## The headset is only half the decision The device is just the body. What decides the clinical experience is the **software** running on it: content designed for healthcare, simple to launch, comfortable, and available **without depending on internet**. :::note **Important note:** virtual reality for clinical use is a **complementary** approach, used under the supervision of healthcare professionals and integrated into the care plan. It does not replace medical care. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to run on affordable standalone headsets, with content stored on the device itself: it works without internet, is simple for the team to operate, and collects no patient clinical data. Choose the headset by daily operation, not by the spec sheet. The best device is the one the team uses every day. On why asking for resolution and field of view in a tender distinguishes nobody, see [how to write a tender specification](/blog/caderno-de-encargos-realidade-virtual-saude/en/). And before comparing headsets with each other, there is the earlier comparison: [virtual reality or a tablet?](/blog/realidade-virtual-ou-tablet-qual-a-diferenca/en/). Q: Which is the best virtual reality headset for clinical use? A: There is no absolute winner: it depends on the setting. For most clinics, care homes and at-home use, an affordable standalone headset such as the Meta Quest 3 or Pico 4 is the best fit: light, cable-free, easy to clean and quick to prepare between patients. The Apple Vision Pro offers superior quality but is far more expensive and heavier, which makes repeated bedside use harder. Q: Do you need a powerful computer to use virtual reality in healthcare? A: No. Standalone headsets (Quest 3, Pico 4) have the computer built in and work without a PC or cables. This is decisive in healthcare: less equipment, less setup and greater mobility between beds, rooms or homes. Q: Does the headset need internet to work? A: It depends on the software. A solution well designed for healthcare should store its content on the device itself, so it works even without a connection: essential in wards, care homes and home visits where Wi-Fi is weak or absent. ### How to fund virtual reality: budget, grants and alternatives to buying URL: https://rver.pt/blog/financiamento-comparticipacao-realidade-virtual-saude/en/ Date: 2 July 2026 The problem is usually not the price: it is the budget line. Capital or operating expense is the question that decides whether the project starts this quarter or in a year. *Updated 16 August 2026.* When an institution recognises the value of virtual reality for clinical use, the brake that appears next is rarely technical. It is financial, but not in the way people expect. **The problem is usually not the price; it is the budget line.** And there are more doors than outright purchase. This page is part of the [ROI guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/); this one is about how to pay, not about what it returns. ## First: there is no patient reimbursement Worth being clear, because it is the first question. Virtual reality for clinical use **is not reimbursed at patient level** the way a prescribed medicine would be. It is acquired by the institution (hospital, clinic, care home, charity) as equipment and a working tool. That is not bad news: it just means the route is not a prescription, it is the organisation's purchasing decision. [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## Second, and equally important **Medical device registration does not confer eligibility for public funding.** They are separate things: registration concerns regulatory conformity; eligibility depends on the specific funding programme, its rules and whether it is open. Be wary of anyone presenting registration as a passport to a grant: we do not. ## The question that decides everything: capital or operating? This is where most processes stall, and it is an accounting question, not a technology one: - **Capital.** Buying equipment. It has to enter the investment plan, carries approval thresholds and often an annual cycle. If this year's plan has closed, the project waits twelve months. - **Operating expense.** A service paid yearly or monthly. It comes out of the running budget, with lower approval thresholds and no waiting for the cycle. RVer is always the second: an annual service, with the headsets remaining ours. The institution uses it and never buys it, so it does not wait for the investment plan. Worth confirming with your finance director, **before** requesting a proposal, which budget line it falls under. ## The routes, in order of speed 1. **Operating budget**: the fastest when the monthly figure fits the thresholds of whoever decides locally. 2. **Public procurement**: when the amount or the entity's rules call for a procedure, with the timelines it brings. 3. **Philanthropy, donations and foundations**: common in charities, and particularly suited to something you can show a donor. 4. **Grants and funding programmes**: they exist, they change, and they have to be checked case by case, at the time, for your type of entity. We do not assume eligibility on your behalf. 5. **Projects with clinical or academic partners**: when RVer becomes part of a protocol or a co-validation. These are the main ones. The full list, by type of institution (hospitals and local health units, charities and misericórdias), with the status of each programme, is in [How to fund and procure](/en/aquisicao/). ## The internal case, written for whoever signs The person approving is rarely the person using. The document that tends to pass has four lines, none of them enthusiasm: - **what it solves**, in one sentence, tied to a problem already known inside; - **the total annual cost**, including staff time (the line nobody adds: it is in the [ROI guide](/blog/custo-roi-realidade-virtual-instituicao-saude/en/)); - **what you commit to measuring** in the first three months; - **how it stops**, if it does not work. That last one is what gives the signer confidence. A proposal with no exit looks like a bigger risk than it is. ## Test before deciding A three-month pilot settles most of the budget discussion, because it trades a promise for your own data. What to measure (and what is not worth trying to measure) is in [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/) and in [“The ROI nobody can prove”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). In a care home, the sum that usually opens the budget door is a different one, and it is in [what it returns in a care home](/blog/roi-realidade-virtual-lar-de-idosos/en/). :::note Nothing on this page is financial or legal advice, nor a guarantee of eligibility for any funding. Programme rules change and depend on the type of entity; confirm with the body managing the programme. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. Q: Is virtual reality for clinical use reimbursed? A: Not at patient level, the way a prescribed medicine would be. It is contracted by the institution as a service and a working tool, so funding happens on the organisation’s side. Q: Does medical device registration give access to public funding? A: No. They are separate: registration concerns regulatory conformity, while eligibility depends on the specific programme’s rules and the type of entity. It has to be confirmed with the body managing the programme, case by case. Q: What funding routes exist? A: The main ones, in order of speed: operating budget, public procurement, philanthropy and foundations, funding programmes (to be checked case by case) and projects with clinical or academic partners. The full list, by type of institution, is in How to fund and procure (rver.pt/en/aquisicao/). Q: Why does capital versus operating expense matter so much? A: Because it changes the approval path. A purchase enters the investment plan, with higher thresholds and an annual cycle; a service comes out of the running budget, with lower thresholds. RVer is an annual service: the institution uses it and never buys it, so it does not wait for the investment cycle. Q: Can we test before investing? A: Yes, and it settles most of the budget discussion: a three-month pilot trades a promise for the institution’s own data. Decide beforehand what you will measure: sessions delivered, who started taking part, real staff time and refusals. ### Virtual reality at home: how far therapy can leave the institution URL: https://rver.pt/blog/realidade-virtual-domicilio-telereabilitacao/en/ Date: 29 June 2026 The most effective therapy is the one with continuity. Taking virtual reality into the home promises to fill the gap between sessions, but it only works when the question of who, how and with what supervision is taken seriously. There's an uncomfortable question every therapy faces: **what happens between the sessions?** A patient is seen once or twice a week at the institution, makes progress, and then goes days with nothing structured until they return. For many people, it's in that gap that the gains dissolve. Virtual reality for clinical use has a clear opportunity here: to step outside the institution's walls and give continuity to care at home. It's an exciting idea, and this week it's exactly what we were discussing with a client. But it's also an idea that demands honesty about its limits. ## The case for it: continuity Rehabilitation, cognitive stimulation, anxiety management: almost everything virtual reality for clinical use does benefits from **repetition**. It isn't the isolated session that changes a patient's trajectory; it's the sum of many, done regularly. The problem is that the institution can only offer a limited number of in-person sessions. Team time is scarce, travel is heavy, especially for older patients or those with reduced mobility, and waiting lists are long. The result: much of the therapeutic potential goes unused, not for lack of effectiveness but for lack of opportunities. Taking virtual reality home changes that arithmetic. Between in-person sessions, the patient can keep up a guided practice rhythm, in their own environment, without depending on a trip. For those who live far away, struggle to leave home, or simply need more frequency than the institution can give, the difference is enormous. ## The condition that makes it possible: content without internet There's a technical detail that decides whether home virtual reality is viable or a source of frustration: **dependence on an internet connection.** Many homes, especially those of older patients, have weak, intermittent or non-existent internet. A solution that needs streaming to work will fail exactly where it's most needed. That's why, at RVer, the therapeutic content is stored on the device itself and runs offline. The session always runs, regardless of the network. The connection, when it exists, serves only what makes sense to do in the background: syncing the session records and updating the content library. Never for the experience to happen. It's a distinction that looks technical but is actually clinical: because it determines whether the right patient, in the right home, can really use the tool. ## The case for caution: not everything should leave the institution This is where we have to be clear, because it's easy to let enthusiasm outrun common sense. **Taking therapy home is not the same as leaving the patient alone with it.** Home virtual reality is only responsible if it keeps three things: - **Triage of who can.** Some patients need direct in-person supervision: because of the complexity of their condition, fall risk, agitation, frailty. Those aren't candidates for autonomous home use, and saying so is part of the clinical work, not a limitation to be worked around. - **A plan set by the professional.** What's available at home, with what goals, for how long and with what content is a clinical decision made beforehand, and not something left to the patient's chance. - **Follow-up, not abandonment.** The professional keeps looking at what was done, through the session records, and adjusts the plan. Distance changes the form of supervision; it doesn't remove it. :::note We've written before about why, at RVer, every session has a professional nearby, and why artificial intelligence shouldn't replace clinical judgement. The home isn't an exception to that principle: it's a test of it. The question isn't "how do we take the professional out of the equation?", but "how do we keep the professional present even at a distance?". ::: ## Telerehabilitation: the professional present, even at a distance The word "telerehabilitation" alarms people when they read it as "rehabilitation without a therapist." It isn't that. Done well, it's the therapist extending their reach: defining the work, seeing what the patient did between appointments, and using the in-person time, which is precious, for what can only happen face to face. Virtual reality fits this model well because it makes what's done at home **structured and recordable**. Instead of "do the exercises and tell me later," the patient runs a session designed for them, and the professional sees what happened. Continuity stops depending on memory and goodwill, and starts having data. ## Where this is going We're exploring home use with clients who feel, day to day, the cost of the gap between sessions. Not as a way to do it cheaper at the expense of less care, but as a way to give **more therapy** to those who benefit from it, without multiplying trips or burning out the team. The rule that guides us is simple: virtual reality can leave the institution, but clinical care can't be left behind. When those two things travel together, taking therapy home stops being a risk and becomes exactly what it should be: a way to be closer to the patient, even when they're far away. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: Q: Does virtual reality at home replace the sessions at the institution? A: That's not the idea. The home is there to give continuity between in-person sessions, not to replace them. Clinical assessment, the care plan and the key moments still happen with the professional. Home use is a remotely supervised extension, not a substitute for in-person care. Q: How does supervision work if the professional isn't present? A: Continuity doesn't mean leaving the patient to their own devices. The professional defines in advance what content is available, with what goals and for how long, and follows what was done through the session records. Patients who need direct in-person supervision aren't candidates for home use: that triage is part of the clinical work. Q: Does the patient's home need internet for this to work? A: Not for the session itself. The therapeutic content is stored on the device and runs without a connection, which is essential in homes where internet is weak or absent. A connection is only useful, when it exists, to sync records and update content, never for the experience to run. ### Four hours in the chair: how virtual reality helps during hemodialysis URL: https://rver.pt/blog/realidade-virtual-hemodialise/en/ Date: 28 June 2026 Few treatments ask as much time of the patient as hemodialysis. Virtual reality won't speed up the machine, but it can completely change how those hours are lived. Hemodialysis has a feature that sets it apart from almost every other treatment: its main demand isn't pain, it's **time**. Three sessions a week, three to four hours each, for years. For many people with renal failure, it's the structure their whole life is organised around. And in practice, that time is almost always still time. The patient is connected to the machine, one arm held immobile because of the vascular access, with little room to move. What's left is hours to fill, and boredom, anxiety and a sense of being trapped are complaints as real as any physical symptom. This is exactly where virtual reality for clinical use finds one of its most natural fits. ## The problem isn't only clinical: it's lived When people talk about improving the dialysis experience, they think first about parameters: blood pressure, cramps, session tolerance. Those matter. But there's a dimension that rarely shows up in the metrics and weighs enormously on the person in the chair: **what to do with your mind during all those hours.** Stare at a ceiling. Watch TV you didn't choose. Think about the illness. Count the time left. The monotony of long sessions feeds anxiety, irritability and, over the months, discouragement. And a discouraged patient adheres less, tolerates less and suffers more. Virtual reality goes straight at that emptiness. Instead of four hours staring at the unit, the patient can be on a calm beach, walking through a forest, watching a concert or travelling somewhere they've never been. This isn't luxury entertainment: it's a way to **shrink subjective time** and give back some choice to someone who has so little of it during treatment. ## Why dialysis is a good setting for VR Not every clinical context lends itself equally to virtual reality. Dialysis has several features that make it particularly favourable: - **The session is long and predictable.** There's plenty of time to put the headset on calmly, choose content and have a complete experience, unhurried. - **The patient is seated and stable.** Unlike acute settings, the person is in a comfortable, monitored position: ideal conditions for a safe immersive experience. - **It repeats over time.** Because the patient returns several times a week, content can be varied, preferences built and the experience tuned session after session. - **The team is already there.** A dialysis unit always has nursing staff on hand: which means the supervision VR needs is already part of the workflow. :::note The vascular access sets a clear limit: the fistula arm must stay still. So the content is chosen to be contemplative and low-movement (landscapes, slow journeys, calm environments) rather than experiences that invite gesturing. VR adapts to the treatment's constraint, not the other way around. ::: ## Safety first: what has to be guaranteed Bringing virtual reality into a dialysis unit demands care. Some principles are non-negotiable: The equipment is **self-contained, with no wires attached to the patient**: it occupies sight and hearing, nothing more. The vascular access stays visible and accessible to the team at all times. Content is selected to minimise any risk of motion sickness, which matters especially in a population that may already have blood-pressure swings during the session. And the headset comes off in seconds: if blood pressure needs checking, the machine adjusting or any intervention, none of it is hindered. Then there's **patient triage**. Not everyone is a candidate: those with marked nausea, certain eye or vestibular conditions, or significant agitation may not benefit. That decision is clinical and belongs to the professional, who knows the patient and their history. ## What we're learning: honestly We're currently running an **RVer testbed in a dialysis unit**, and we'd rather be clear about it: we don't sell promises we haven't verified. The goal is to find out, on real ground, what works and what doesn't. The questions we care about are concrete. Do patients want to come back to it? What kind of content holds attention best: landscapes, journeys, music? Does cleaning between patients fit the unit's rhythm without slowing anything down? Does the experience actually reduce anxiety and the sense of time? And above all: does the nursing team feel this helps them, or that it adds work? It's these answers, not brochures, that will tell us how virtual reality should be used in dialysis. When we have data worth sharing, we'll share it, including whatever goes less well. ## A layer of humanity over a hard treatment Hemodialysis keeps people alive, but it charges a heavy price in time and quality of life. We won't pretend a headset fixes that. What virtual reality can do is more modest and still important: turn empty hours into something more bearable, give some choice to people who have little, and show the patient that the team cares not only about their kidneys but about their experience. In a chair where so many hours are spent, that's no small thing. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: Q: Does virtual reality interfere with the dialysis machine or the vascular access? A: No. The headset is a self-contained device with no wires attached to the patient; it occupies only sight and hearing. The fistula arm stays still and visible to the team, and the content is chosen so it doesn't call for large movements. The VR session adapts to the treatment, never the other way around. Q: Is the patient cut off from the team during the session? A: They shouldn't be. At RVer, virtual reality is used with the nurse nearby, who keeps monitoring blood pressure, symptoms and the course of dialysis. The headset can be removed in seconds if intervention is needed. It's a layer of comfort on top of care, not a way to leave the patient alone. Q: Is it suitable for every dialysis patient? A: Not necessarily. Patients prone to motion sickness, with vestibular issues, certain eye conditions or significant agitation may not be candidates, and it's the professional who makes that call. For many others, especially those facing the boredom and anxiety of long sessions, it can be a valuable support. ### Why artificial intelligence isn't ready to be the clinician yet URL: https://rver.pt/blog/ia-nao-esta-pronta-para-ser-o-clinico/en/ Date: 16 June 2026 Artificial intelligence already does extraordinary things. But there's a question worth separating from the excitement: is it ready to be, on its own, the professional who decides what happens to a patient? Today, the honest answer is no. There's a phrase that gets repeated at conferences and pitches: "AI will replace the doctor." It usually comes with an impressive number and a rising chart. It's a good phrase for selling, and a bad way to think about healthcare. Not because artificial intelligence is bad. On the contrary: at many tasks, it's already better than any of us. The question is different, more surgical: **is it ready to take, on its own, the place of whoever decides what happens to a patient?** Looking at what AI is today, the answer is no, and it's worth understanding exactly why. ## 1. It doesn't perceive the patient. It processes data about them. A health professional, beside a person, is reading far more than what they measure. They read the expression, the breathing, the hesitation, the "it's nothing" that means the opposite. They catch the signal that fits in no form. AI doesn't see the person: it sees the data we give it about them. And in the populations that matter most to us, that's a serious problem: a person with dementia, a patient in distress, someone who can't describe what they feel. It's precisely where self-report fails that the human gaze becomes irreplaceable. The machine wasn't in the room. ## 2. It is, at times, confidently wrong This may be the most dangerous trait of today's AI: it errs with the same fluency with which it gets things right. It produces an articulate, plausible, self-assured answer, and sometimes simply a false one. Without hesitating, without flagging the doubt. In a search engine, a wrong answer is an inconvenience. Beside a patient, it's another matter. A professional knows how to say "I'm not sure, let's check." AI tends not to know that it doesn't know, and that false confidence, in healthcare, is a real risk. ## 3. It cannot be responsible When a clinician decides, someone is responsible for that decision: a trained person, subject to rules, ethics, accountability. If something goes wrong, there's someone to answer and someone to learn. An algorithm doesn't carry that responsibility: it can't. "The model decided" is not an acceptable answer in front of a patient or a family. And a clinical decision with no one to own it isn't autonomy: it's an accountability vacuum dressed up as efficiency. ## 4. It fails on the rare case, and medicine lives on rare cases Artificial intelligence is brilliant at the average. It learns from the most common patterns and answers them very well. The problem is that healthcare is full of exceptions, and the exception is often **the** vulnerable patient: the one who reacts atypically, who has several conditions at once, who doesn't fit the mould. It's exactly there, in the long tail of unusual cases, that AI is weakest, and where an experienced professional makes the difference. Betting the safety of those who need it most precisely on the technology's weak point is a hard trade to justify. ## 5. It learned from data that doesn't represent everyone A model is only as good as the data it learned from. And that data tends to under-represent precisely some of the populations we serve: the oldest, the multi-morbid, certain groups. The result is blind spots, and a system's blind spots tend to land on those already at a disadvantage. ## 6. It knows patterns, not meaning Finally, there's something AI doesn't do: understand what's at stake. It doesn't weigh the dignity of a frightened person, a family's wishes, the difference between treating to cure and accompanying to comfort. It recognizes correlations; it doesn't assign meaning. And much of what a professional does, especially in caring for fragile people, is exactly that: making sense, deciding with values, caring. ## "Not yet" is an open door We say "not yet" on purpose. This isn't technophobia or a rejection of AI: it's a judgment about its current state. As reliability improves, evidence accumulates, regulation matures and accountability becomes clear, the role of artificial intelligence will grow, and rightly so. Until then, the responsible way to use AI in healthcare is simple to state: **in the service of the professional, not in their place.** That's the line. And it's by respecting it that we keep building RVer around an old and still irreplaceable idea: that behind every session, there is one person caring for another. Q: Is RVer against artificial intelligence? A: Not at all. AI has a real and growing role in healthcare: organizing information, suggesting options, supporting the team. Our position is different and more specific: in its current state, AI isn't ready to replace a professional's judgment beside a vulnerable patient. That's the difference between a support tool and an autonomous decision-maker. Q: What does a professional do that AI still can't? A: They perceive the person in front of them: the discomfort that isn't said, the subtle reaction, the sign that escapes any form. They weigh context, values and the rare case. And, above all, they are responsible for the decision. AI processes data; the clinician cares for a person. They're not the same thing. Q: So when will AI be ready? A: We say 'not yet' deliberately: it's an open door, not a rejection. As evidence, reliability, regulation and accountability mature, AI's role will grow. Until then, the responsible path is AI in the service of the professional, never in their place. ### No buffering, no relying on Wi-Fi: why RVer's content lives on the device URL: https://rver.pt/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/en/ Date: 15 June 2026 The best technology in healthcare is the kind that always works, not just when the network is good. That's why, at RVer, the videos aren't streamed over the internet: they live inside the device itself. Picture the scene: a quiet room in a care home, a resident ready for a session, and the Wi-Fi flickering the way it tends to in old buildings with thick walls. If the experience depended on streaming, this is where everything would fall apart: image stalling, quality dropping, the person taking the headset off in frustration. It was with exactly this room in mind that we made a fundamental technical decision: **RVer's content isn't streamed over the internet. It lives on the device.** ## The problem with streaming 360 video High-quality 360 video is heavy. To wrap vision in every direction with clarity, it needs far more data than a normal video. Streaming that in real time demands a fast **and stable** connection, and stability is precisely what's missing in many care homes, hospitals and day centres. The result of streaming in those environments is predictable: loading pauses, loss of sharpness at peak moments, lag. In an experience whose goal is to bring calm, none of this is acceptable. A therapeutic session can't be held hostage by the quality of the network at that exact moment. ## Our choice: the content is already there At RVer, the videos are placed on the device itself. When the session starts, there's nothing to download, nothing to wait for: the content is already present, ready to play. The image runs smoothly because it isn't arriving over the network: it's coming from the device's own memory. This brings three concrete benefits: - **Guaranteed smoothness.** No buffering, no quality drops. The experience is equally smooth in a room with excellent Wi-Fi or with no connection at all. - **Reliability.** The session always happens. It doesn't depend on the network being good at that hour, in that corner of the building. - **Simplicity.** The team puts the headset on and starts. No connection diagnostics, no "loading." ## What about updates? The natural question: if the content is on the device, how does it grow and refresh? This is where the internet comes in, but at the right moment. The library is updated occasionally, when a connection is available, syncing new therapeutic environments. The difference is that this happens **outside the session**, in the background, not while the person is living the experience. Separating the two (play locally, update when possible) is what gives the best of both worlds: content that stays fresh and playback that's always smooth. ## Standalone hardware, simple setup This architecture fits the current generation of standalone headsets: devices that need no computer, no cables, no complex installation. Everything required for the session is contained in the device itself. For people working on the ground, that means bringing the experience to any room, any bedside, without setting anything up. ## The right technology is the kind that disappears In the end, the goal of a good technical decision is that no one has to think about it. The person putting on the headset shouldn't know, or worry, whether there's a network. They should simply find themselves, in an instant, in a calm place. Keeping the content on the device is, ultimately, just that: getting the technology out of the way so that only the experience remains. It's less visible than a shiny new feature, but it's the kind of decision that separates a demo that impresses from a tool you can rely on, every day. It is one of the reasons IT tends to approve this quickly: [the eight questions hospital IT asks](/blog/informatica-hospital-perguntas-realidade-virtual/en/). Q: Does RVer need the internet to work? A: To play the experiences, no. The videos are stored on the device itself, so playback is smooth and reliable even in places with weak Wi-Fi or no connection. An internet connection is used only for occasional tasks, such as updating the content library, never during the session. Q: Why is that better than streaming? A: Streaming high-quality 360 video demands a lot of bandwidth and a stable connection, something many care homes and hospitals don't have consistently. Storing the content locally eliminates stalls, buffering and quality drops. The experience is always smooth, regardless of the network. Q: What about privacy? A: Having the content on the device means the experience doesn't depend on transmitting data over the network during the session. It's a simpler, more robust architecture, aligned with careful use in a healthcare setting. Data-protection matters are handled with the rigor the sector requires. ### Why there's always a professional alongside: VR isn't an app left in the patient's hands URL: https://rver.pt/blog/acompanhamento-clinico-sessoes-realidade-virtual/en/ Date: 14 June 2026 Technology in healthcare is only worth something when someone is watching the patient. At RVer, virtual reality never replaces the professional: it's in their hands. And that choice isn't a detail: it's the principle. There's a recurring temptation in digital health: to turn a clinical tool into a product you hand to the patient and let run on its own. It's understandable: it promises scale, cuts costs, sounds like the future. But in vulnerable populations, that temptation carries a price that rarely shows up in the pitch. At RVer, we made the opposite choice, and we made it deliberately: **every session is accompanied by a health professional**. It's not a limitation we haven't solved yet. It's a decision of principle. ## Technology doesn't observe the patient, the professional does A virtual reality for clinical use session looks simple from the outside: the person puts on the headset and relaxes. But what makes that session safe and useful happens around it. It's the professional who knows that **this** person is prone to vertigo and therefore chooses stable content. It's the professional who notices the person is more agitated than usual and decides to keep it short. It's whoever spots pallor, discomfort, an unexpected emotional reaction, and acts. None of this is in the content. It's in the eyes of the person accompanying. Virtual reality delivers the experience. Clinical judgment (what is appropriate, for whom, when and how far) remains human. And it's that judgment that separates a therapeutic tool from a mere screen. ## The recent case we should talk about News came up recently that a health system would offer an artificial intelligence solution to guide patients' physical rehabilitation without a therapist. The intention (widening access, cutting waiting lists) is good. The execution, taking the professional out of the equation, deserves a careful look. Physical rehabilitation isn't performing movements. It's **reading the body as it moves**: sensing whether the pain is the pain that belongs or the pain that warns, whether the person is compensating with the wrong side, whether there's a red flag hidden in a gesture. An algorithm can count repetitions and measure angles. What it doesn't do (because it isn't there, and because it's responsible for no one) is the clinical part. And there's the equity problem, usually forgotten. Whoever is left alone with an app is almost always the one who would most need support: the older person, the complex patient, those with less digital literacy or less of a support network. Calling it autonomy to leave these people to fend for themselves is, to put it mildly, optimistic. None of this is an argument against artificial intelligence. It's an argument against **removing the human** from where the human is irreplaceable. ## Where AI helps, and where it shouldn't be in charge It's worth being fair. Artificial intelligence has a place in healthcare: it can help organize content, record what happened in a session, suggest options to the team, provide support between appointments. These are tasks where it adds real value. What it shouldn't do is take the clinician's place in front of a fragile patient, with no one validating the decision. The distinction is simple: AI as the team's **copilot** is a good idea; AI as a **substitute** for the professional, in caring for vulnerable people, is handing responsibility to a machine that cannot hold it. ## What this means at RVer RVer was built on this principle. That's why the system is designed for the team: the team chooses the right content for each person, knows the contraindications, runs and supervises the session. The technology does what technology does well: deliver an immersive, calm and safe experience. The decisions stay with whoever is responsible for the patient. We don't sell care without carers. We give carers a better tool. It's a small distinction in a sentence and an enormous one in practice, and it is, ultimately, what separates a technological promise from good clinical practice. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: On the intended user, training and who decides inside the institution: [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). Before the record comes the explanation and the right to stop: [is consent required?](/blog/consentimento-informado-realidade-virtual-saude/en/). Q: Can I use RVer without a health professional present? A: That's not how RVer is designed. Every session is accompanied by a professional (doctor, nurse, therapist or trained caregiver) who chooses the right content, observes the person's reaction and decides when to start, continue or stop. The technology is a tool in the team's hands, not a substitute for it. Q: But can't artificial intelligence guide the therapy on its own? A: AI can help with concrete tasks: suggesting, recording, supporting between sessions. What it cannot do is take over clinical judgment: assessing pain, detecting an adverse reaction, sensing that something is wrong with a fragile patient. In vulnerable populations, removing the professional isn't efficiency: it's transferring the risk to those least able to protect themselves. Q: Doesn't that make the solution more expensive and less scalable? A: Accompanying doesn't mean tying up a professional full-time. It means integrating the session into the existing care flow, with supervision and judgment. RVer's goal is to empower the team (to give it a safe, effective tool) not to promise care without carers. ### Comfort and motion sickness in VR: why 360 video is gentler URL: https://rver.pt/blog/conforto-e-enjoo-realidade-virtual/en/ Date: 14 June 2026 'What if it makes me dizzy?' It's one of the first questions from anyone who has never used virtual reality. The answer depends less on the technology and more on how the content is made, and here 360 video starts with an advantage. People who have never tried virtual reality often carry one image in their heads: the game that makes you dizzy, the simulator that leaves someone pale after two minutes. It's a legitimate concern, and also a misunderstanding. Motion sickness in virtual reality is real, but it depends far more on **how the content is made** than on the technology itself. ## What VR motion sickness is The technical term is *cybersickness*. The symptoms are familiar to anyone who has felt sick in a car or on a boat: nausea, dizziness, cold sweats, disorientation. The cause is the same too: a **sensory conflict**. Our sense of balance lives in the inner ear and works in constant dialogue with vision. When the two agree, we feel stable. When they disagree, the eyes see movement the body doesn't feel, the brain receives contradictory signals and responds with discomfort. In travel sickness, the body moves and the eyes (reading a book) don't see that movement. In virtual reality, the opposite often happens: the eyes see movement while the body stays still. ## Why some content makes you sick and some doesn't The key is **camera movement**. In games and synthetic experiences, the camera moves artificially: it walks, runs, flies, climbs stairs: all without the person's body moving. That artificial, intense and prolonged locomotion is the main cause of motion sickness. The more aggressive the movement, and the less fluid the image, the greater the discomfort. **Stationary 360 video** works differently. The camera is fixed at a point and the person simply looks around, as they would in a real room. What they see follows their head movement exactly: there's no imposed motion, no conflict. That's why 360 video is gentle by nature, and especially suited to more fragile patients, of any age. It's no accident: it's a design choice. For calm, therapeutic use, a fixed camera isn't a limitation, but it's an advantage. ## The exception: not all 360 is equal It's worth being honest. Even in 360 video, certain footage can cause some discomfort: aerial (drone) shots, fast pans, scenes captured while moving inside a vehicle. There, visual movement without body movement returns. The solution is simple: **choose stable, calm content**, especially for those who are more sensitive. A serene landscape, a square, the sea (filmed from a fixed point) are as immersive as they are comfortable. ## Who should be cautious Virtual reality is safe for the vast majority of people, but some situations call for caution or advise against it: - **A tendency toward vertigo** or balance disorders. - **Strong motion sickness** or nausea already present. - **Photosensitive epilepsy**: avoid content with flashes or intense light. - **Recent ear infections** or acute conditions affecting balance. Flagging these situations up front, and matching them to the right content, is part of responsible use. That's why it makes sense for each video to carry clear indications about its intensity and any contraindications, which in RVer [remove the content from the list](/en/rver-ai/) rather than flag it. ## How to run a comfortable session Small precautions make all the difference: - **Seated and stable.** Most therapeutic sessions are done seated, in a safe spot. - **Start short and calm.** A few minutes of stable content to let the person adjust. Extend later if they're comfortable. - **The person controls the pace.** They can take the headset off at any time. Just knowing that is reassuring. - **Good clarity.** A proper fit and clean lenses reduce eye strain and fatigue ([why RVer uses pancake lenses](/en/equipamento/)). - **Watch for early signs.** Pallor, sweating, "I feel odd": stopping is always the right call. Discomfort passes quickly with rest. ## In short Motion sickness in virtual reality is real but avoidable. Most of the problem comes from content that moves the camera artificially: exactly what stationary 360 video does not do. With stable content, short sessions and attention to the person, the overwhelming majority of patients, of all ages, experience it comfortably. Technology doesn't have to cause discomfort. Chosen well and used well, it does precisely the opposite: it brings calm. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: Motion sickness is one part of the bigger question. The rest (eyes, photosensitive epilepsy, older people and age limits) is gathered in [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). Q: What is VR motion sickness? A: It's a discomfort (nausea, dizziness, disorientation) that can arise when the eyes see movement the body doesn't feel. It's called cybersickness and comes from a sensory conflict between vision and the inner ear, similar to travel sickness but in reverse. It's far more common in experiences that move the camera artificially than in stationary 360 video. Q: Does 360 video also cause motion sickness? A: Much less. In 360 video the camera is fixed and the person simply looks around from a single point: what they see follows their head movement. With no artificial locomotion, the sensory conflict is minimal. The exception is footage with heavy camera movement (aerial shots, fast pans, inside vehicles), which is best avoided with sensitive users. Q: Who should be cautious or avoid it? A: People prone to vertigo, balance disorders, active nausea or strong motion sickness should use it with caution. Content with flashes or intense light should be avoided by anyone with photosensitive epilepsy. As always, use is supervised, individualized and part of the care plan. ### Returning to a familiar place: virtual reality and reminiscence therapy URL: https://rver.pt/blog/reminiscencia-lugares-familiares-realidade-virtual/en/ Date: 14 June 2026 Someone with dementia may not remember what they had for lunch, yet recognize, in an instant, the square of their childhood. Reminiscence therapy works with exactly that memory, and virtual reality takes it further. There is a feature of dementia that surprises those facing it for the first time: the most recent memory fades first, while the oldest often remains. A person may not recognize the room where they slept last night, yet describe in detail the house where they grew up seventy years ago. It is this enduring memory, **autobiographical memory**, that reminiscence therapy works with. ## What reminiscence therapy is Reminiscence is one of the most established non-pharmacological approaches in supporting older people and those with dementia. The idea is simple: use cues from the past (a song, a photograph, a smell, a place) to evoke recollections and, with them, emotion, conversation and connection. The goal is never to "test" whether the person remembers. It's the opposite: to offer them ground where memory is still firm, where they feel capable and recognized. Benefits [documented in the literature](/estudos/tema/qualidade-de-vida/en/) include improved mood, reduced agitation, and a stronger sense of identity and belonging. ## Why virtual reality takes reminiscence further Traditionally, reminiscence relies on photographs, albums and objects. These are valuable tools, but static. Virtual reality adds the missing dimension: that of **being there**. Returning to a place is different from seeing it in a picture. When someone with reduced mobility, who hasn't left a care home in years, "walks" again through the square of their village, the church where they married, or along the sea of their hometown, the recollection activates more fully. Immersion engages attention completely and gives the brain rich sensory cues: exactly the kind of trigger that old memory recognizes. For many, it is also a reunion with places they can no longer visit physically. Virtual reality gives that access back. ## The place has to be the right place Here is a point that makes all the difference and is easy to underestimate: **the content has to be culturally close**. A beautiful generic landscape may relax, but it doesn't evoke memory. What evokes memory is recognition: "this is my town," "I know this place." For a Portuguese person, returning to a familiar place in their own country (a city they know, a [sanctuary they made a pilgrimage to](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/en/), a beach where they spent summers) carries an emotional weight no image from another continent can match. Cultural and geographic relevance isn't a detail: it's what separates a pleasant experience from a true reunion. That's why it makes sense to build content libraries rooted in the reality of the people who will see them. ## How to use it well Virtual reality in reminiscence works best when it is **shared**, not solitary. A few practical principles: - **Choose the place with the person (or the family; the [life story form](/en/ferramentas/historia-de-vida/) helps).** Knowing which places shaped someone's life is the first step. A place with personal history is worth more than the most spectacular scenery. - **Be present.** The greatest value lies in the conversation the experience sparks. Reminiscence is a moment of connection, not a screen to keep someone occupied. - **Short, calm sessions.** The aim is comfort and positive evocation, without fatigue or over-stimulation. - **Watch the reaction.** Not every memory is a happy one. Choose places tied to positive recollections, stay alert to signs of distress, and stop if needed. ## A tool of dignity Ultimately, reminiscence therapy with virtual reality isn't about technology. It's about recognizing that, even as the illness advances, the person is still there, with their history, their places, their identity. Taking them back to a place they love, even for a few minutes, is a way of telling them that their story still matters. It's a simple, powerful reminder: behind a diagnosis there is always a whole life, and that life has an address. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: The wider picture (calm, agitation and care in dementia) is in [virtual reality in dementia](/blog/realidade-virtual-demencia-alzheimer/en/). On where these sessions fit in the week, see [a care home activity plan](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). Q: What is reminiscence therapy? A: It's an approach that uses cues (photographs, music, objects or places) to evoke memories of the past, especially in older people or those with dementia. The goal isn't to test memory, but to awaken positive recollections, spark conversation and reinforce the person's sense of identity and continuity. Q: Why does virtual reality help with reminiscence? A: Because it lets the person return to places they can no longer visit in person: their hometown, a church, the sea. Immersion in a recognizable environment activates memory more richly than a photograph, and local, culturally close content makes the reunion far more meaningful. Q: Is it suitable for everyone with dementia? A: It should always be individualized and supervised. You choose places tied to positive memories, avoiding any that might cause sadness or confusion, and watch the person's reaction. It is a complementary tool, part of the care plan, and never a substitute for human presence. ### Not entertainment: the validated library the clinical team chooses for each person URL: https://rver.pt/blog/biblioteca-validada-equipa-clinica-realidade-virtual/en/ Date: 14 June 2026 There's a gulf between 'putting on a nice video' and 'choosing the right environment for that person, on that day.' That gulf is where the difference between entertainment and therapy lives. Try the thought experiment: two people, the same equipment, two opposite outcomes. To one, you show a serene landscape and they calm down. To the other, you show the same landscape and nothing happens, or worse, they grow uncomfortable. The equipment is identical. What changed is the **fit between content and person**. That's why, at RVer, the content library isn't a detail of the product. It is the product. ## Beautiful isn't the same as therapeutic The internet is full of 360 videos. Many are gorgeous. Almost none were designed for a fragile person, in a care home or a hospital, with a clinical goal in mind. Therapeutic content is a different thing. It's an environment chosen **for a purpose**: to calm someone who is anxious, to activate someone who needs stimulation, to evoke memory in someone living with dementia, to give a moment of comfort to someone in palliative care. And it's an environment assessed for safety (pace, image stability, absence of triggers) because what is harmless for most may not be for everyone. RVer's library is built that way: curated with healthcare professionals, not merely gathered. ## The team chooses, and that's the part that matters Having good content isn't enough. You have to choose **the right content for the right person**, and that decision is clinical. The team supporting the person chooses based on three things: - **The intent.** The goal of that session (to calm, to stimulate, to reminisce) guides the choice. A serene environment and a stimulating one serve different purposes. - **The person's state, in that moment.** Not just who the person is, but how they are today. The content suited to a quiet afternoon may not be the best on a more agitated day. - **The profile and contraindications.** A tendency toward vertigo, sensitivity to intense light, specific frailties. Knowing what to avoid is as important as knowing what to offer. That's why RVer organizes the library so this choice is simple and safe: each environment carries an indication of its intensity and its contraindications, so the team decides with information, not by trial and error. ## Familiar content has a value of its own There's one more dimension that makes all the difference: **closeness**. For many people, especially older ones, returning to a recognizable place carries an emotional weight a generic landscape never will. A place you know, a city you lived in, a spot with personal history. A library rooted in the reality of the people who see it isn't just more pleasant: it's more effective. ## A library that grows Clinical needs are varied, and people tire of repetition. So the library is updated regularly, with new therapeutic environments. The goal is for the team to always have the right option at hand (to calm, to activate, to remember) and for the experience to stay alive over time. ## In short Technology delivers the immersion. But it's the content (chosen, validated, fitting) that turns it into care. At RVer, the library isn't a collection of videos: it's a set of clinical tools, in the hands of those who know which to use, with whom, and when. Because in the end, the question is never "which video shall we put on?" It's "what does this person need, right now?" :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: Q: What makes RVer's library different from 360 videos available online? A: Curation and validation. Each environment is selected for a therapeutic purpose (to calm, to stimulate, to evoke memory, to bring comfort) and assessed for suitability and safety. It isn't a collection of pretty landscapes; it's a library designed for clinical use, with clear indications of intensity and contraindications. Q: How is content chosen for each person? A: The clinical team chooses, based on the goal (calm, activate, reminisce), the person's state at that moment, and their profile: including any contraindications, such as a tendency toward vertigo or sensitivity to intense light. The same environment that helps one person may not suit another. Q: Is the library fixed or does it grow? A: It grows. The library is updated regularly with new therapeutic environments, so the experience stays rich and relevant over time, avoiding repetition and responding to different clinical needs. ### Where virtual reality in healthcare is heading: 2026 trends URL: https://rver.pt/blog/tendencias-realidade-virtual-saude-2026/en/ Date: 12 June 2026 For years, the question about virtual reality in healthcare was 'does it work?'. In 2026, the conversation changed: it became 'how do we integrate this into everyday care?'. That shift says everything. For years, talking about virtual reality in healthcare meant talking about potential. Promising studies, isolated pilots, "someday." In 2026, the tone has changed. Virtual reality for clinical use has stopped being a technological curiosity and become a tool that institutions are actively trying to integrate: methodically, carefully and with realistic expectations. We gathered the trends that best capture this moment. No hype, no promises of revolution: just what is actually changing. ## 1. From "does it work?" to "how do we integrate it?" The most important shift of 2026 isn't technological: it's a change of mindset. The evidence base has grown enough that the conversation inside institutions no longer revolves around "will this work?" but around **integration**: at which points of the patient journey it makes sense, who operates it, how it is documented, how the outcome is measured. It's the classic transition of a maturing technology: from experimental project to part of the care pathway. And it's good news, because the focus moves away from novelty toward what really matters: the benefit to the person. ## 2. Mental health and comfort lead the way Of all the applications, the fastest-growing area isn't surgery or training: it's **emotional wellbeing**: anxiety, stress, comfort. The logic is simple. Immersive distraction is a non-pharmacological way to shift the focus of attention, and that has value in countless everyday clinical moments: a wait, an uncomfortable procedure, a long afternoon in a care home. For more fragile populations, such as care-home residents or those in palliative care, this may be virtual reality's most immediate contribution: offering a moment of calm, of escape, of dignity, without adding medication. ## 3. Pain remains the best-documented case If one application has robust evidence, it's **distraction for pain**. Several clinical trials show significant reductions in pain intensity with immersive virtual reality during procedures, and some solutions demonstrate effects that persist over time, not just in the moment. The mechanism is well understood: attention is a limited resource. By engaging sight and hearing in a captivating environment, less capacity is left to process the pain signal. It doesn't replace treatment, it complements it, and does so with no side effects. ## 4. Standalone headsets made it practical None of this would have left the lab without a change in hardware. **Standalone** virtual reality headsets (no computer, no cables, no installation) transformed practical feasibility. You turn them on, put them on, and they're ready. This accessibility changed the game for people working on the ground: the experience can be brought to the bedside, to a care-home room or to someone's home, with simple cleaning between uses and at a cost incomparably lower than a few years ago. The barrier is no longer technical. ## 5. Personalization is the next frontier The current generation of virtual reality for clinical use mostly delivers the same content to everyone. The next adapts: it tunes the environment, the pace and the intensity to the person's profile and state. In practice, this starts with something simple and powerful: **choosing the right content for each user**. A serene landscape for someone who needs to calm down; a stimulating environment for someone who benefits from cognitive activation; a familiar place for someone living with dementia. Tying each piece of content to an intent and a clinical profile is the first step toward a virtual reality that responds to the person, not to an average. ## 6. Evidence, standards and data protection are no longer optional As use becomes widespread, the bar rises. Institutions no longer accept "it seems to help": they ask for evidence, clear protocols and guarantees of **data protection** and clinical governance. In the European context, the GDPR is not a detail: it's a precondition. This demand is healthy. It separates serious solutions from passing fads and protects the person who matters most: the patient. The 2026 trend is professionalization: less technological demo, more clinical rigor. ## What this means, in practice Virtual reality in healthcare is entering its adult phase. It isn't a solution for everything, and any claim to the contrary deserves skepticism. But in the right applications (comfort, anxiety, pain, stimulation, supporting fragile people) it is now a concrete, accessible tool, increasingly backed by evidence. The challenge of 2026 is no longer to prove the technology has value. It's to use it well: with clinical judgment, with the right content for each person, and with the respect a healthcare setting demands. Q: Is virtual reality in healthcare an established practice now, or still experimental? A: It depends on the application. Immersive distraction for pain and anxiety now has a solid evidence base and is moving from pilot projects to structured use in many institutions. Other areas remain in research. The clear 2026 trend is that the discussion has shifted from whether it works to how to integrate it safely into clinical workflows. Q: What changes with virtual reality personalization? A: Today's generation generally delivers the same content to everyone. The next adapts to the person: adjusting the environment to their profile, emotional state and therapeutic goal. In practice, it means choosing the right content for each user instead of a one-size-fits-all solution. Q: Do I need complex equipment to use virtual reality for clinical use? A: Not anymore. Today's standalone headsets need no computer and no cables: you put them on and they are ready. That accessibility is what made virtual reality practical at the bedside, in a care home or at home, and it is one of the reasons adoption accelerated. ### Virtual reality for burn pain during wound care: what the evidence shows URL: https://rver.pt/blog/realidade-virtual-queimaduras-tratamento-feridas/en/ Date: 10 June 2026 Few procedures are as painful as a burn dressing change, repeated day after day. Among non-drug approaches, distraction-based virtual reality is one of the best-studied, and the evidence is consistent. Changing the dressings on a burn is one of the most painful procedures in all of medicine, and it is not done once, but repeated daily through washing, debridement, and re-dressing. Pain medication helps, but rarely removes the pain entirely. Among the non-pharmacological approaches studied to close that gap, **distraction-based virtual reality** is one of the most thoroughly researched. The evidence is worth looking at. ## The mechanism: attention is a limited resource The logic rests on a simple fact about the mind: **pain demands attention**, and attention is finite. An absorbing immersive environment competes for that same limited attention. The more the experience pulls the mind in, the fewer cognitive resources remain to process the painful signal. This is not "ignoring" pain by willpower: it is redirecting the attention that pain relies on to be felt at full intensity. ## What the systematic reviews say Here the evidence base is unusually solid for a non-drug intervention: - A **systematic review and meta-analysis** pooling around **1,293 burn patients across 30 studies** found that virtual reality **significantly reduced pain severity** during wound care compared with standard care alone (a moderate-to-large effect). - Beyond a single pain score, the pooled data show reductions in **worst pain intensity**, **pain unpleasantness**, and **time spent thinking about pain**, while increasing how much "fun" patients reported during an otherwise dreaded procedure. - Reviews focused on **pediatric burn patients** report the same direction of effect for both **pain and anxiety**, two things that feed each other in children facing repeated procedures. > That immersive distraction lowers procedural burn pain is among the better-supported claims in non-pharmacological pain management: backed by meta-analyses, not single studies. ## The limits it is honest to mention - Effects are measured **during and around the procedure**; VR is a tool for acute procedural pain, not a treatment for the underlying injury. - Studies are **heterogeneous** (different headsets, content, burn severities, and age groups), which widens the range of reported effects. - It is an **adjunct**: it works alongside analgesia and skilled wound care, not instead of them. :::note **Important note:** virtual reality for procedural pain is a **complementary** approach used under clinical supervision. It does not replace analgesia, sedation where indicated, or the judgement of the burn-care team. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to deliver calm, absorbing immersion that the clinical team can start in seconds during a procedure: simple to use at the bedside, hygienic between patients, and with no collection of patient clinical data. When a procedure is unavoidable but the pain around it is not fixed, immersive distraction offers a low-risk way to make it more bearable: always as a complement to proper analgesia and care. ## References Independent studies on virtual reality and burn-care pain (general research, not specific to any product): - [Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9676699/) - [Impact of Virtual Reality Technology on Pain and Anxiety in Pediatric Burn Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9563984/) - [Virtual reality as a pain reduction method in burn and wound healing: a systematic review and meta-analysis, *Burns & Trauma* (Oxford Academic)](https://academic.oup.com/burnstrauma/article/doi/10.1093/burnst/tkaf061/8245060) Q: Does virtual reality reduce pain during burn wound care? A: The evidence points clearly that way. Systematic reviews and meta-analyses pooling over a thousand burn patients find that virtual reality, used alongside standard analgesia, significantly reduces pain intensity during wound care and dressing changes: one of the most painful procedures in medicine. Q: How does VR reduce procedural pain? A: Through immersive distraction. Pain demands attention; an absorbing virtual environment competes for that same limited attention, leaving fewer cognitive resources to process the painful signal. Patients report less worst-pain intensity, less unpleasantness, and less time spent thinking about the pain. Q: Does it replace pain medication? A: No. Virtual reality is studied and used as a complement to standard analgesia, not a substitute. It is an adjunct that can lower the pain experienced during the procedure, always under the care of the clinical team. ### Virtual reality for preoperative anxiety: what the research shows URL: https://rver.pt/blog/realidade-virtual-ansiedade-pre-operatoria/en/ Date: 10 June 2026 Few moments in care are as anxious as the wait before surgery. Among the approaches studied to ease it, virtual reality already gathers consistent evidence from randomized trials, in adults and, especially, children. The hours before an operation are, for many people, the most anxious part of the whole experience: the wait, the unknown, the operating room itself. That anxiety is not only unpleasant: in children especially it is linked to a more difficult recovery. Among the non-pharmacological approaches studied to ease it, **virtual reality** already has a consistent base of evidence from randomized trials. It is worth seeing what they show. ## The mechanism: distraction and preparation Virtual reality is used here in two distinct ways, and the difference matters: - **Distraction**: immersing the patient in a calm, absorbing environment that pulls attention away from the wait and the clinical setting. Attention is finite; an engaging virtual world leaves less of it for anxious anticipation. - **Preparation (exposure)**: walking the patient, beforehand, through what will actually happen: the rooms, the steps, the sounds. The unknown is a large part of preoperative fear, and making it familiar reduces it. Reviews comparing the two suggest the **distraction approach tends to show the stronger effect**, though both are used. ## What the randomized trials say Here the evidence comes from controlled trials, not just observation: - A **meta-analysis of 10 randomized controlled trials** with around **813 patients** found preoperative anxiety **significantly lower** in the virtual-reality groups than in controls. - Across a broader review of **29 studies**, **25 (86%)** showed statistically significant reductions in preoperative anxiety after a VR intervention, with a pooled effect size that is **moderate** and consistent. - Reviews focused on **pediatric surgical patients** report the same significant benefit: important because anxiety before anesthesia is both common and consequential in children. > That virtual reality lowers preoperative anxiety is supported by multiple meta-analyses of randomized trials (in adults and children alike), which is a stronger footing than single studies provide. ## The limits it is honest to mention - Effects are measured **around the perioperative window**; this is about easing a specific, time-limited anxiety, not treating an anxiety disorder. - Studies vary in **headset, content, and whether they distract or prepare**, which widens the range of reported effects. - It is a **complement** to good clinical communication and care, not a replacement for either. :::note **Important note:** virtual reality for preoperative anxiety is a **complementary** approach used under clinical supervision. It does not replace anesthetic assessment, premedication where indicated, or the reassurance of the surgical team. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to deliver calm immersion that staff can start in seconds in a pre-op bay or day-surgery unit: simple to use, hygienic between patients, and with no collection of patient clinical data. When the wait before surgery is unavoidable but the anxiety around it is not fixed, immersive virtual reality offers a low-risk, drug-free way to make it calmer, always as a complement to attentive clinical care. ## References Independent studies on virtual reality and preoperative anxiety (general research, not specific to any product): - [The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials](https://pmc.ncbi.nlm.nih.gov/articles/PMC7600416/) - [The Role of Preoperative Virtual Reality for Anxiety Reduction in Pediatric Surgical Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC11801400/) - [Effects of Virtual Reality–Based Interventions on Preoperative Anxiety in Patients Undergoing Elective Surgery: Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC12079079/) Q: Does virtual reality reduce anxiety before surgery? A: Randomized trials say it does. Meta-analyses pooling hundreds of patients find preoperative anxiety significantly lower in groups given virtual reality compared with usual care, with a moderate effect. The benefit appears in both adults and children awaiting surgery. Q: How does VR lower preoperative anxiety? A: Mainly two ways. Distraction immerses the patient in a calm environment that pulls attention away from the wait and the operating room. Preparation, or 'exposure', walks the patient through what will happen beforehand, so the unknown becomes familiar. Reviews suggest the distraction approach tends to show the stronger effect. Q: Is it useful for children specifically? A: Yes: it is one of the most promising uses. Anxiety before anesthesia is common and distressing in children and is linked to a harder recovery. Meta-analyses focused on pediatric surgical patients report significant reductions in preoperative anxiety with virtual reality. ### Fear of the dentist: how virtual reality helps overcome dental anxiety URL: https://rver.pt/blog/realidade-virtual-medo-do-dentista/en/ Date: 9 June 2026 The drill, the smell, the chair: for millions of people, going to the dentist is a source of real anxiety. Virtual reality carries attention somewhere else, and changes the experience. Few fears are as common, and as quiet, as the **fear of the dentist**. A significant share of the population is estimated to postpone dental treatment because of anxiety, sometimes for years, worsening problems that would have been simple to resolve. The drill, the sound, the smell, the feeling of having no control: everything contributes to an experience many people prefer to avoid. Virtual reality offers a simple approach to this problem: **shifting the focus of attention**. ## The mechanism: immersive distraction Anxiety feeds on anticipation. In the dentist's chair, attention narrows onto every sound and every movement, and that vigilance amplifies the discomfort. Immersive virtual reality engages vision and hearing at once, carrying the person into a calm environment and removing them mentally from the treatment room. With less available "bandwidth" to process fear and pain, the visit becomes more tolerable. It is the same mechanism, **distraction analgesia and anxiolysis**, that makes VR effective in other healthcare procedures. ## What the evidence says Dental anxiety is one of the areas where VR distraction has been tested with encouraging results: - Studies in **pediatric dentistry** show reductions in anxiety and fear behavior during treatments using virtual reality distraction. - In **adults with dental anxiety**, trials indicate lower pain perception and discomfort when the visit takes place with immersive distraction. - The effect is particularly relevant because dental anxiety is **self-perpetuating**: fear leads to postponement, postponement worsens the problems, and the problems confirm the fear. Breaking this cycle has long-term value. > Making the first visit tolerable can be the difference between someone who returns to caring for their teeth and someone who disappears for years. ## Why it matters, beyond the visit - **Fewer postponed treatments**: reducing fear means people seeking care earlier, while problems are still small. - **Easier appointments**: a calm patient makes the professional's work easier and reduces the need for interruptions. - **A non-pharmacological alternative**: useful when avoiding or reducing the use of sedation is the goal. :::note **Important note:** virtual reality is a **complementary**, non-pharmacological approach. It does not replace anesthesia, sedation, assessment, or the decisions of healthcare professionals, and is always used under their supervision and integrated into the care plan. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for the team to start, comfortable for the patient, and with no collection of patient clinical data: exactly what a practice needs to make a difficult appointment calmer. When fear is the barrier, lowering it is the treatment that makes every other one possible. ## References Independent studies on virtual reality and dental anxiety (general research, not specific to any product): - [Nezhad et al. (2024). The effect of virtual reality for anxiety and pain in dentistry: a systematic review and meta-analysis (*Community Dental Health*)](https://doi.org/10.1922/CDH_00160Nezhad08) - [Zaidman et al. (2023). Distraction with virtual reality goggles in paediatric dental treatment: a randomised controlled trial (*International Dental Journal*)](https://doi.org/10.1016/j.identj.2022.06.003) Q: Does virtual reality really help with fear of the dentist? A: Yes. Several studies show that virtual reality distraction during dental visits reduces anxiety and pain perception, in both children and adults. By engaging vision and hearing in a calm environment, less attention is left for fear and discomfort. Q: How does virtual reality work in the dentist's chair? A: The patient puts on an immersive headset and is carried into a relaxing environment (a beach, a forest, a calm landscape) while the professional carries out the treatment. Immersive distraction reduces anticipatory anxiety and the attention given to the cues of the appointment. Q: Is it useful for children afraid of the dentist? A: Yes, and it is one of the most studied applications. In children, VR distraction can make the visit calmer and reduce the fear that would otherwise carry into adulthood. It is always used under the supervision of the clinical team. ### Virtual reality during chemotherapy: distraction and comfort through cancer treatment URL: https://rver.pt/blog/realidade-virtual-quimioterapia-oncologia/en/ Date: 9 June 2026 Chemotherapy treats the body but wears down the mind: the waiting, the anxiety, the nausea. Virtual reality carries the patient somewhere else during the session. **Chemotherapy** treats the body, but it carries a cost beyond the physical. Sessions are long (sometimes several hours hooked to an IV) threaded with anxiety, anticipation, and symptoms like nausea and fatigue. For many patients, the psychological strain of the wait is a real part of the experience. Virtual reality offers something simple but valuable in this context: **a way to mentally leave the treatment room** without leaving the chair. ## The mechanism: occupy attention, ease the wait During a long infusion, attention tends to fix on the room, the IV, and every bodily sensation, and that focus amplifies anxiety and discomfort. Immersive virtual reality engages vision and hearing, carrying the patient into a calm environment or an absorbing experience. With attention elsewhere, there is less mental room for anticipatory anxiety and for symptom vigilance. The treatment time passes differently: less like a wait, more like a pause. ## What the evidence says Oncology is one of the areas where VR distraction has been drawing growing attention, with encouraging results (see the [anxiety](/estudos/tema/ansiedade/en/) topic in the library): - Trials with patients in **chemotherapy** show reductions in anxiety and improvements in mood during sessions using virtual reality. - Several studies point to **lower perceived nausea and fatigue** when the session takes place with immersive distraction. - VR is particularly well suited because the chemotherapy experience combines **long waiting time** with **high emotional load**: exactly the ground where immersive distraction is most useful. > It does not change the treatment, but it can change how the patient experiences it, and across many cycles, that counts. ## Why it matters, beyond the session - **Better experience across many cycles**: people in chemotherapy repeat sessions over weeks or months; making each one more tolerable has a cumulative effect. - **Less anticipatory anxiety**: a lighter experience can reduce the dread of the sessions to come. - **A non-pharmacological approach**: useful as a complement, without adding medication. :::note **Important note:** virtual reality is a **complementary**, non-pharmacological approach. It does not replace chemotherapy, antiemetic medication, assessment, or the decisions of healthcare professionals, and is always used under their supervision and integrated into the care plan. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for the team to start, comfortable for the patient, and with no collection of patient clinical data: well suited to a treatment room, in a [hospital or day hospital](/en/solucoes/hospital/), where time and comfort matter. When treatment is long and hard, giving the patient a better place to look has value of its own. ## References Independent studies on virtual reality in oncology and chemotherapy (general research, not specific to any product): - [Czech et al. (2024). Effects of immersive virtual therapy on the psychological and physical well-being of women with breast cancer: a randomised controlled trial (*Current Oncology*)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11505915/) - [Erdős and Horváth (2023). The impact of VR on psychological and physiological variables in children receiving chemotherapy: a pilot cross-over study (*Integrative Cancer Therapies*)](https://doi.org/10.1177/15347354231168984) Q: Does virtual reality help during chemotherapy? A: Oncology studies point that way: trials of virtual reality distraction during chemotherapy recorded less anxiety and better mood during sessions, and some report lower perceived nausea and fatigue. These are studies by independent researchers, not of RVer, and virtual reality does not replace treatment. Q: How is virtual reality used during chemotherapy sessions? A: During the infusion, which can last hours, the patient puts on an immersive headset and is carried into a relaxing environment or an engaging experience. The distraction shifts attention away from the room, the IV, and the symptoms, making the wait less heavy. Q: Is it safe for cancer patients? A: Virtual reality is a non-invasive, complementary approach, used under the supervision of the healthcare team and integrated into the care plan. It does not replace any medical treatment. Sessions are adapted to each patient's condition and comfort. ### Virtual Reality for pain management: how immersive distraction works URL: https://rver.pt/blog/realidade-virtual-gestao-da-dor/en/ Date: 4 June 2026 Pain is both a physical and an attentional experience. When the mind is fully engaged somewhere else, less capacity is left to process the pain signal: that is where virtual reality for clinical use comes in. Pain management in hospital settings has long relied on pharmacological approaches. They are effective, but they carry known limitations: side effects, the risk of tolerance, and situations where additional medication is undesirable. This is why interest is growing in **non-pharmacological alternatives** that can complement the clinical plan, and virtual reality (VR) is one of the most promising. ## The mechanism: attention is a limited resource Pain perception is not a purely mechanical process. The brain has to *attend* to the pain signal for it to translate into conscious suffering. Attention, however, is finite. Immersive virtual reality engages several senses at once: vision, hearing, and often the sense of presence in a different space. By drawing the patient into a captivating environment, it reduces the attentional capacity available to process the painful stimulus. This is what the [literature](/estudos/tema/dor/en/) describes as **distraction analgesia**. > The more immersive the experience, the greater the distraction effect tends to be, because the brain has less free "bandwidth" for pain. ## Why VR differs from other distractions Watching television or listening to music also distract, but passively and partially. VR stands out for three reasons: - **Multisensory immersion**: the field of view is fully replaced, removing the stimuli of the clinical room. - **Interactivity**: the patient can look around and sometimes interact, which deepens engagement. - **Sense of presence**: the feeling of "being somewhere else" mobilises cognitive resources more completely. ## Relevant clinical contexts VR for clinical use has applications at various points in the patient journey: - Short painful procedures (dressing changes, punctures, minor interventions), in [hospitals and clinics](/en/solucoes/hospital/). - Rehabilitation, where immersion can make repetitive exercises more tolerable. - [Palliative care](/en/solucoes/cuidados-paliativos/) and the management of discomfort and associated anxiety. - Waiting periods, where patient comfort shapes the overall experience. :::note **Important note:** VR for clinical use is a **complementary** approach. It does not replace assessment, diagnosis, or prescription by healthcare professionals, and is always used under their supervision and integrated into the defined clinical plan. ::: In palliative care, physical pain is only one of the four components of [total pain](/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/en/). ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for clinical teams to use and comfortable for the patient, with no collection of patient clinical data. The goal is not to promise miracles, but to offer a tool registered as a medical device that helps make the care experience more human, calm, and tolerable. Q: How does virtual reality help manage pain? A: Virtual reality captures the patient's attention in an immersive environment, reducing the attentional capacity available to process the painful stimulus. This distraction analgesia effect can help lower perceived discomfort during procedures or pain states. Q: Does VR replace pain medication? A: No. VR for clinical use is a complementary, non-pharmacological approach. It is used alongside the clinical plan defined by healthcare professionals, never as a substitute for medical assessment or prescription. Q: In which clinical contexts can it be used? A: It is applicable in contexts such as short painful procedures, rehabilitation, palliative care, and managing discomfort during waiting periods, always under the supervision of healthcare professionals. ### Fear of needles and procedural pain: virtual reality's best-proven use URL: https://rver.pt/blog/realidade-virtual-medo-de-agulhas-procedimentos/en/ Date: 4 June 2026 Injections, dressing changes, burns: short but intense moments, especially for those afraid of needles. This is where virtual reality shows some of its most solid results. Of all the applications of virtual reality in healthcare, one gathers particularly strong evidence: **distraction during painful procedures**. Injections, catheter placement, dressing changes, burn care: short but intense moments, often made worse by **fear of needles**. This is exactly the ground where virtual reality shows some of its best results. ## The mechanism: attention is a limited resource Pain needs attention to become conscious suffering. And attention is finite. Immersive virtual reality engages vision and hearing at once, carrying the person into a captivating environment and removing them entirely from the procedure room. With less available "bandwidth," less attention is left for pain and for fear. This is what is called **distraction analgesia**. In the specific case of needle fear, distraction works at two moments: during the needle itself *and* in the anticipatory anxiety, which is often the hardest part. ## What the clinical trials say This is one of the most studied areas of VR in healthcare, with consistent evidence: - A **meta-analysis** that gathered 21 trials concluded that the virtual reality group had a significant reduction in worst-pain intensity, in discomfort, and in time spent thinking about pain, with an increase in the "fun" component of the experience. - Randomized controlled trials in **children with burns**, among the most painful procedures there are, showed reductions in pain during care using VR distraction. - Immersive distraction is particularly valuable because procedural pain is often **intense and undertreated**, and analgesics are not always enough or desirable. > Few applications of virtual reality in healthcare have an evidence base as consistent as distraction during painful procedures. ## Why it matters, beyond the pain - **Less associated trauma**: repeated painful experiences, especially in children, can create lasting fear of healthcare. Making the moment more tolerable has long-term value. - **Easier procedures**: a calmer, stiller person makes the team's work easier. - **A non-pharmacological alternative**: useful when reducing additional medication is the goal. :::note **Important note:** virtual reality is a **complementary**, non-pharmacological approach. It does not replace analgesia, assessment, or the decisions of healthcare professionals, and is always used under their supervision and integrated into the care plan. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built precisely for this kind of moment: simple for the team to start, comfortable for the patient, and with no collection of patient clinical data. When the evidence is strong and the use is simple, the value is direct: making a difficult moment (an injection, a dressing change) more tolerable for the person living it. ## References Independent studies on virtual reality and procedural pain (general research, not specific to any product): - [Efficacy of VR for pain in children with burns: systematic review and meta-analysis (*Frontiers*, 2025)](https://www.frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2025.1651695/full) - [VR in modulating pain for children with acute burn injuries: randomized controlled trial](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC554986/) On why occupying the field of view is not the same as watching a screen beside you, see [virtual reality or a tablet?](/blog/realidade-virtual-ou-tablet-qual-a-diferenca/en/). Q: Does virtual reality really help with fear of needles and injection pain? A: Yes: it is one of the best-evidenced VR applications in healthcare. Several clinical trials and meta-analyses show that immersive distraction during procedures significantly reduces pain intensity, discomfort, and time spent thinking about pain, especially in children. The effect is robust and well documented. Q: How does virtual reality reduce the pain of a procedure? A: Through immersive distraction. Attention is a limited resource: by fully engaging vision and hearing in a captivating environment, less capacity is left to process the pain signal and fear. This is the mechanism known as distraction analgesia. Q: Is it for adults or only children? A: The strongest evidence is in children, but the mechanism applies at any age. In adults with fear of needles or anxiety about procedures, immersive distraction can equally help make the moment more tolerable. ### Virtual reality in pediatrics: making procedures less frightening URL: https://rver.pt/blog/realidade-virtual-pediatria-criancas/en/ Date: 4 June 2026 For a child, the hospital is a strange and often frightening place. Virtual reality for clinical use speaks the language children understand best: play and imagination. A child does not process a hospital stay the way an adult does. They cannot rationalise the need for a procedure or put discomfort into perspective. What they feel is more direct: fear of the unknown, anxiety about what is coming. Supporting a child in a hospital setting calls for tools that speak their language, and virtual reality for clinical use speaks it particularly well. ## Why VR works so well with children Virtual reality combines two things children respond to naturally: **immersion** and **play**. Instead of asking a child to "stay still and not think about what is about to happen," it offers them somewhere to go with their imagination. - **Immersion is total**: the field of view is replaced, removing the clinical stimuli that frighten. - **Engagement is active**: looking around, exploring, and reacting keep the child genuinely occupied. - **The language is familiar**: the register of play and fantasy is the one the child already lives in. > For a child, not "being treated" but "being somewhere else" completely changes how the moment is experienced. ## The mechanism: distraction that reduces fear As in pain management, attention is a limited resource. When a child is fully engaged in an immersive environment, less attention is left for fear and for the discomfort of the procedure. This distraction does not deceive the child, it simply gives them a better place to focus while the team does its work. ## Relevant pediatric contexts - Short procedures, such as punctures, dressing changes, or minor interventions. - Waiting periods, often loaded with anticipatory anxiety. - Moments of discomfort during the stay, where distraction helps to calm. :::note **Important note:** virtual reality for clinical use in pediatrics is a **complementary** approach, used with age-appropriate content and durations and always under the supervision of healthcare professionals. It does not replace parental support, clinical assessment, or the presence of the team. ::: ## What the studies say Virtual reality distraction during paediatric procedures is one of the most studied areas of virtual reality in healthcare. Some examples from our [study library](/estudos/tema/criancas-e-jovens/en/): - **Three meta-analyses** ([Eijlers et al., 2019](/estudos/eijlers-2019-systematic-review-meta-analysis-virtual-reality-a75363/en/); [Nordgård and Låg, 2021](/estudos/nordgard-2021-effects-virtual-reality-procedural-pain-anxiety-329973/en/); [Tas et al., 2022](/estudos/tas-2022-virtual-reality-pediatrics-effects-pain-anxiety-290064/en/)) bring together dozens of studies in children and young people and report less pain and less anxiety during procedures with virtual reality. Nordgård and Låg observed larger effects with non-interactive virtual reality, such as immersive video. - **Needles and cannulas:** two randomised trials in Australian hospitals ([Chan et al., 2019](/estudos/chan-2019-virtual-reality-pediatric-needle-procedural-pain-2e603b/en/)) and two trials with young people aged 10 to 21, during blood draws ([Gold and Mahrer, 2018](/estudos/gold-2018-virtual-reality-ready-prime-time-medical-107e51/en/)) and intravenous catheter placement ([Gold et al., 2021](/estudos/gold-2021-effect-immersive-virtual-reality-intervention-pain-902b4d/en/)). - **Before surgery:** a virtual tour of the operating theatre before anaesthesia ([Ryu et al., 2017](/estudos/ryu-2017-randomized-clinical-trial-immersive-virtual-reality-e9871d/en/)). These are studies of virtual reality in general, each with its research team's own equipment and content. They are not studies of RVer, and the results are the authors'. ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for clinical teams to use and comfortable for the patient, including the youngest ones, with no collection of patient clinical data. In pediatrics, the goal is to make difficult moments a little lighter: to give the child somewhere to go while they receive the care they need. RVer is used from the age of 10. On the remaining precautions, see [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). Q: Is virtual reality safe for children in hospital settings? A: When used under the supervision of healthcare professionals, with age-appropriate content and durations, virtual reality for clinical use is a non-invasive, non-pharmacological approach. It is always integrated into the clinical plan and used only when appropriate for each child. Q: In which pediatric situations can it help? A: It can help reduce the fear and anxiety associated with short procedures (such as punctures or dressing changes), waiting periods, and moments of discomfort, by capturing the child's attention in an immersive, engaging environment. Q: Does virtual reality replace the presence of parents or staff? A: No. It is a complementary tool. The presence of parents and the clinical team remains essential; virtual reality only adds a form of distraction and comfort during difficult moments. ### Palliative care: comfort and dignity with Virtual Reality URL: https://rver.pt/blog/cuidados-paliativos-conforto-realidade-virtual/en/ Date: 4 June 2026 In palliative care the goal changes: it's not about curing, but caring: ensuring comfort, dignity, and quality of life. Virtual reality offers something precious in that context: the chance to be, for a moment, somewhere else. Palliative care has a different goal from the rest of medicine. It doesn't seek to cure, it seeks to **care**: to relieve suffering, preserve dignity, and improve the quality of the days that remain. In that context, every moment of comfort counts. This is where virtual reality for clinical use finds one of its most human roles, and one research already studies: the library gathers those studies under [palliative care](/estudos/tema/paliativos/en/). ## Escape: being somewhere else A palliative care patient spends a lot of time in the same space, often with pain, fatigue, or anxiety. Virtual reality offers **escape**: the chance, for a few minutes, to be on a beach, in a garden, in their homeland, or in a place they always wanted to visit. It is not running from reality. It is a rest from it. And that rest has value: it can shift focus away from discomfort and make room for calm. > When the body can no longer travel, the mind still can. VR restores that possibility. ## Comfort and emotional wellbeing Beyond escape, VR can support: - **Relaxation**: calm scenarios and a gentle pace help lower anxiety. - **Distraction from discomfort**: immersion shifts attention away from pain and malaise. - **Meaningful moments**: revisiting places of personal and emotional value. - **A sense of control**: choosing where to go, at a time in life when so much escapes control. ## Family, closer One of the hardest aspects of end of life is distance from family. **RVer** includes **[real-time video call with family](/blog/videochamadas-familia-realidade-virtual/en/)**: the patient sees and hears their loved ones while sharing the same immersive scenario, even when they are far away. It's a way to keep connection and presence when physical closeness isn't always possible. :::note **Important note:** VR for clinical use in palliative care is a **complementary, non-pharmacological** support for comfort and wellbeing. It is used with short sessions, suitable scenarios, and always under the supervision of the healthcare team, adapted to the patient's condition and wishes. It does not replace clinical care. ::: ## The role of RVer **RVer** is a virtual reality system for clinical use, a **Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal)** (MDR 2017/745). It is designed to be simple, comfortable, and respectful: easy for [palliative care teams](/en/solucoes/cuidados-paliativos/) to use, and **with no collection of patient clinical data**. At a time when every day is precious, RVer's goal is simple: to help make each one a little more comfortable, calmer, and more connected to those who matter. Q: How does virtual reality help in palliative care? A: VR offers escape and moments of wellbeing: letting the patient visit meaningful places, relax in calm environments, and distract from discomfort. It is used as non-pharmacological comfort support, under the supervision of the palliative care team. Q: Is VR appropriate for end-of-life patients? A: When used with short sessions, calm scenarios, and under the supervision of the healthcare team, VR can bring moments of comfort and connection. Its use is always adapted to the patient's condition and wishes. Q: Can the family take part? A: Yes. RVer includes real-time video call with family, allowing moments of closeness even at a distance: the patient sees and hears their family while sharing the same immersive experience. ### Class I Medical Device: what it means for VR in healthcare URL: https://rver.pt/blog/dispositivo-medico-classe-1-realidade-virtual/en/ Date: 4 June 2026 There is a vast difference between a wellbeing app and a registered medical device. For a hospital, that difference is everything. Here is what Class I registration represents, and why it should weigh on the decision. There are many virtual reality apps today that promise relaxation or distraction. But using technology in a clinical environment raises a different question: **does this solution meet the requirements of a medical device?** The answer separates a consumer product from a tool fit to be part of healthcare. ## What Class I means under MDR 2017/745 The **MDR 2017/745** is the European Union's Medical Device Regulation. It classifies devices by risk level, from Class I (lowest) to Class III (highest). Class I covers devices with low risk to the user, but **"low risk" does not mean "no requirements"**. Even in Class I, the manufacturer must: - Maintain complete **technical documentation** of the device. - Implement a **risk management** system. - Ensure **post-market surveillance** and traceability. - **Register** the device with the competent authority. [Image: The three bands of the software regime for medical devices, and where RVer’s base product sits. RVer Motion, RVer Neuro and RVer Exposure are modules in development, not covered by that registration. Source: MDCG 2019-11 and Rule 11 of Annex VIII of the MDR.] ## The role of Infarmed In Portugal, **Infarmed** is the national authority for medical devices. Registration with Infarmed means the device and its manufacturer are identified to the Portuguese authority, within the European framework. It is not an approval or a certification. > Registration is not a decorative badge. It is proof that there is accountability, process, and traceability behind the product. ## EUDAMED EUDAMED is the European database on medical devices set up under MDR 2017/745. Registration in EUDAMED is not an approval: it makes the identification of the device and of the manufacturer searchable across the European Union. Since October 2026, the RVer base product has been registered in EUDAMED, under Basic UDI-DI 56006195127RVERTZ. ## Why this matters for a hospital When choosing technology for a healthcare service, the [procurement team](/en/aquisicao/) and clinical professionals need guarantees that a store app does not offer: - **Safety:** the device has been assessed for risks to the patient. - **Accountability:** there is an identified manufacturer responsible for compliance. - **Traceability:** there is a process to report and resolve incidents. - **Institutional trust:** it eases integration in regulated contexts. ## RVer and compliance by design **RVer** is a virtual reality system for clinical use registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It was built for the healthcare context from the start, including an important privacy decision: **it does not collect patient clinical data**. In RVer's case, the [registration covers the base product](/en/ciencia/): the video library. The [RVer Motion, RVer Neuro and RVer Exposure](/en/modulos/) modules are in development and not covered by that registration, and the base product bears the CE mark under MDR 2017/745. For a hospital or clinic, this translates into a tool that can be adopted with the confidence that it meets the applicable regulatory framework. Q: What is a Class I Medical Device? A: It is the lowest risk class of medical devices under the European MDR 2017/745 regulation. It covers devices with low risk to the user that must still meet safety, quality, and compliance requirements and be registered with the competent authority. Q: What does registration with Infarmed mean? A: It means the device and its manufacturer are registered with the Portuguese authority and that the manufacturer meets the MDR requirements: it maintains technical documentation, risk management, and post-market surveillance, and that the device is registered for use in Portugal. The registration applies to the device as registered: in RVer's case, to the base product. Q: Why does this matter when choosing VR technology for healthcare? A: Registration as a medical device identifies the manufacturer and the device, and requires safety, traceability and accountability obligations that a consumer app does not have, which is essential in a clinical context. ### Virtual reality to help manage stress: what the research shows URL: https://rver.pt/blog/reduzir-stress-com-realidade-virtual/en/ Date: 4 June 2026 Stress is universal, and so is the search for ways to ease it. Among the approaches studied, relaxation-based virtual reality already gathers consistent evidence, including measurable physiological effects. Stress is one of the most universal experiences, and "how to reduce stress" is one of the most frequent health searches. Among the non-pharmacological approaches studied, **relaxation-based virtual reality** stands out for already having a relatively consistent body of evidence. It is worth seeing what the research shows. ## The mechanism: immersion that calms The logic is direct. Calm immersive environments (typically natural landscapes) capture attention and remove the stimuli of the real setting. Combined, at times, with guided breathing or biofeedback, they help lower the **physiological arousal** associated with stress. The intended result is a state of relaxation, induced by the experience. ## What the systematic reviews say Here the evidence is more robust than in many other VR applications (the library gathers it under [relaxation, stress and anxiety](/estudos/tema/ansiedade/en/)): - A **systematic review** (2024) gathered **50 studies** and around **2,885 participants**, concluding that virtual reality is "a generally low-risk, feasible intervention" for those struggling with stress, with strong potential and no documented harm. - Earlier reviews, with dozens of studies and over a thousand participants, describe relaxation VR as **feasible, acceptable, and effective in the short term** at increasing relaxation and reducing stress. - Several studies go beyond subjective report and measure **physiological markers**: heart rate, electrodermal activity, and **salivary cortisol** (the "stress hormone"), recording reductions after VR relaxation sessions. > That immersive relaxation reduces stress in the short term is among the best-supported points, including through objective physiological markers, not just reported feeling. ## The limits it is honest to mention - Most of the evidence concerns **short-term** effects; less is known about sustained benefit over time. - Results are **heterogeneous** across studies, with varied designs and populations. - VR is one tool among several; it does not cancel out other stress-management strategies. :::note **Important note:** relaxation-based virtual reality is a **complementary** well-being approach. It does not replace care from healthcare professionals when stress is intense, persistent, or associated with clinical distress. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to promote relaxation and comfort through immersion: simple for teams to use and with no collection of patient clinical data. Outside clinical settings, the same relaxation is what [spas and wellness spaces](/en/solucoes/spa/) use. When the evidence is solid, the message can be direct: relaxation-based virtual reality is a viable, low-risk way to support stress reduction, always as a complement and never as a substitute for appropriate care. ## References Independent studies on virtual reality and stress (general research, not specific to any product): - [Virtual Reality and Stress Management: A Systematic Review (2024)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323791/) - [Virtual reality relaxation for the general population: a systematic review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197783/) - [Physiological Responses to VR-Based Stress Regulation and Relaxation: A Systematic Review, *Stress and Health* (2026)](https://onlinelibrary.wiley.com/doi/10.1002/smi.70164) Q: Does virtual reality help reduce stress? A: Research points that way. Systematic reviews with thousands of participants describe relaxation-based virtual reality as a viable, low-risk approach to reducing stress and increasing relaxation, with demonstrated short-term effects. Some studies also measure reductions in physiological markers such as cortisol. Q: How does VR reduce stress? A: Through immersion in calm environments (often natural landscapes) sometimes combined with guided breathing or biofeedback. The immersion captures attention and helps lower the physiological arousal associated with stress, promoting a state of relaxation. Q: Is the effect real or just subjective? A: Both. Beyond the sense of relaxation reported by participants, several studies document changes in objective physiological markers: heart rate, electrodermal activity, and salivary cortisol. Even so, the evidence is mostly short-term and results vary between studies. ### What it costs and what it returns: the guide to VR ROI in healthcare URL: https://rver.pt/blog/custo-roi-realidade-virtual-instituicao-saude/en/ Date: 4 June 2026 The price of the service is the easy part of the sum. This page is the starting point: the three different sums, the cost nobody adds up, and what cannot be proven. *Updated 16 August 2026.* When an institution considers adopting virtual reality for clinical use, the first question is usually "how much does it cost?". It is the wrong question to start with, or at least half a question. The price of the service is the easiest and most visible part of the sum. This page is the starting point for the topic: **what goes into the cost, where the return sits in each setting, and what cannot be proven**. Each section points to the article that develops it. Annual cost set against the level of published evidence is on [Annual cost vs evidence](/en/custo-e-evidencia/). ## First: there is no single sum, there are three The most common mistake is applying a hospital's arithmetic to a house that is not a hospital. The levers differ, and some simply do not exist: | Setting | What dominates the sum | Where to go deeper | |---|---|---| | Hospital and clinic | procedure time, sedation, missed appointments | [where the saving is](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/en/) | | Care home | occupancy, staff time per activity | [what it returns in a care home](/blog/roi-realidade-virtual-lar-de-idosos/en/) | | Either one | what the economic evidence supports | [the ROI nobody can prove](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/) | A care home has no theatre and no sedation to avoid. A hospital does not fix bed occupancy with an activity. Starting from the right sum saves half a meeting. [Image: How responsibilities split between RVer and the institution, from the equipment to the clinical decision.] ## The total cost, line by line The price of the service, headsets included, is the line everyone sees. The other four decide whether the service pays for itself: - **Staff time.** The largest of them all and the most forgotten. A session is about five minutes to choose and fit the headset, plus the session itself. Multiplied by your team's real hourly cost, that is the recurring cost that counts. - **Hygiene between uses.** A short routine, but it exists and it takes minutes. It is described in [equipment hygiene and safety](/blog/higiene-seguranca-equipamento-realidade-virtual/en/). - **Initial training.** How long until the team is operational without supervision. If it is long, the equipment ends up in a cupboard. - **Space and logistics.** Where it lives, who prepares it, how it moves between floors or services. The more friction at each of these points, the higher the real cost, whatever the invoice says. ## The return is measured in use, not in the contract A service contracted and rarely used returns zero, however good the technology. Which is why the metric that best predicts the value of an installation is the simplest one: **sessions delivered per week**. Anything that adds friction (a missing cable, a password nobody knows, a hygiene routine that takes too long, depending on hospital Wi-Fi) cuts usage and, with it, the return. That is why the content [lives on the headset and does not depend on the network](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/en/). ## What does not belong in the sum Do not count on reduced medication, fewer falls or clinical improvement. There are no trials supporting those lines for our product, and putting them in a tender builds a case that does not survive the first hard question. The economic literature on virtual reality in healthcare is thin: of the **130 studies** in our public library (October 2026), **eight** are about [cost and return](/estudos/tema/custos-e-roi/en/), all from very specific contexts. Why their numbers are not yours is explained in [“The ROI nobody can prove”](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/en/). ## How to prove it in the first service A three-month pilot answers better than any brochure, as long as you decide **beforehand** what you are going to count. Four metrics are enough: sessions delivered, who took part who did not before, real staff time per session, and refusals or interruptions. None is clinical, deliberately. A pilot answers implementation questions and does not answer efficacy. How to design one is in [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/), and how to write requirements without asking for things that do not exist is in [“The tender document”](/blog/caderno-de-encargos-realidade-virtual-saude/en/). ## And if the budget does not stretch this year RVer is an annual service: it sits in the operating budget and needs no upfront investment. The routes (cooperation agreements, corporate giving, foundation awards, municipal councils) are in [How to fund and procure](/en/aquisicao/), and the options (operating budget, grants, alternatives to investment) are in [how to fund it](/blog/financiamento-comparticipacao-realidade-virtual-saude/en/). ## In short | If you are… | Start with | |---|---| | A hospital or clinic | the four savings levers | | A care home | the occupancy sum | | Going to tender | the tender document | | Justifying it to management | the three-month pilot | :::note Nothing on this page is an efficacy claim. The Class I medical device registration (EUDAMED and INFARMED) covers the base product and concerns regulatory conformity, not clinical performance. Decisions about the care plan always belong to the clinical team. ::: RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration. Q: How do you assess the return on a virtual reality investment in healthcare? A: Start from the setting, because the levers change: in a hospital, procedure time, sedation and missed appointments count; in a care home it is mostly occupancy and staff time per activity. In either case, the metric that best predicts value is the number of sessions delivered per week: equipment that is rarely used returns zero. Q: Is the cost only the price of the service? A: No. Beyond the price of the service there are four recurring lines: staff time per session (the largest), hygiene between uses, initial training, and space and logistics. The more friction at each, the higher the real cost, whatever the invoice says. Q: Can I count on savings in medication or fewer falls? A: No. There are no trials supporting those lines for our product. In October 2026, of the 130 studies in our public library, eight are about cost and return, all from very specific contexts. Presenting clinical savings in a tender builds a case that does not survive the first hard question. Q: How do you stop the equipment becoming a cost with no return? A: By cutting the friction of use and by measuring. The content lives on the headset and does not depend on the network, the hygiene routine is short, and a three-month pilot with four metrics (sessions delivered, who started taking part, real staff time and refusals) shows quickly whether it entered the routine. Q: What if there is no budget this year? A: RVer is an annual service and needs no upfront investment. The routes (operating budget, cooperation agreements, corporate giving, foundation awards, municipal councils) are on the How to fund and procure page. It is worth understanding the options before assuming the project waits another year. ### Virtual reality in stroke rehabilitation: more therapy time URL: https://rver.pt/blog/realidade-virtual-reabilitacao-avc/en/ Date: 4 June 2026 Recovering movement after a stroke is a matter of repetition and time. Virtual reality has a clear role here: to increase and enrich that therapy time, with evidence to back it. Recovery after a stroke depends largely on one thing: **repetition**. Relearning to move an arm or a hand means practising movements over and over, across weeks and months. The problem is that repetition is tiring and demotivating, and this is exactly where virtual reality finds its most solid role. ## The clear role: increase and enrich therapy time Virtual reality did not come to replace the physiotherapist. Its contribution is more specific and more valuable than that: **making practice more engaging** and allowing patients to do more. - **More repetitions**: turning the exercise into an immersive game or task helps the patient do more movements without giving up. - **Immediate feedback**: the environment responds to each movement, guiding execution. - **Motivation**: immersion fights the boredom of repetition, one of the biggest obstacles to rehabilitation. ## What the evidence says Stroke rehabilitation is one of the VR applications with the most robust evidence base: - The **Cochrane** review on virtual reality for stroke rehabilitation, updated in 2025 with **190 trials** and **7,188 participants**, found moderate- to low-certainty evidence of a **slight** benefit for upper-limb function, and a **clearer benefit when VR is added** to usual care to **increase total therapy time** than when it replaces it. - More recent meta-analyses reinforce gains in upper-limb motor function, functional independence, and dexterity, with better results for longer interventions (over six weeks) and those started early after the stroke. > The message of the evidence is precise: virtual reality does not replace rehabilitation: it multiplies it. The value is in adding time and quality to practice. ## The limits it is honest to mention - The benefit is clearest as a **complement**, not as standalone therapy. - The evidence is stronger for the **upper limb**; for gait and balance other reviews report positive results, and for quality of life it is less conclusive. - The type of system and the duration strongly influence results. :::note **Important note:** virtual reality in stroke rehabilitation is a **complementary** approach, integrated into a rehabilitation plan defined and supervised by healthcare professionals. It does not replace physiotherapy or clinical assessment. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for teams to use and comfortable for the patient, with no collection of patient clinical data. The reading of the six most recent reviews, including the 2025 Cochrane review, is in [stroke and virtual reality: what the evidence shows](/blog/avc-realidade-virtual-o-que-diz-a-evidencia/en/). In stroke rehabilitation, the evidence points to an honest path: use immersion to make the long work of recovery more engaging and productive, always alongside, and never instead of, conventional therapy. The guided-movement module, [RVer Motion](/en/modulos/motion/), is in development and not covered by the Class I registration. ## References Independent studies on virtual reality and stroke rehabilitation (general research, not specific to any product): - [Virtual reality for stroke rehabilitation: *Cochrane* review (Laver et al., 2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12178777/) - [VR-enhanced training for upper-limb function after stroke: meta-analysis, *JMIR* (2025)](https://www.jmir.org/2025/1/e66802) Q: Does virtual reality help recovery after a stroke? A: Yes, mainly as a complement. The Cochrane review (updated in 2025, with 190 trials and 7,188 participants) concluded that virtual reality can be beneficial for upper-limb function and activities of daily living when used in addition to usual therapy, increasing total rehabilitation time. More recent meta-analyses reinforce the benefit for motor function. Q: Does VR replace conventional physiotherapy? A: No. The evidence shows virtual reality works best as a complement to conventional therapy, not a substitute. Its value is in adding practice time, motivation, and repetition, always integrated into the rehabilitation plan defined by professionals. Q: Why does virtual reality help in rehabilitation? A: It makes repetitive exercises more motivating and engaging, gives immediate feedback, and allows more repetitions: factors associated with better recovery. Immersion helps the patient stay engaged in a process that is, by nature, long and demanding. ### Cognitive stimulation with virtual reality in care homes and dementia care URL: https://rver.pt/blog/estimulacao-cognitiva-idosos-realidade-virtual/en/ Date: 4 June 2026 For a person with dementia, a field of flowers or a familiar street can do more than entertain: it can evoke a memory, bring calm in a moment of agitation, and restore, for a moment, a sense of place. Ageing and neurodegenerative disease bring challenges that go beyond the physical: memory loss, disorientation, isolation, and agitation. Cognitive stimulation is one of the most valued non-pharmacological approaches to support these patients, and virtual reality opens new possibilities for it. ## Rich stimulation, without leaving the room Many patients, especially in care homes or health units, have reduced mobility. Their world shrinks to the space of a room. Virtual reality offers something rare in that context: **rich, varied stimulation with no travel risk**. A walk through a garden, a sea view, a street in a familiar city: immersive environments activate attention, spatial perception, and memory in a way a flat screen cannot. ## Reminiscence: memories that return **Reminiscence therapy** uses cues from the past to evoke memories and encourage communication. VR is a natural tool for this: a scenario recalling a homeland, an era, or a meaningful place can awaken memories and open conversation. How to do it, step by step, is in [returning to a familiar place](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/). > For a patient with dementia, recognising a place can be a moment of clarity and connection, and those moments have real value. ## What VR can support In a geriatric context, VR for clinical use can contribute to: - **Cognitive stimulation**: attention, memory, and orientation. - **Moments of agitation**: calm scenarios can help manage moments of restlessness. - **Wellbeing and presence**: meaningful experiences for those with reduced mobility. - **Communication**: opening conversation from what the patient sees and recognises. :::note **Important note:** using VR with older people and patients with dementia is done with calm scenarios, short sessions, and always under the assessment and supervision of the healthcare team. It is a **complementary, non-pharmacological** approach: it does not replace clinical care or the defined treatment. ::: ## The role of RVer **RVer** is a virtual reality system for clinical use, a **Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal)** (MDR 2017/745). It is designed to be simple for [care-home](/en/solucoes/lar-residencial/) and geriatric-unit teams to use, comfortable for the patient, and **with no collection of patient clinical data**. The idea is not to replace human care, but to give teams one more way to bring stimulation, calm, and meaningful moments to the daily lives of those they care for. On the cognitive and safety limits in full, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). If you are comparing with a multisensory room, see [Snoezelen or virtual reality](/blog/sala-snoezelen-ou-realidade-virtual-lares/en/). Q: How does virtual reality stimulate cognition in older people? A: VR presents rich, multisensory environments that stimulate attention, memory, and orientation. In reminiscence therapy, familiar scenarios can evoke memories and encourage communication. It is used as non-pharmacological support, under professional supervision. Q: Is it safe for dementia patients? A: VR for clinical use is used with calm scenarios and short sessions, always under the assessment and supervision of the healthcare team, who adapt its use to each patient. It does not replace clinical care. Q: What benefits can it bring in a care home or geriatric unit? A: It can support cognitive stimulation, help manage moments of agitation, promote wellbeing, and offer meaningful experiences to those with reduced mobility, always according to clinical assessment. ### Virtual reality in dementia: reminiscence, calm, and moments of presence URL: https://rver.pt/blog/realidade-virtual-demencia-alzheimer/en/ Date: 4 June 2026 In dementia, the present can be confusing and the distant past sharper. Virtual reality for clinical use can offer a calm place to be, and, at times, a bridge to old memories. Caring for someone with dementia is, in large part, caring for moments. There is no cure to offer, but there is a quality of presence to protect: helping to manage agitation, bringing calm, creating instants of recognition and peace. It is in this register, the moment and well-being, that virtual reality for clinical use can play a role. ## Calm environments as an anchor Agitation in dementia often arises from an environment that confuses or overwhelms: noise, unpredictable stimuli, the sense of not knowing where one is. A calm immersive environment does the opposite: it replaces the chaos with a simple, predictable, gentle scene. - **Controlled stimuli**: instead of a busy room, a quiet and stable landscape. - **Slow pace**: no demands and no surprises, just a place to be. - **Gentle focus**: something pleasant to look at, which helps to settle. > The goal is not to "do" anything. Sometimes it is enough to offer a quiet place where the person can simply be. ## Reminiscence: the past may be closer In dementia, old memories often endure longer than recent ones. Environments tied to familiar times or places (a beach, a field, an everyday scene from another era) can prompt recognition, conversation, and positive emotion. This is the principle of **reminiscence therapy**, here supported by immersion. When it works, it is not the "technology" that matters to the person: it is the moment of connection to something known. ## Care and gentleness above all Dementia demands extra caution. Immersion must always be gentle, brief, and attentive to the person's reaction. - **Short** sessions, with familiar content and no jolts. - Constant attention to signs of discomfort, stopping immediately if they appear. - Individual fit: what comforts one person may not suit another. :::note **Important note:** virtual reality for clinical use in dementia is a **complementary** approach, always under the supervision of healthcare professionals and adapted to each person. It does not replace clinical assessment, medication, or human support, and should be stopped at any sign of discomfort. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for teams to use and comfortable for the person, with no collection of patient clinical data. In dementia, value is measured in moments: a little more calm, an instant of recognition, a more serene presence. That is what this tool aims to support. To go further: [reminiscence therapy](/blog/reminiscencia-lugares-familiares-realidade-virtual/en/), step by step; [cognitive stimulation](/blog/estimulacao-cognitiva-idosos-realidade-virtual/en/) in a care home; what changes with the [types of dementia](/blog/tipos-de-demencia-o-que-muda-numa-sessao/en/); and how RVer is used in [care homes](/en/solucoes/lar-residencial/). When the person cannot consent, the workflow is different: [is consent required?](/blog/consentimento-informado-realidade-virtual-saude/en/). On the restlessness that appears late in the day, see [what the team can change in the environment](/blog/agitacao-fim-da-tarde-demencia-sundowning/en/). Q: How can virtual reality help people with dementia? A: Through calm, familiar immersive environments, virtual reality for clinical use can help manage moments of agitation and provide moments of tranquillity. Scenes tied to old memories may also encourage reminiscence and recognition, always gently and under supervision. Q: Is virtual reality suitable in advanced stages of dementia? A: Suitability always depends on the individual and must be assessed by healthcare professionals. At any stage, sessions should be short, with gentle and familiar content, and stopped at any sign of discomfort. Q: Does this replace medication or care in dementia? A: No. It is a complementary, non-pharmacological approach, used as part of the care plan defined by the clinical team, never as a substitute for assessment, medication, or human support. ### Privacy and GDPR in healthcare virtual reality: why collecting no data is a design decision URL: https://rver.pt/blog/privacidade-rgpd-realidade-virtual-saude/en/ Date: 4 June 2026 In healthcare, every piece of data collected is a responsibility. The most robust approach to privacy starts with a simple question: does this data really need to exist? In healthcare, the conversation about data protection usually centres on how to store information securely: encryption, access controls, audit logs. All of this is necessary. But there is an even more robust approach, and one often overlooked: **not collecting the data at all**. It is a principle that GDPR itself enshrines: **data minimisation**. And in virtual reality for clinical use, it can be applied almost entirely. ## The safest data is the data that doesn't exist Every piece of personal data collected creates obligations: justifying the legal basis, ensuring security, defining retention periods, responding to access or erasure requests, and managing the risk of a potential breach. Health data adds even more demand, as it is a **special category** of data under GDPR. So the right question at the start of any project is not "how will we protect this data?" but rather "**do we really need to collect it?**". Whenever the answer is no, all the downstream risk disappears. > There is no possible leak of data that was never collected. Minimisation is not just compliance: it is the simplest form of risk management. [Image: What the Companion app records from each session, and what RVer deliberately does not do with that record.] ## The therapeutic function does not need to identify the patient The value of a virtual reality for clinical use session (distraction, relaxation, comfort) does not depend on knowing who the patient is or recording their health data. The immersive experience works the same way without that collection. The operational management that is needed (knowing which devices exist, their status, which service they are in) can be done at the **device and service level**, not the individual level. Separating fleet management from patient identity is what keeps the solution useful without turning it into a repository of clinical data. ## What this simplifies in practice - **Smaller risk surface**: less personal data means fewer points of exposure in a potential breach. - **Simpler to demonstrate compliance**: data minimisation is an explicit GDPR principle, not an exception. - **Easier to earn trust**: for the service and for the patient, "we do not collect your clinical data" is a clear, verifiable guarantee. :::note **Important note:** GDPR compliance is a shared responsibility between the solution provider and the healthcare institution using it. The approach described here reduces risk at the source, but does not remove each institution's organisational obligations regarding data processing. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to work **without collecting patient clinical data**: a design choice that puts privacy at the centre, rather than treating it as an afterthought. In healthcare, the most responsible technology is often the one that asks for the least. Protecting patient data starts by deciding, from the outset, not to collect it. The questions the IT department usually adds to these are in [“The eight questions hospital IT asks”](/blog/informatica-hospital-perguntas-realidade-virtual/en/). On consent itself, see [is consent required?](/blog/consentimento-informado-realidade-virtual-saude/en/). Q: Does RVer collect patients' clinical data? A: No. RVer is designed to work without collecting patient clinical data. This is a deliberate design decision: by not collecting personal clinical data, much of the risk associated with its processing and storage is eliminated at the source. Q: Why does collecting no data help with GDPR compliance? A: GDPR applies to the processing of personal data. The less personal data (and in particular health data, which is a special category) a solution processes, the smaller the risk surface and the simpler it becomes to demonstrate compliance. Data minimisation is, in fact, a core principle of GDPR itself. Q: Can a VR medical device really work without patient data? A: Yes. The therapeutic function (providing an immersive distraction or relaxation experience) does not depend on identifying the patient or collecting their health data. The operational management of the equipment can be done at the device and service level, not the individual level. ### Hygiene and safety of virtual reality equipment in hospital settings URL: https://rver.pt/blog/higiene-seguranca-equipamento-realidade-virtual/en/ Date: 4 June 2026 In a hospital setting, any shared equipment is also a matter of infection control and comfort. Virtual reality for clinical use is no exception. Bringing virtual reality to a patient's bedside raises the same questions as any shared equipment in healthcare: how it stays clean, how comfort is ensured, and how its use is kept safe. Solving this well is what separates a good idea from a sustainable practice. ## Infection control: a simple, consistent routine Equipment that moves from patient to patient needs a clear hygiene routine, and above all one that is **easy to follow**. The simpler the routine, the more likely it is to be done every time. - **Contact surfaces** cleaned between uses, with products compatible with the materials. - **Attention to skin-contact areas**, usually the ones requiring the most care. - **Replaceable hygienic covers** where applicable, reducing direct contact. The routine should always align with the institution's own **infection-control protocols**, not replace them. ## Comfort: short sessions by principle Comfort is not a detail: it is part of safety. Long sessions increase the risk of eye strain, fatigue, or discomfort. So the baseline rule is simple: **short sessions**, adjusted to each patient, and always interruptible. > At the first sign of discomfort, dizziness, or nausea, the session stops. No exceptions. ## Safety: supervision and individual suitability Not everyone, and not every moment, is suitable for a VR session. Suitability should be assessed case by case by healthcare professionals, taking the patient's condition into account. The presence and supervision of the team during the session is an essential part of safe use. ## Logistics that sustain the practice Hygiene and safety only hold up if logistics make them easy: a defined place for the equipment, clear responsibility for cleaning and charging, and hygiene materials always at hand. Without this, good practice fades over time. :::note **Important note:** virtual reality for clinical use is a **complementary** approach, used under the supervision of healthcare professionals and integrated into the care plan. Hygiene and safety routines should always follow the institution's infection-control protocols and standards. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built for shared clinical use: simple for teams to maintain and operate, comfortable for the patient, and with no collection of patient clinical data. In healthcare, safety and hygiene are not accessories to the technology: they are the condition for it to actually be used next to those who need it. Hygiene is one of the safety questions we get asked. The others are in [is virtual reality bad for you?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/en/). Q: How do you clean virtual reality equipment between patients? A: With a simple, consistent routine: contact surfaces cleaned with products compatible with the material, special attention to skin-contact areas, and where applicable the use of replaceable hygienic covers. The routine should follow the institution's infection-control protocols. Q: How long should a session last to be comfortable? A: Sessions should be short and adjusted to each patient. Brief sessions reduce the risk of discomfort, eye strain, or fatigue, and the session should be stopped at any sign of unease. Q: Are there contraindications for using virtual reality? A: Suitability should always be assessed by healthcare professionals on a case-by-case basis. In any situation of discomfort, dizziness, or nausea, the session should be stopped immediately. Use is always supervised and integrated into the care plan. ### Virtual reality for clinical use from a nursing perspective: a tool at the bedside URL: https://rver.pt/blog/enfermagem-realidade-virtual-terapeutica/en/ Date: 4 June 2026 It is nursing that stands at the bedside in the difficult moments. A tool that helps calm the patient, without adding load, pays off directly. Nursing holds a unique place in care: it is the one physically present in the moments when the patient feels the most anxiety or discomfort. It is the one doing the dressing change, the puncture, accompanying the tense wait before a procedure. So any tool that helps calm the patient in those moments, without adding work, speaks directly to nursing. ## The concrete problem: difficult moments at the bedside Many nursing procedures are short but generate anxiety and discomfort out of proportion to their duration. A tense patient is harder to care for, and the moment itself becomes harder for everyone. Calming is not just kindness: it makes the clinical work easier. ## How VR fits into the nursing flow Virtual reality for clinical use captures the patient's attention in an immersive environment, reducing the attention available for discomfort. Applied by nursing, it fits into moments that already exist: - During **short procedures**, such as dressing changes or punctures. - In the **anxious wait** before an intervention. - In **moments of agitation or discomfort** during the stay. > A calmer patient makes the procedure easier to conduct, and that is time and tension saved for whoever is at the bedside. ## The condition: it can't weigh on the daily routine Nursing does not adopt tools that add friction. To be used, VR has to be **quick to start and simple to operate**: no technical flows, no lengthy setup, no long training. If it takes more than a few steps, it stays in the cupboard. So simplicity is not a luxury: it decides whether the tool reaches the patient or not. :::note **Important note:** virtual reality for clinical use is a **complementary** approach, used under the supervision of healthcare professionals and integrated into the care plan. It does not replace clinical assessment, medication, or the nursing team's judgement about what is appropriate for each patient. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to be simple for teams to operate (including front-line nursing), comfortable for the patient, and with no collection of patient clinical data. For those at the bedside, the value is concrete: a calmer patient, a difficult moment made more tolerable, without one more weight on the shift. To know upfront which patients can take part, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). Q: How can virtual reality support nursing work? A: By capturing the patient's attention in an immersive environment, virtual reality for clinical use can reduce anxiety and discomfort during nursing procedures, such as dressing changes or punctures, making those moments calmer for the patient and easier for the team to conduct. Q: Does it add to the daily nursing workload? A: It shouldn't. A tool designed for clinical settings has to be quick to start and simple to operate. Well designed, it fits into moments that already exist (a wait or a procedure), without creating significant extra tasks. Q: Do nurses need specialised training to use it? A: No specialised training is required. With brief, practical guidance, any nurse can start and accompany a session, always within the care plan and the institution's protocols. ### How to integrate virtual reality for clinical use into the clinical workflow URL: https://rver.pt/blog/integrar-realidade-virtual-fluxo-clinico/en/ Date: 4 June 2026 The best clinical tool is useless if no one has time to use it. Adopting virtual reality for clinical use depends less on the technology and more on how it fits into the real workflow. The biggest barrier to adopting a new technology in healthcare is rarely the technology itself. It is time. Already-overloaded teams do not adopt tools that add friction, however good they are. So integrating virtual reality for clinical use successfully is, above all, an exercise in **fitting the workflow**. ## Start by finding the right moments Virtual reality for clinical use does not create a new block in the schedule: it fits into moments that already exist and that today are "dead time" or difficult time: - The **wait** before a procedure, loaded with anxiety. - The **short procedure** itself, where distraction helps. - Moments of **discomfort or agitation** during the stay. Identifying these moments in the patient journey is the first step. The tool enters where there is already a need, not where space has to be invented. [Image: The four steps of an RVer session. Steps 3 and 4 are optional: a session runs without them.] ## Keep it simple for whoever operates it If using the system requires a dedicated technician, adoption dies. The goal is for **any team member**, nurses, assistants, therapists, to be able to start a session with minimal training. > Rule of thumb: if you need a manual to start a session, the tool is too complex for the floor. ## Short sessions, fitted to reality Long interventions compete with everything else and lose. Short sessions, adjusted to the patient and the moment, fit in without disrupting the routine. The best design adapts to the existing flow, instead of demanding that the flow adapt to it. ## Predictable hygiene and logistics To be used between patients, the equipment needs a simple, clear cleaning routine and predictable logistics: where it lives, who charges it, how it is prepared. Without this, even a good tool ends up forgotten in a cupboard. :::note **Important note:** virtual reality for clinical use is a **complementary** approach, integrated into the care plan and used under the supervision of healthcare professionals. Its adoption should respect each institution's clinical and infection-control protocols. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built with adoption in mind: simple for teams to operate, comfortable for the patient, and with no collection of patient clinical data. The right technology in healthcare is not the most sophisticated: it is the one the team can actually use every day. The question that follows the workflow is who runs it: [who can run a session](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/en/). To test the workflow before adopting it, see [how to run a pilot](/blog/piloto-realidade-virtual-hospital-como-correr/en/). Q: Who operates virtual reality for clinical use in a team? A: A specialised technician is not required. With minimal training, any team member, nurses, assistants, or therapists, can start and accompany a session. The system should be simple enough for that. Q: How long does a typical session take? A: Sessions are typically short, adjusted to the context and the patient. Rather than long interventions, they fit into moments that already exist in the patient journey, such as a wait or a short procedure. Q: Does it take a lot of training to get started? A: No. A tool designed for clinical settings should require only brief, practical training. If the learning curve is too demanding, adoption fails: so simplicity is a requirement, not an extra. ### Virtual reality against burnout in healthcare workers URL: https://rver.pt/blog/realidade-virtual-burnout-profissionais-saude/en/ Date: 4 June 2026 Burnout drains the people who care. Among the approaches studied to reduce it, relaxation-based virtual reality, in short breaks during the shift, is starting to show encouraging results. Burnout has stopped being an individual problem and become a structural issue in healthcare teams. Emotional exhaustion, depersonalisation, and loss of accomplishment affect those who care, and, in turn, the quality of care. Approaches that help are in demand, and relaxation-based virtual reality is one of those being studied, with a simple logic: create a moment of recovery in the middle of the shift. ## The idea: a break that actually switches off In a demanding workday, "taking a break" rarely means switching off. The break room is still full of stimuli, conversations, and reminders of work. Virtual reality offers something different: for a few minutes, the worker is transported to a calm environment (a natural landscape, sometimes with guided breathing) that fully replaces the field of view and isolates from the stimuli of the ward. The goal is not to fix the shift, but to give body and mind a real window of recovery. ## What the studies say The research is recent, mostly feasibility studies, but the signals are consistent: - A study with **mental-health** staff observed, over 5 weeks of VR relaxation sessions, improvements in subjective well-being, perceived stress, worry, **burnout** indicators, and sleep quality. - A pilot trial with healthcare workers during the pandemic recorded significant reductions in **stress, anxiety, and depressive symptoms** after a VR intervention. - In intensive-care nurses, short VR relaxation breaks reduced immediate perceived stress during demanding shifts. > The pattern is coherent: short immersive relaxation breaks, repeated over time, can ease the stress and exhaustion of those working in healthcare. ## The limits it is honest to mention - Most of the evidence comes from **feasibility studies** and small samples; larger trials are lacking. - The measured effects are mostly **short-term**. - And most importantly: VR acts on the **individual**, not on the organisational causes of burnout. Workload, understaffing, and emotional demand require structural responses. :::note **Important note:** relaxation-based virtual reality is a **complementary** support for individual well-being. It does not replace the organisational changes needed to prevent burnout, nor professional support when exhaustion is intense or persistent. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. Its simplicity (usable in a few minutes, with no technical flows and no collection of patient clinical data) makes it suitable for recovery breaks for the teams themselves too. Caring for those who care is part of a sustainable health system. Relaxation-based virtual reality does not solve burnout, but it can be a useful, accessible, and validated tool to ease its weight on daily life. ## References Independent studies on virtual reality and stress/burnout in healthcare workers (general research, not specific to any product): - [Multi-session VR relaxation for mental-health staff: feasibility study (2025)](https://www.sciencedirect.com/science/article/pii/S2212657025000182) - [VR stress reduction program for healthcare professionals: pilot trial](https://pmc.ncbi.nlm.nih.gov/articles/PMC12022780/) - [VR relaxation in intensive-care nurses (*Frontiers in Psychology*, 2021)](https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.706527/full) Q: Does virtual reality help reduce burnout? A: Preliminary studies point that way. Short virtual reality relaxation breaks during the shift have been associated with reductions in perceived stress, anxiety, and burnout indicators in healthcare workers. The evidence is still early, mostly feasibility studies, but consistent. Q: How does it work in practice? A: The worker takes a short break, typically around 10 minutes, immersed in a calm virtual reality environment, sometimes with guided breathing. The goal is quick recovery during the workday, creating a moment to switch off even in a demanding setting. Q: Does this fix the causes of burnout? A: No. Burnout has organisational causes (workload, lack of resources, emotional demand) that no technology resolves. Relaxation-based virtual reality is a complementary support for individual well-being, not a substitute for the organisational changes that are needed. ### Virtual reality for chronic pain: what the evidence shows URL: https://rver.pt/blog/realidade-virtual-dor-cronica/en/ Date: 4 June 2026 Chronic pain works differently from acute pain, and calls for different approaches. Virtual reality enters here not just as distraction, but as part of a broader strategy, with growing evidence. Chronic pain is not simply acute pain that has gone on too long. It is a distinct phenomenon, in which the nervous system stays on alert even after the original injury has healed: a process sometimes described as **central sensitisation**. So the tools that help with acute pain do not always apply the same way. Virtual reality is one of those being studied in this more complex context too. ## Acute vs. chronic pain: why the mechanism changes In **acute pain** (a dressing change, a puncture) virtual reality works mainly through **immediate distraction**: it occupies attention during the procedure and reduces perceived pain in that moment. In **chronic pain**, the goal is broader. It is not about getting through a moment, but about living better with a long-term condition. Here VR combines several elements: - **Distraction and relaxation**, to lower tension and hypervigilance to pain. - **Physiological regulation**, sometimes through biofeedback: the patient sees and learns to influence signals such as breathing or heart-rate variability. - **Reducing the impact on daily life**, more than eliminating the pain itself. ## What the clinical trials say The research is recent but encouraging, especially in two heavily searched conditions: - **Fibromyalgia**: a randomized controlled trial published in *ACR Open Rheumatology* (2025) tested immersive virtual reality combined with multisensor biofeedback. The treatment group had significantly lower pain (P = 0.011) and improvement on the fibromyalgia impact questionnaire (P = 0.018), alongside physiological improvements (heart-rate variability, respiratory rate, skin conductance) and high satisfaction, with no safety concerns. - **Chronic low-back pain**: a systematic review with meta-analysis concluded that virtual reality–based rehabilitation is associated with a significant reduction in pain in people with low-back pain. > The pattern is consistent: virtual reality, especially combined with relaxation and biofeedback, can reduce chronic pain intensity and its impact, as part of a broader approach. ## The limits it is honest to mention - Many studies are still **pilot trials**, with small samples; larger trials are lacking. - The effect tends to be **small to moderate** and varies between people and conditions. - Chronic pain requires a **multidisciplinary** approach; VR is a complement, not the centre of treatment. :::note **Important note:** virtual reality is a **complementary**, non-pharmacological approach. Chronic pain should be assessed and managed by healthcare professionals, within a multidisciplinary plan. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It works through immersion, relaxation, and comfort: simple for teams to use and with no collection of patient clinical data. In chronic pain, the honest promise is not "ending the pain," but offering a validated tool that helps reduce its weight on daily life, always integrated into the plan defined by healthcare professionals. ## References Independent studies on virtual reality and chronic pain (general research, not specific to any product): - [Immersive VR + biofeedback in fibromyalgia: RCT, *ACR Open Rheumatology* (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12080186/) - [VR-based rehabilitation for low-back pain: systematic review and meta-analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9958662/) Q: Does virtual reality help with chronic pain? A: The evidence points that way. Clinical trials in conditions such as fibromyalgia and chronic low-back pain have associated virtual reality, often combined with biofeedback, with significant reductions in pain intensity and daily-life impact. It is a promising area, still consolidating, used as a complement to the clinical plan. Q: What is the difference between VR for acute and chronic pain? A: In acute pain, VR works mainly through immediate distraction during a procedure. In chronic pain, the focus broadens: beyond distraction, it aims at relaxation, physiological regulation (for example through biofeedback), and reducing the impact of pain on quality of life over time. Q: Does virtual reality replace chronic pain treatment? A: No. Chronic pain requires a multidisciplinary approach defined by healthcare professionals. Virtual reality is a complementary, non-pharmacological tool, integrated into that plan: never a substitute for assessment, medication, or clinical follow-up. ### Virtual reality for better sleep: what the studies say about VR and insomnia URL: https://rver.pt/blog/realidade-virtual-dormir-melhor-insonia/en/ Date: 4 June 2026 People who sleep badly look for answers. Among the non-pharmacological approaches studied for sleep, relaxation-based virtual reality is starting to gather evidence (promising, if still early). Sleeping badly is one of the most common health complaints, and one of the most searched online. Among the non-pharmacological approaches research has explored for sleep, **relaxation-based virtual reality** is one of the newest. It is worth looking at what the studies show, without hype or automatic scepticism. ## The plausible mechanism: relaxing before sleep Difficulty falling asleep is often tied to a state of **physiological arousal**: a racing mind, a tense body. Any approach that helps lower that arousal creates more favourable conditions for sleep. This is where relaxation-based virtual reality comes in: calm immersive environments, sometimes combined with guided breathing or biofeedback, aim to induce a state of calm before bed. It is not a sedative: it is a relaxation aid. ## What the studies say The research is recent, but clinical trials already exist: - A **randomized controlled trial** published in the *Journal of Medical Internet Research* (2025), with 118 participants over 4 weeks, observed improvements in sleep quality measured by the **PSQI** (in the VR group, the global score fell from 9.70 to 7.20), alongside reduced depressive and anxiety symptoms. - A randomized trial published in *Sleep Medicine* (2024) tested relaxation VR used at home, in the evening, for 6 weeks, in patients with **chronic insomnia**, with associated improvements in sleep quality. > The signal is consistent: immersive relaxation environments can support sleep. But the evidence is still early, with small samples and few long-term studies. ## The limits it is honest to mention - The literature acknowledges that evidence on VR for sleep disorders is **limited and still inconclusive**. - Persistent insomnia has a well-established first-line approach, **cognitive behavioural therapy for insomnia (CBT-I)**, that VR does not replace. - The effect comes from relaxation, not from any "magic" property of the technology. :::note **Important note:** relaxation-based virtual reality is a **complementary** approach. Persistent insomnia should be assessed by healthcare professionals. This article is informational and does not constitute clinical advice or replace appropriate care. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. Its focus is relaxation and comfort through immersion: used under the supervision of professionals and with no collection of patient clinical data. The honest reading of the evidence is also the most useful: relaxation-based virtual reality is a promising aid for sleep, not a substitute for what is already proven. ## References Independent studies on virtual reality and sleep (general research, not specific to any product): - [Impact of Virtual Reality–Based Biofeedback on Sleep Quality: RCT, *JMIR* (2025)](https://www.jmir.org/2025/1/e65772) - [Virtual reality improves sleep quality in chronic insomnia: *Sleep Medicine* (2024)](https://www.sciencedirect.com/science/article/abs/pii/S1389945724003988) Q: Does virtual reality really help you sleep better? A: Some studies point that way. In clinical trials, relaxation-based virtual reality has been associated with improvements in sleep quality, measured by scales such as the PSQI. The evidence is promising but still early, and results vary between studies and individuals. Q: How might virtual reality support sleep? A: It works mainly through relaxation: calm immersive environments help reduce physiological arousal (the 'racing' state before sleep), creating more favourable conditions for falling asleep. It is not a sedative: it is a relaxation aid. Q: Does VR replace insomnia treatment? A: No. Persistent insomnia should be assessed by healthcare professionals, and cognitive behavioural therapy for insomnia (CBT-I) remains the best-supported first-line approach. Relaxation-based virtual reality is, at most, a complement. ### Virtual reality in care homes and in hospitals: the same principle, different contexts URL: https://rver.pt/blog/realidade-virtual-lares-idosos-vs-hospital/en/ Date: 4 June 2026 Hospital and care home share the principle, immersion for comfort and well-being, but live at different rhythms. Understanding the difference is what makes use effective in each. Virtual reality for clinical use rests on a single principle: using immersion to promote comfort, calm, and well-being. But the same equipment lives very differently depending on the setting. A hospital and a care home share the principle, and diverge in almost everything else: rhythm, goals, and needs. ## The hospital: the acute moment In the hospital, time is marked by clinical events. VR for clinical use enters mainly in **occasional, acute moments**: - The anxiety before a procedure. - The discomfort during a short intervention. - The tense wait, loaded with uncertainty. Use is **event-driven**: it arises when there is a concrete clinical need and ends with it. The cadence is irregular, dictated by each patient's journey. ## The care home: continuous well-being In a care home, the logic reverses. There is not so much the "acute moment," but rather **everyday life** over time. Here, VR for clinical use serves another purpose: - **Stimulation and a break from routine**, against the monotony that weighs. - **Calming environments**, for moments of agitation or restlessness. - **Reminiscence**, connecting the resident to familiar times and places. The cadence is more **regular and scheduled**, part of a well-being routine, not a response to an isolated clinical event. > In the hospital, VR responds to a moment. In the care home, it accompanies a journey. The equipment is the same; the purpose changes. ## What stays the same in both Despite the differences, two requirements are common and non-negotiable: - **Simplicity of operation**: in any context, if it is hard to use, it is not used. - **Hygiene and individual suitability**: clear cleaning routines and content adjusted to each person, always under supervision. :::note **Important note:** in any context, virtual reality for clinical use is a **complementary** approach, used under the supervision of professionals and adapted to each person. It does not replace clinical assessment or human support, and should be stopped at any sign of discomfort. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. It is built to serve both the acute pace of the hospital and the continuous well-being of the care home: simple for teams to operate, comfortable for the person, and with no collection of patient clinical data. One principle, two worlds: the value lies in adapting the use to the context, keeping the same simplicity and the same care in both. On which patients can actually use it, and where the answer is no, see [accessibility in virtual reality](/blog/acessibilidade-realidade-virtual-quem-pode-usar/en/). On how this enters the weekly plan, see [where virtual reality fits a care home activity plan](/blog/plano-de-atividades-lar-idosos-realidade-virtual/en/). Q: Is virtual reality for clinical use used the same way in care homes and hospitals? A: The principle is the same, using immersion to promote comfort and well-being, but the context differs. In hospitals, it tends to focus on acute moments, such as procedures or anxious waits. In care homes, the focus is more on continuous well-being, stimulation, and breaking the routine over time. Q: What benefits does VR bring in a care home? A: In a care home, virtual reality for clinical use can offer moments of stimulation, calming environments, reminiscence, and a break from monotony, contributing to residents' well-being. It is always used gently, adapted to each person, and under the supervision of professionals. Q: Are the technical needs different between the two contexts? A: In both, simplicity of operation and hygiene routines are essential. What changes most is the cadence of use (occasional and tied to clinical events in the hospital, more regular and scheduled in the care home) and the type of content favoured in each. ### Virtual reality for anxiety disorders: what the clinical research shows URL: https://rver.pt/blog/realidade-virtual-perturbacoes-ansiedade/en/ Date: 4 June 2026 Calming the anxiety of a moment is one thing; treating an anxiety disorder is another. Here too virtual reality has been studied, with growing evidence and a well-defined role. There is an important difference between **calming the anxiety of a moment** (the wait before a test, say) and **treating an anxiety disorder**, a persistent clinical condition. Virtual reality has been studied on both levels. Here we are talking about the second: its role in clinical treatment, led by professionals. ## The logic: a safe, controllable environment The central piece is **virtual reality exposure therapy**. In psychotherapy, gradual exposure to feared situations is one of the most effective approaches for anxiety. Virtual reality adds practical advantages: - **Safety and control**: the anxiety-provoking situation happens in a virtual environment, adjustable by the professional. - **Reproducibility**: the same scene can be repeated and graded as many times as needed. - **Accessibility**: it can recreate situations that are hard to arrange in real life. All of this **in the service of psychotherapy**, led by a mental-health professional, and not as a standalone tool. ## What the evidence says This is one of the areas of VR in healthcare with the most consolidated evidence base: - A **meta-analysis** (2018), with 23 studies, concluded that virtual reality interventions are significantly more effective than no treatment in reducing **anxiety and depression** symptoms, with effects comparable to conventional exposure therapy. - A **Cochrane** review (2019) found **moderate-quality** evidence of the effectiveness of virtual reality in anxiety disorders. - A more recent meta-analysis (2026), with 26 randomized trials and 1,649 participants, recorded significant effects in reducing anxiety and associated symptoms. > The evidence is consistent: virtual reality is an effective tool in the treatment of anxiety, as long as it is integrated into a clinical intervention led by professionals. ## The limits it is honest to mention - The strongest evidence concerns specific **phobias and anxiety**; for other conditions (such as post-traumatic stress) the data are more **inconclusive**. - VR is a **means in the service of psychotherapy**, not a treatment that removes the need for the professional. - The quality and design of studies vary, and not all systems are equivalent. :::note **Important note:** virtual reality in the treatment of anxiety disorders is a tool for **clinical** use, led by mental-health professionals. It does not replace assessment, psychotherapy, or medication. This article is informational and does not constitute clinical advice; for persistent anxiety, seek a professional. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. Its focus is immersion for comfort and relaxation, simple for teams to use and with no collection of patient clinical data. The honest reading of the evidence distinguishes the levels: virtual reality has a proven role in treating anxiety when integrated into clinical intervention, and a complementary role in everyday comfort and relaxation in healthcare. ## References Independent studies on virtual reality and anxiety (general research, not specific to any product): - [Effectiveness of VR for anxiety and depression symptoms: meta-analysis, *Scientific Reports* (2018)](https://www.nature.com/articles/s41598-018-28113-6) - [VR exposure therapy for anxiety and PTSD: meta-analysis of randomized trials, *JOGH* (2026)](https://jogh.org/2026/jogh-16-04090/) Q: Does virtual reality help treat anxiety? A: Research points that way. Meta-analyses show that virtual reality–based interventions are more effective than no treatment in reducing anxiety and depression symptoms, with effects comparable to conventional exposure therapy. A Cochrane review found moderate-quality evidence of effectiveness in anxiety disorders. Q: What is virtual reality exposure therapy? A: It is an approach in which the patient is exposed, gradually and in a controlled way, to anxiety-provoking situations, within a safe virtual environment led by a professional. It allows working through fear in a reproducible, adjustable context, as part of psychotherapy. Q: Does VR replace psychological support? A: No. Virtual reality is a tool in the service of clinical intervention, used by mental-health professionals within a therapeutic plan. It does not replace assessment, psychotherapy, or medication when indicated. ### Virtual reality for treating phobias: the strongest evidence of all URL: https://rver.pt/blog/realidade-virtual-tratamento-fobias/en/ Date: 4 June 2026 If there is one domain where virtual reality is already an established treatment, it is phobias. VR exposure therapy matches (and sometimes exceeds) the gold standard. If there is one area where virtual reality has gone from promise to **established treatment**, it is the treatment of phobias. Here the evidence is not merely encouraging: it is among the strongest in all VR-in-healthcare research. ## The logic: gradual exposure, in safety The most effective treatment for phobias is **gradual exposure**: facing the fear in a controlled way, step by step, until the fear response diminishes. The practical problem is arranging that exposure: it is not always easy (or safe) to take someone onto a plane, a high rooftop, or near a spider. **Virtual reality exposure therapy (VRET)** solves this. It recreates the feared situation in a safe, adjustable, repeatable virtual environment, always led by a mental-health professional: - **Precise grading**: intensity rises at the patient's pace. - **Complete safety**: the fear is faced without real risk. - **Unlimited repetition**: the scene can be repeated as many times as needed. ## What the meta-analyses say The numbers speak for themselves: - A **meta-analysis** of randomized trials directly comparing VR exposure with real-life exposure (the gold standard) found a **large effect** in favour of VRET over controls (Hedge's g ≈ 1.08), with efficacy comparable to (and sometimes slightly better than) real exposure, in specific phobias, agoraphobia, and social phobia. - Specific phobias are described as the **most mature** domain of VRET research, supported by a vast body of randomized trials (heights, spiders, flying, fear of needles). - A recent meta-analysis (2026), with 26 trials and 1,649 participants, confirmed significant and clinically meaningful effects in reducing phobia symptoms. > For specific phobias, virtual reality exposure therapy is now an evidence-based treatment, comparable to the gold standard. ## The limits it is honest to mention - The strongest evidence is for **specific phobias**; for other conditions (such as post-traumatic stress) the data are more inconclusive. - VRET is **psychotherapy led by a professional**, not unsupervised self-application. - The outcome depends on a well-structured therapeutic plan, not the technology alone. :::note **Important note:** virtual reality exposure therapy is a **clinical** intervention, led by mental-health professionals. It is not a self-treatment tool and does not replace assessment or psychotherapy. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. Its focus is immersion for comfort and relaxation, simple for teams to use and with no collection of patient clinical data. The treatment of phobias shows how far VR in healthcare can go when the evidence matures: from promising support to established treatment, always in the service of clinical intervention. ## References Independent studies on virtual reality and phobias (general research, not specific to any product): - [VRET vs. real-life exposure in phobias: systematic review and meta-analysis (*Frontiers in Psychology*, 2019)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6746888/) - [VR exposure therapy for anxiety and PTSD: meta-analysis of randomized trials, *JOGH* (2026)](https://jogh.org/2026/jogh-16-04090/) Q: Is virtual reality effective for treating phobias? A: Yes, and this is one of the best-evidenced VR applications in healthcare. Meta-analyses show large effects in treating specific phobias, comparable to or slightly better than real-life exposure. For specific phobias, virtual reality exposure therapy is considered an evidence-based treatment. Q: What is virtual reality exposure therapy? A: It is a form of psychotherapy in which the patient faces, gradually and in a controlled way, what they fear (heights, flying, spiders, public speaking) within a safe virtual environment led by a mental-health professional. Controlled repetition helps reduce the fear response. Q: Is it better than facing the fear in real life? A: The evidence shows comparable, and in some studies slightly higher, efficacy. The big advantage of VR is practical: it can create and grade situations that are hard or impossible to arrange in reality, in complete safety and repeatably. ### What the scientific evidence says about virtual reality in healthcare URL: https://rver.pt/blog/evidencia-cientifica-realidade-virtual-saude/en/ Date: 4 June 2026 Virtual reality in healthcare is neither a miracle nor a fad. The honest reading of the evidence lands somewhere more useful: promising in specific areas, still consolidating in others. Whenever a technology enters healthcare, two symmetrical and equally wrong reactions appear: the enthusiasm that treats it as a miracle and the scepticism that dismisses it as a fad. Virtual reality for clinical use is no exception. The useful, and honest, reading sits in between, and it requires looking at the evidence carefully. ## What is more established The most studied application of virtual reality in healthcare is **distraction for the management of pain and anxiety**. The mechanism is plausible and well described: attention is a finite resource, and an immersive environment occupies it, leaving less capacity to process pain or anxiety. There is a growing body of research pointing to benefits of this distraction effect across several clinical contexts: short procedures, anxiety tied to waiting, discomfort. It is one of the areas where the evidence is most consistent. > That immersive distraction helps reduce perceived pain and anxiety is among the points best supported by current research. ## What is still consolidating Not all applications are at the same level. Many are at earlier stages, with smaller or less conclusive studies. Here caution is needed: - Strength varies widely **between applications**: what holds for acute pain does not automatically transfer to other uses. - Many studies have **small samples** or designs that limit strong conclusions. - In several areas, larger-scale and long-term studies are still lacking. Acknowledging this does not weaken the technology: it makes the discourse credible. ## How to read the evidence without falling into extremes Some practical principles for interpreting claims about VR in healthcare: - **Be wary of absolutes.** "Cure" or "eliminates pain" are warning signs, not science. - **Distinguish applications.** A claim only holds for the context in which it was studied. - **Value caution.** Those who acknowledge the limits of the evidence are usually more reliable than those who promise everything. - **Defer the decision to the clinic.** Interpreting results and deciding on use rest with healthcare professionals. :::note **Important note:** virtual reality for clinical use is a **complementary**, non-pharmacological approach, presented on the basis of the available evidence and used under the supervision of healthcare professionals. It does not replace proven treatments, clinical assessment, or medical prescription. This article is informational and does not constitute clinical advice. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. The registration and the CE marking attest to regulatory compliance and safety for its intended use, and the stance is deliberately cautious: to offer a validated, complementary tool, without promising what the evidence does not yet support. The honest approach to science is not the one that promises the most: it is the one that clearly distinguishes what is already known from what is still being studied. Q: Is there scientific evidence that virtual reality helps in healthcare? A: There is a growing body of research on virtual reality as a distraction tool for managing pain and anxiety, with promising results across several contexts. As in any developing field, the strength of the evidence varies between applications, and interpretation should always be done by healthcare professionals. Q: Is virtual reality a proven therapy or still experimental? A: It depends on the application. The distraction effect on pain and anxiety is among the most studied and established; other applications are at earlier research stages. That is why VR for clinical use is presented as a complementary approach, not as a substitute for proven treatments. Q: How should I interpret claims about the benefits of virtual reality? A: With a critical mind. Be wary of absolute promises or 'cures.' A correct reading of the evidence recognises concrete benefits in specific areas, stays cautious where research is still limited, and always defers the clinical decision to healthcare professionals. ### Managing anxiety in hospital settings with Virtual Reality URL: https://rver.pt/blog/reduzir-ansiedade-com-realidade-virtual/en/ Date: 4 June 2026 The wait for a procedure, the noise of a treatment room, the uncertainty: the hospital environment generates anxiety. Virtual reality for clinical use offers a way to take the patient somewhere calmer, without leaving the chair. Anxiety in a healthcare context is not a minor detail. It increases the perception of pain, makes it harder for patients to cooperate during procedures, and makes the care experience more difficult for everyone. Managing that emotional state is part of caring well, and the answer does not always have to be medication. ## Where hospital anxiety comes from Three factors usually feed anxiety in a clinical environment: - **Uncertainty**: not knowing what will happen or how long it will take. - **Loss of control**: being in an unfamiliar space, dependent on others. - **Environmental stimuli**: clinical sounds, lights, and the anticipation of discomfort. Virtual reality acts on all three at once: it replaces the environment, restores a sense of choice, and offers a reassuring focus of attention. ## How immersion calms Calm virtual environments (a beach, a forest, a serene landscape) combined with ambient sound and a gentle pace, can help lower the state of alertness. By engaging the patient's attention, VR reduces the mental space devoted to worry and negative anticipation. > It is not about pretending the procedure isn't happening: it is about giving the patient a more comfortable place to be while it does. ## Moments where it makes a difference - **Before a procedure:** reducing anticipatory anxiety during preparation or the wait. - **During prolonged treatments:** making long sessions more tolerable. - **In inpatient care:** offering moments of pause and wellbeing. - **In sensitive populations:** comfort support, always per clinical assessment. :::note **Important note:** VR for clinical use is a **complementary, non-pharmacological** support. It does not replace clinical assessment or the care of healthcare professionals, and is used under their supervision. ::: ## RVer: comfort designed for the clinical context **RVer** is a virtual reality system for clinical use, a **Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal)** (MDR 2017/745). It is designed to fit easily into team workflows and to be comfortable for the patient, and it **does not collect patient clinical data**, respecting privacy by design. Q: Does virtual reality help reduce anxiety before a procedure? A: VR for clinical use can help shift attention away from the source of stress and induce a more relaxed state through calm, immersive environments. It is used as non-pharmacological support, under the supervision of healthcare professionals. Q: Who can benefit from VR for anxiety? A: Patients waiting, before procedures, during prolonged treatments, or in inpatient settings may benefit, always according to the clinical team's assessment. Q: Does VR for clinical use collect patient data? A: RVer does not collect patient clinical data. It was designed with privacy and compliance in mind as a registered medical device. ### Family video calls in virtual reality: sharing the experience from afar URL: https://rver.pt/blog/videochamadas-familia-realidade-virtual/en/ Date: 4 June 2026 Isolation is one of the least visible costs of a long hospital stay. Virtual reality can bring distant loved ones closer, not just with a call, but with a shared experience. During a long hospital stay, technology has already solved part of the distance problem: a video call lets you see and hear someone far away. But something is still missing: the **shared experience**. Talking is different from doing something *together*. Virtual reality for clinical use opens a new possibility: the family doesn't just look at the patient's face, but shares the same immersive environment, in real time. ## How the shared experience works The model is simple and rests on two complementary sides: - **On the patient's side**: they wear the virtual reality device and, through the camera, see the family they are talking to. - **On the family's side**: from an ordinary browser, they see in real time what the patient is experiencing in the immersive environment. The result is not a call where each person describes what they see. It is a common experience: both look at the same place and can comment on it, reminisce, and talk from it. > The difference between "I'm looking at the sea" and "we're looking at the sea together" is exactly the difference this feature aims to create. ## Why this matters clinically Social isolation is not only an emotional issue. It is associated with greater anxiety, poorer adherence, and a harder care experience. Maintaining the family bond has real value for patient well-being. - **Reduces the feeling of isolation** during long stays or clinical isolation. - **Gives the family an active role**, instead of the passive role of simply waiting for news. - **Creates positive shared moments** that help balance the hospital experience. ## Simple for the family, simple for the team For a tool to be used, it has to be easy. The family joins from a phone, tablet, or computer, with nothing to install. The clinical team starts the session without complex technical steps. :::note **Important note:** this feature is a complement to care and human contact, not a substitute for in-person visits or clinical follow-up. It is always used under the supervision of healthcare professionals and integrated into the care plan. ::: ## The role of RVer **RVer** is a virtual reality system designed for healthcare environments and registered as a **Class I Medical Device (base product) in EUDAMED and with INFARMED (Portugal)**, bearing the CE mark under MDR 2017/745. The family video call feature is built to be simple on both sides, with no collection of patient clinical data. The goal is clear: use technology to bring people closer, making the care experience more human even when distance imposes limits. Q: How does the family video call work in RVer? A: The patient wears the virtual reality device while the family joins a video call. The patient sees the family through the device's camera, and the family sees, in real time, the immersive environment the patient is experiencing, so they can talk about it together. Q: Does the family need special equipment? A: No. The family joins from a browser on a phone, tablet, or computer. There is no app to install and no virtual reality device needed on the family's side. Q: Does this replace in-person visits? A: No. It is a complement that helps maintain the family bond when in-person visits are not possible or are limited: due to distance, clinical isolation, or restricted hours. ### Motor rehabilitation with Virtual Reality: more adherence, better outcomes URL: https://rver.pt/blog/reabilitacao-motora-com-realidade-virtual/en/ Date: 4 June 2026 The biggest obstacle in rehabilitation isn't the difficulty of the exercises: it's the repetition. Virtual reality turns those exercises into purposeful tasks, and that changes how patients commit to recovery. Rehabilitation runs on repetition. To recover movement, strength, and coordination, a patient has to repeat the same motions dozens of times, session after session. The problem is rarely capability: it's the **motivation to keep repeating** over weeks. This is where virtual reality for clinical use makes a difference. ## The adherence problem The literature is consistent on one point: rehabilitation success depends heavily on the patient's **adherence** to the plan. Skipped exercises, abandoned sessions, and low motivation are leading reasons for incomplete recoveries. Traditional exercises don't help: they're repetitive, abstract, and give little immediate feedback. The patient doesn't see progress after each repetition: only fatigue. ## How VR changes the equation Virtual reality reframes the exercise as a **purposeful task**. Instead of "raise your arm 20 times," the patient reaches for objects, follows paths, or completes a goal inside an immersive scenario. The movement is the same: the experience is entirely different. Three mechanisms make this effective: - **Clear goal**: each movement serves a visible purpose within the task. - **Immediate feedback**: the patient sees the result of every motion in real time. - **Engagement**: immersion shifts focus away from effort and discomfort, onto the task. > When exercise stops feeling like exercise, repetition stops being a burden, and adherence rises naturally. ## Where it applies VR-assisted rehabilitation has applications across several contexts: - **Neurological rehabilitation**: motor recovery after stroke or injury. - **Orthopaedic rehabilitation**: recovering range and strength after surgery or trauma. - **Functional maintenance**: for patients who benefit from regular motor stimulation. :::note **Important note:** VR for clinical use is a complement to the rehabilitation plan. It does not replace the physiotherapist or clinical assessment, and is used under the supervision of the healthcare team, integrated into the programme defined for each patient. ::: ## The role of RVer **RVer** is a virtual reality system for clinical use, a **Class I Medical Device (base product) registered in EUDAMED and with INFARMED (Portugal)** (MDR 2017/745). It is designed to fit into the work of rehabilitation teams: easy to use, comfortable for the patient, and **with no collection of patient clinical data**. The goal is simple: make rehabilitation more consistent by helping the patient stay committed to recovery all the way through. For one specific condition and what the research devotes to it, see [virtual reality and Parkinson's disease](/blog/realidade-virtual-doenca-de-parkinson/en/). :::note In RVer, guided exercise in virtual reality is RVer Motion, a module in development that is not covered by the Class I medical device registration. The registration covers the base product, the 360° video library. ::: Q: How does virtual reality help with motor rehabilitation? A: VR turns repetitive exercises into engaging tasks with clear goals and immediate feedback. This increases patient motivation and adherence, key factors for rehabilitation success. It is used as a complement to the physiotherapy plan, under professional supervision. Q: Which patients can benefit? A: Patients recovering motor function after stroke, injury, orthopaedic surgery, or in neurological rehabilitation may benefit, always according to the rehabilitation team's assessment. Q: Does VR replace the physiotherapist? A: No. VR for clinical use is a complementary tool that supports the physiotherapist's work. The professional defines, supervises, and adjusts the plan: VR helps make it more motivating and consistent. ## Artigos (português) ### Dia Mundial da Diabetes 2026: agir cedo, também numa instituição URL: https://rver.pt/blog/dia-mundial-da-diabetes-2026-agir-cedo/ Date: 24 October 2026 O tema escolhido para 2026 e 2027 é agir cedo. Numa instituição, isso começa por coisas pequenas e repetidas, muito antes de qualquer tecnologia. A 14 de novembro assinala-se o Dia Mundial da Diabetes. Em 2026 calha num sábado, por isso muitas instituições vão marcá-lo na sexta-feira, dia 13, ou na semana seguinte. Este artigo explica o tema deste ano e o que ele quer dizer numa instituição que cuida de pessoas todos os dias: um lar, uma IPSS, um serviço de internamento. ## O que é o Dia Mundial da Diabetes O dia foi criado em 1991 pela Federação Internacional de Diabetes (IDF) e pela Organização Mundial da Saúde, e passou a dia oficial das Nações Unidas em 2006. A data é o aniversário de Frederick Banting, que descobriu a insulina com Charles Best em 1921. ## O tema de 2026: agir cedo A IDF escolheu **«Early action on diabetes»** para 2026 e 2027: agir cedo, no diagnóstico e na redução do risco ([página oficial](https://worlddiabetesday.org/)). A ideia é simples. Muita gente vive com diabetes tipo 2 durante anos sem saber, e o que se faz nesses anos conta. ## Agir cedo numa instituição Num lar ou numa IPSS, agir cedo raramente é uma campanha. É rotina: - **Reparar no que muda**: mais sede, mais cansaço, feridas que demoram a sarar, idas mais frequentes à casa de banho. Quem está todos os dias com a pessoa vê primeiro, e deve saber a quem dizer. - **Os pés**: numa pessoa com diabetes, uma ferida pequena no pé pode tornar-se um problema sério. Olhar para os pés faz parte do cuidado diário. - **A comida e o movimento do dia a dia**: não são dietas nem programas, são escolhas pequenas repetidas. Uma caminhada curta no corredor conta. - **A família**, que muitas vezes continua a trazer doces nas visitas sem saber. O diagnóstico e o plano de tratamento são da equipa de saúde. O papel de quem cuida no dia a dia é não deixar passar os sinais. ## Uma ideia para o dia 14 O nosso [calendário de dias mundiais](/ferramentas/dias-mundiais/) sugere um atelier de cozinha sem forno, com uma receita adaptada. Funciona porque junta conversa, memória e escolhas concretas: quem cozinhou a vida toda tem muito a dizer sobre o que se pode trocar numa receita. ## Quem já vive com diabetes Para quem vive com a doença há muitos anos, o dia lembra outra coisa: as complicações levam tempo. Pensos que se repetem, internamentos mais longos, dias passados num quarto. [Estar parado no internamento também tem custo](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/). É aqui que uma atividade não farmacológica pode ter lugar, sem prometer nada sobre a diabetes. Nos momentos de dor previsível, como a mudança de um penso, a distração imersiva é uma das ferramentas estudadas ([o mecanismo](/blog/realidade-virtual-gestao-da-dor/)). Nos dias longos, uma sessão é uma pausa: um sítio conhecido, uma paisagem, uma conversa a seguir. ## Onde entra o RVer O RVer é um sistema de realidade virtual usado em instituições de saúde e de apoio social, com uma biblioteca de vídeos 360° filmados em lugares reais. Tem modo deitado para quem não se pode sentar ([como funciona com pessoas acamadas](/blog/realidade-virtual-modo-deitado-acamados/)), funciona sem internet e é conduzido pelo profissional a partir de um telemóvel ou tablet. Não mede glicemia, não muda nenhum plano de tratamento e não substitui nenhum cuidado da diabetes. Quem decide se uma sessão faz sentido, e quando, é a equipa. ## Em resumo - 14 de novembro de 2026, um sábado: Dia Mundial da Diabetes. - O tema de 2026 e 2027 é agir cedo: diagnóstico e redução do risco. - Numa instituição, agir cedo é rotina: reparar nos sinais, olhar para os pés, escolhas pequenas no dia a dia. - Para quem já vive com a doença, os dias longos de tratamento também contam. Q: Quando é o Dia Mundial da Diabetes 2026? A: A 14 de novembro de 2026, um sábado. A data é o aniversário de Frederick Banting, que descobriu a insulina com Charles Best em 1921. Q: Qual é o tema do Dia Mundial da Diabetes 2026? A: «Early action on diabetes», agir cedo na diabetes, escolhido pela Federação Internacional de Diabetes para 2026 e 2027. Foca o diagnóstico precoce e a redução do risco. Q: O que pode uma instituição fazer no Dia Mundial da Diabetes? A: Coisas simples e úteis: um atelier de cozinha com uma receita adaptada, uma conversa com as famílias sobre o que se traz nas visitas, e rever com a equipa os sinais a que deve estar atenta. Q: A realidade virtual trata a diabetes? A: Não. Uma sessão de realidade virtual não mede nem altera nada na diabetes. Pode ser uma pausa num dia longo de internamento ou uma distração num momento de dor previsível, sempre decidida pela equipa. ### Dia do Cuidador Informal 2026: quem cuida em casa também precisa de pausa URL: https://rver.pt/blog/dia-do-cuidador-informal-2026-quem-cuida-em-casa/ Date: 22 October 2026 Cuidar de alguém em casa não tem horário nem folga marcada. O dia 5 de novembro serve para lembrar quem o faz, e o que existe para que essa pessoa possa parar. O **Dia do Cuidador Informal** é assinalado em Portugal a 5 de novembro. Em 2026 é uma quinta-feira. Autarquias, associações de cuidadores, IPSS e serviços de saúde costumam aproveitar a semana para sessões de informação, encontros e homenagens. ## O que é o Dia do Cuidador Informal 2026 Ao contrário de outros dias de saúde, este não tem uma entidade única que o promova nem um tema oficial para o ano. Não encontrámos o ato que o instituiu. A data aparece com nomes diferentes, como Dia Mundial, Dia Nacional ou simplesmente Dia do Cuidador Informal, e é usada por organismos públicos: o Governo Regional da Madeira, por exemplo, dedicou-lhe uma [nota de análise](https://www.madeira.gov.pt//Portals/56/Documentos/Nota%20de%20An%C3%A1lise%202%20-%20Dia%20Mundial%20do%20Cuidador%20Informal_rev%20ACS.pdf) a 5 de novembro de 2024. O enquadramento legal é mais claro do que a data. O **Estatuto do Cuidador Informal** foi aprovado pela [Lei n.º 100/2019, de 6 de setembro](https://diariodarepublica.pt/dr/detalhe/lei/100-2019-124500714), e regula os direitos e deveres do cuidador e da pessoa cuidada, bem como as medidas de apoio. Foi alterado várias vezes desde então. O dia importa porque o cuidado informal sustenta uma parte enorme do apoio a pessoas dependentes, e quase sempre longe da vista. ## Quem cuida em casa O cuidador informal é a mulher que cuida do marido depois do AVC. A filha que passa pela casa da mãe antes e depois do trabalho. O vizinho que leva as refeições. O marido de oitenta anos que dá banho à mulher com demência, porque ela só deixa que seja ele. Os números ajudam a perceber o perfil. Segundo o Inquérito Nacional de Saúde de 2019 do INE, citado na nota da Madeira, as mulheres são mais de 60% dos cuidadores informais em Portugal, e cerca de 20% (19,9%) das mulheres com 65 ou mais anos também prestam cuidados informais. Ou seja, uma parte de quem cuida já precisa, ela própria, de algum cuidado. O cansaço do cuidador raramente aparece de uma vez. Aparece em sinais pequenos: deixar de ir ao médico, dormir mal, perder a paciência e sentir culpa por isso, deixar de ver os amigos porque não há com quem deixar a pessoa. ## O descanso do cuidador, na lei e na prática Na versão original do Estatuto, a lei reconhece ao cuidador o direito a beneficiar de **períodos de descanso** que visem o seu bem-estar e equilíbrio emocional. E prevê formas concretas de o assegurar: a referenciação da pessoa cuidada para internamento na Rede Nacional de Cuidados Continuados Integrados, o encaminhamento periódico e transitório para uma estrutura residencial ou lar residencial, e o apoio domiciliário adequado à situação. Na prática, o descanso depende de haver vaga, de a pessoa cuidada aceitar sair de casa, e de o cuidador conseguir deixá-la sem culpa. Quem trabalha nas instituições conhece bem esta parte. A primeira semana de um internamento de descanso é muitas vezes mais difícil para o cuidador do que para a pessoa internada. ## As instituições que apoiam quem cuida Centros de dia, serviços de apoio domiciliário, lares, unidades de cuidados continuados e equipas de cuidados paliativos fazem pelo cuidador mais do que aparece nos relatórios. Dão-lhe horas livres. Explicam-lhe como mobilizar a pessoa sem se magoar. Ouvem-no no corredor. Ligam quando alguma coisa muda. Há também uma parte menos falada: a **visita**. Quando a pessoa passa a viver num lar ou fica internada, o cuidador continua a ser cuidador, agora de visita. E a visita nem sempre é fácil. A conversa repete-se, a pessoa com demência pode não o reconhecer naquele dia, e muitas visitas acabam a arrumar a gaveta e a perguntar se comeu. Algumas equipas tentam que a visita seja um momento partilhado em vez de mais uma tarefa: uma atividade em que o familiar participa, uma música que os dois conhecem, uma caixa de fotografias, um passeio no jardim. Quem cuida também tem direito a estar com a pessoa sem estar a cuidar dela. Escrevemos sobre o que a tecnologia faz e não faz em casa em [cuidador informal: o que a tecnologia faz em casa, e o que não faz](/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/), e sobre o apoio domiciliário em [quando o cuidado sai da instituição](/blog/quando-o-cuidado-sai-da-instituicao-sad-mais-saude/). ## Onde o RVer entra O RVer não é vendido para uso em casa. Está nas instituições: lares, hospitais, cuidados continuados e paliativos. É aí que pode tocar a vida do cuidador, de forma discreta. Numa sessão conduzida pela equipa, a pessoa cuidada pode ver um lugar que os dois conheceram juntos, a praia das férias, a aldeia, o santuário, e o cuidador fica ao lado a conversar sobre isso. Quem não pode estar presente pode acompanhar a sessão por [chamada de família](/blog/videochamadas-familia-realidade-virtual/), vendo o mesmo lugar. É um momento em comum. Não substitui a visita nem o cuidado. Para quem cuida em casa, deixámos [ferramentas gratuitas](/ferramentas/) pensadas para o dia a dia, e explicámos porque as fizemos em [cinco ferramentas gratuitas para quem cuida](/blog/ferramentas-gratuitas-para-quem-cuida/). O enquadramento para [lares residenciais](/solucoes/lar-residencial/) e para [cuidados paliativos](/solucoes/cuidados-paliativos/) está nas páginas de cada contexto. ## Em resumo - O Dia do Cuidador Informal é assinalado a 5 de novembro, sem tema oficial nem entidade promotora única. - O Estatuto do Cuidador Informal, de 2019, prevê períodos de descanso e formas de os assegurar. - Muitos cuidadores são mulheres, e uma parte tem mais de 65 anos. - As instituições já apoiam quem cuida de muitas maneiras, e a visita pode ser um momento partilhado. - O RVer está nas instituições, não em casa, e entra apenas como um momento em comum. O produto base do RVer é um dispositivo médico Classe I, registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição e complementam os cuidados existentes. --- **Fontes:** Governo Regional da Madeira, Direção Regional para as Políticas Públicas Integradas e Longevidade, [Nota de Análise n.º 2/2024, Dia Mundial do Cuidador Informal](https://www.madeira.gov.pt//Portals/56/Documentos/Nota%20de%20An%C3%A1lise%202%20-%20Dia%20Mundial%20do%20Cuidador%20Informal_rev%20ACS.pdf), com dados do Inquérito Nacional de Saúde 2019 (INE); [Lei n.º 100/2019, de 6 de setembro](https://diariodarepublica.pt/dr/detalhe/lei/100-2019-124500714), Diário da República. Q: Quando é o Dia do Cuidador Informal 2026? A: É assinalado a 5 de novembro, que em 2026 é uma quinta-feira. Também aparece como Dia Mundial ou Dia Nacional do Cuidador Informal. Q: O Dia do Cuidador Informal tem tema em 2026? A: Não há um tema oficial nem uma entidade promotora única. A data é usada por organismos públicos, autarquias e associações de cuidadores. Q: O cuidador informal tem direito a descanso? A: O Estatuto do Cuidador Informal, aprovado pela Lei n.º 100/2019, prevê períodos de descanso e medidas para os assegurar, como o internamento da pessoa cuidada na rede de cuidados continuados, a estadia temporária num lar ou o apoio domiciliário. As condições concretas devem ser confirmadas junto da Segurança Social. Q: O RVer pode ser usado em casa pelo cuidador? A: Não. O RVer é usado em instituições, com sessões conduzidas pela equipa. O cuidador pode participar numa sessão durante a visita ou acompanhá-la à distância por chamada de família. ### Realidade virtual e demência: o que diz a evidência e como conduzir uma sessão URL: https://rver.pt/blog/realidade-virtual-demencia/ Date: 20 October 2026 A realidade virtual não trata a demência, não abranda a doença e não substitui nenhum cuidado. Dito isto logo à partida, fica a pergunta que interessa a uma equipa: pode ajudar a ter melhores momentos com quem vive com demência? A investigação tem estudado precisamente isso, e este artigo resume o que encontrou, o que ainda não se sabe e como se conduz uma sessão com cuidado. O RVer não é só para pessoas com [demência](/glossario/demencia/): é usado com utentes dos 10 aos 100 anos, em hospitais, lares e cuidados paliativos. Mas é uma das perguntas que mais nos fazem, e merece resposta própria. ## Resposta curta Como complemento não farmacológico, conduzido por alguém da equipa, a realidade virtual tem sido estudada sobretudo para bem-estar, humor, envolvimento e reminiscência em pessoas com [défice cognitivo ligeiro](/glossario/defice-cognitivo-ligeiro/) ou demência. Os estudos são, na maioria, pequenos e curtos. O que sustentam é um uso modesto: um bom momento, uma conversa, um lugar de volta. ## O que a investigação estudou A [biblioteca de estudos](/estudos/tema/qualidade-de-vida/) da RVer reúne dezenas de referências sobre realidade virtual e qualidade de vida, e uma parte importante é sobre pessoas com défice cognitivo ou demência. Alguns exemplos: - Uma meta-análise sobre a eficácia da realidade virtual em pessoas com défice cognitivo ligeiro ou demência ([Kim, 2019](/estudos/kim-2019-effectiveness-virtual-reality-people-mild-cognitive-f82e55/)). - Uma revisão de âmbito sobre realidade virtual para promover o bem-estar de pessoas com demência ([Appel, 2021](/estudos/appel-2021-virtual-reality-promote-wellbeing-persons-dementia-f82e08/)). - Um estudo piloto sobre reminiscência com headsets de realidade virtual em pessoas com demência ([Coelho, 2020](/estudos/coelho-2020-promoting-reminiscences-virtual-reality-headsets-pilot-a3f704/)). - Um estudo piloto com uma floresta virtual em pessoas com demência ([Moyle, 2018](/estudos/moyle-2018-effectiveness-virtual-reality-forest-people-dementia-fb8fb4/)). - Uma revisão de âmbito sobre realidade virtual imersiva em intervenções de reminiscência com pessoas mais velhas ([Lu, 2023](/estudos/lu-2023-application-fully-immersive-virtual-reality-reminiscence-617211/)). - Um trabalho da equipa RVer sobre défice cognitivo e depressão em pessoas mais velhas ([Ferreira, 2022](/estudos/ferreira-2022-therapeutic-virtual-reality-rver-findings-older-368672/)), assinalado como tal na biblioteca. O que não se sabe também importa. As medidas usadas variam muito de estudo para estudo, as intervenções duram semanas e o seguimento é curto. Também há pouca investigação que distinga as fases da demência e os contextos (casa, lar, hospital). Quem lhe prometer resultados clínicos com base nisto está a exagerar. ## Reminiscência: o uso mais natural A [terapia de reminiscência](/glossario/terapia-de-reminiscencia/) usa memórias antigas como ponto de partida para conversar. Na demência, as memórias mais antigas costumam ficar mais tempo, e é aí que um vídeo imersivo ajuda: em vez de uma fotografia, a pessoa está outra vez na praia onde passava o verão, na romaria da terra, no santuário onde ia todos os anos. Entre os conteúdos do RVer, Fátima é dos mais pedidos. O que torna uma sessão de reminiscência boa não é o equipamento, é a preparação: - **Saber de onde a pessoa vem.** A [ficha de história de vida](/ferramentas/historia-de-vida/), preenchida com a família, diz que lugares escolher e quais evitar. - **Conversar durante e depois.** «Já esteve aqui?», «Quem ia consigo?». A [estimulação cognitiva](/glossario/estimulacao-cognitiva/) por reminiscência acontece na conversa, não no vídeo. - **Aceitar o que vier.** Uma memória pode trazer alegria ou tristeza. As duas são legítimas, e a equipa está lá para isso. ## Agitação, apatia e momentos difíceis Os [sintomas comportamentais e psicológicos da demência](/glossario/scpd/), como a [agitação](/glossario/agitacao/), a apatia ou a deambulação, são das partes mais exigentes do cuidado. A realidade virtual tem sido estudada como uma das abordagens não farmacológicas possíveis, sobretudo para apatia e humor. Na prática, há três regras simples: - **Escolher o momento.** Uma sessão funciona melhor numa altura calma do que no pico de uma crise. Pôr um headset a alguém muito agitado pode piorar as coisas. - **Observar a cara, não o relógio.** Se a pessoa fica tensa, tenta tirar o headset ou não percebe onde está, a sessão acaba ali. Sem insistir. - **Repetir o que resulta.** Quando um lugar funciona com alguém, vale a pena voltar a ele. Na demência, a familiaridade conta mais do que a novidade. ## Adaptar a sessão à fase da demência Não há uma sessão de realidade virtual para «a demência»: há pessoas em fases diferentes, com quadros diferentes. Falámos disso em [tipos de demência e o que muda numa sessão](/blog/tipos-de-demencia-o-que-muda-numa-sessao/). Em resumo: - **Fase ligeira.** A pessoa percebe o que é a experiência e pode escolher o destino. A conversa é mais rica. - **Fase moderada.** Sessões mais curtas, sempre com a mesma pessoa da equipa, explicação simples antes de colocar o headset e conteúdos muito familiares. - **Fase avançada.** Ambientes calmos, sem pedido de interação, e atenção redobrada à reação. Às vezes, o melhor é não fazer. Em todas: sentado ou deitado, nunca de pé, e com alguém ao lado do princípio ao fim. Os cuidados gerais, do [cybersickness](/glossario/cybersickness/) à epilepsia, estão em [a realidade virtual faz mal?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/) ## Como o RVer ajuda a equipa A equipa escolhe o conteúdo num tablet ou computador na rede local, vê o que está a passar e pode pausar ou parar a qualquer momento. Durante a sessão, a família pode juntar-se por videochamada e ver o mesmo lugar, o que dá à reminiscência mais uma voz. A chamada não é gravada, e nenhum dado pessoal ou clínico do utente sai do equipamento. O produto base, a biblioteca de vídeo, é um dispositivo médico Classe I registado no INFARMED e na EUDAMED, com marcação CE. É usado como complemento, sob supervisão da equipa, e não substitui avaliação nem cuidados clínicos. Há mais sobre este contexto em [realidade virtual em lares e ERPI](/solucoes/lar-residencial/). E, porque a demência também chega ao hospital e aos [cuidados paliativos](/solucoes/cuidados-paliativos/), o mesmo sistema serve esses contextos, com utentes dos 10 aos 100 anos. Q: A realidade virtual trata a demência? A: Não. Não trata a doença nem a abranda. É estudada como complemento não farmacológico para bem-estar, humor, envolvimento e reminiscência, sempre com alguém da equipa ao lado. Q: Pode usar-se com alguém agitado? A: Não no pico de uma crise. Uma sessão funciona melhor num momento calmo, e acaba logo que a pessoa fique tensa, tente tirar o headset ou não perceba onde está. Q: Que conteúdos funcionam melhor na demência? A: Lugares familiares e calmos, filmados de um ponto fixo: a terra, a praia, uma romaria, um santuário. A ficha de história de vida, preenchida com a família, ajuda a escolher. Q: Serve em todas as fases da demência? A: Adapta-se. Na fase ligeira a pessoa pode escolher e conversar mais; na moderada as sessões são mais curtas; na avançada ficam ambientes calmos, sem pedido de interação, e às vezes o melhor é não fazer. Q: O RVer é só para pessoas com demência? A: Não. É usado com utentes dos 10 aos 100 anos, em hospitais e clínicas, lares, centros de dia e cuidados paliativos. ### Realidade virtual para idosos: para que serve, o que diz a investigação e que cuidados ter URL: https://rver.pt/blog/realidade-virtual-para-idosos/ Date: 20 October 2026 Quem procura «realidade virtual para idosos» costuma ter uma de três perguntas: serve para quê, faz mal, e como se põe a funcionar numa instituição. Este artigo responde às três, com o que a investigação estudou e com o que não se sabe. Uma nota antes de começar. O RVer não é só para pessoas mais velhas: é usado com utentes dos 10 aos 100 anos, em hospitais, lares e cuidados paliativos. Aqui falamos de um desses contextos, porque é o que mais gente procura. ## O que é, numa frase [Realidade virtual](/glossario/realidade-virtual/) é uma tecnologia que substitui o que a pessoa vê e ouve por outro lugar, filmado ou criado em computador, apresentado num headset que acompanha os movimentos da cabeça. Muita gente procura por «óculos de realidade virtual»; o equipamento chama-se headset e coloca-se à frente dos olhos, com uma fita à volta da cabeça. Com pessoas mais velhas, o conteúdo que faz sentido é quase sempre [vídeo 360°](/glossario/video-360/) filmado de um ponto fixo: uma praia, uma aldeia, uma romaria, um jardim. A pessoa olha à volta, sentada, e está lá. Não há jogo, não há comandos para aprender, não há nada para ganhar. ## Para que se usa com pessoas mais velhas Numa instituição, a realidade virtual entra como [intervenção não farmacológica](/glossario/intervencao-nao-farmacologica/): um complemento às atividades e aos cuidados que já existem, sempre com a equipa ao lado. Os usos mais comuns são quatro. **Reminiscência.** Voltar a ver um lugar da infância, uma festa da terra, um sítio de peregrinação. A [terapia de reminiscência](/glossario/terapia-de-reminiscencia/) usa memórias para conversar, e um vídeo imersivo dá à conversa um ponto de partida concreto. A [estimulação cognitiva](/glossario/estimulacao-cognitiva/) por reminiscência faz parte da finalidade registada do produto base do RVer. **Bem-estar e humor.** Uma pausa num ambiente calmo, numa tarde longa, para quem já não sai do edifício ou do quarto. **Isolamento.** O [isolamento social](/glossario/isolamento-social/) e a [solidão](/glossario/solidao/) são frequentes em quem vive numa [ERPI](/glossario/erpi/). Uma sessão é também uma conversa: sobre o lugar, sobre quem lá esteve, sobre o que mudou. **Momentos de cuidado.** Em hospital, a realidade virtual é estudada como distração durante procedimentos e como forma de ajudar a gerir a dor e a ansiedade. Para quem está acamado, existe um [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/). ## O que diz a investigação A [biblioteca de estudos](/estudos/) da RVer reúne 54 referências sobre realidade virtual e [qualidade de vida](/estudos/tema/qualidade-de-vida/), entre elas 8 revisões sistemáticas ou meta-análises e 4 ensaios aleatorizados. O que esses estudos examinam é sobretudo bem-estar, humor e envolvimento social em pessoas idosas e com doença crónica. Alguns exemplos, todos de autores independentes: - Um estudo de viabilidade com pessoas mais velhas com limitações cognitivas ou físicas, cujo título resume a conclusão dos autores: podem beneficiar de experiências imersivas ([Appel, 2020](/estudos/appel-2020-older-adults-cognitive-or-physical-impairments-c1c87d/)). - Um ensaio aleatorizado multicêntrico em lares, sobre o estado de espírito de residentes que viram vídeos 360° ([Gruber, 2022](/estudos/gruber-2022-vr-nursing-facilities-randomized-controlled-multicenter-dbc731/)). - Um ensaio aleatorizado que comparou reminiscência com realidade virtual imersiva e reminiscência tradicional, em residências para pessoas mais velhas ([Fatah, 2024](/estudos/fatah-2024-effect-immersive-virtual-reality-reminiscence-versus-e7834c/)). - Dois estudos sobre apatia e humor em lares ([Saredakis, 2020](/estudos/saredakis-2020-using-virtual-reality-improve-apathy-residential-e8a152/); [Brimelow, 2020](/estudos/brimelow-2020-preliminary-research-virtual-reality-residential-aged-b40c5d/)). - Uma revisão de âmbito sobre dor e ansiedade em pessoas mais velhas ([Corbel, 2025](/estudos/corbel-2025-effects-virtual-reality-pain-anxiety-older-82db1d/)). O que ainda não se sabe também está escrito na biblioteca: os estudos usam medidas de qualidade de vida muito diferentes, as intervenções são curtas, de semanas, e há pouco seguimento. A realidade virtual não cura nada e não faz milagres. O que a investigação sustenta é um uso modesto e útil: um bom momento, uma conversa, uma pausa. ## Os cuidados que fazem a diferença Com pessoas mais velhas, o risco real não é o ecrã, é o equilíbrio. Por isso as regras são operacionais, não tecnológicas: - **Sentado, sempre.** Numa cadeira estável ou na cama, nunca de pé. - **Acompanhado, sempre.** Alguém da equipa ao lado, do princípio ao fim. - **Sessões curtas.** Poucos minutos chegam, sobretudo nas primeiras vezes. - **Conteúdo sem movimento.** Vídeo filmado de um ponto fixo evita a maior parte do [cybersickness](/glossario/cybersickness/), o enjoo que aparece quando os olhos veem movimento e o corpo não o sente. - **Avaliação antes, quando há dúvida.** Epilepsia ou [fotossensibilidade](/glossario/fotossensibilidade/), problemas de equilíbrio graves e algumas condições psiquiátricas pedem avaliação clínica prévia. - **Ver e ouvir bem.** O headset do RVer usa-se por cima de óculos graduados, e convém confirmar que o aparelho auditivo está a funcionar. - **Higiene entre utentes.** Uma [rotina de limpeza](/ferramentas/higiene/) simples, como em qualquer material partilhado. Explicámos tudo isto em detalhe em [a realidade virtual faz mal?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/) ## Como funciona o RVer num lar O RVer é um sistema completo, não um headset avulso. A equipa usa um tablet ou um computador na rede local da instituição para escolher o conteúdo, ver o que está a passar, pausar e parar a qualquer momento. Uma pessoa consegue gerir vários headsets ao mesmo tempo. Algumas coisas que interessam a quem decide: - O produto base, a biblioteca de vídeo, é um dispositivo médico Classe I registado no INFARMED e na EUDAMED, com marcação CE. - A sessão corre no próprio headset, sem internet, e nenhum dado pessoal ou clínico do utente sai do equipamento. - Durante a sessão, a família pode juntar-se por videochamada e ver o mesmo que a pessoa está a ver. A chamada não é gravada. - Os headsets são da RVer. A instituição contrata um serviço anual, sem investimento em equipamento. Há mais sobre este contexto na página de [realidade virtual em lares e ERPI](/solucoes/lar-residencial/). Para preparar uma primeira sessão de reminiscência, a [ficha de história de vida](/ferramentas/historia-de-vida/) ajuda a escolher o lugar certo. ## Não é só para idosos Este artigo fala de pessoas mais velhas porque é o que muita gente procura. Mas o RVer é usado com utentes dos 10 aos 100 anos: em [hospitais e clínicas](/solucoes/hospital/), para conforto em procedimentos e para ajudar a gerir a dor e a ansiedade; em [cuidados paliativos](/solucoes/cuidados-paliativos/), para conforto e para aproximar a família; e em lares, centros de dia e unidades de cuidados continuados. Q: A realidade virtual é segura para idosos? A: Para a grande maioria das pessoas, uma sessão sentada, curta e acompanhada por alguém da equipa é bem tolerada. O risco real é o equilíbrio, por isso nunca se faz de pé. Epilepsia, fotossensibilidade e alguns problemas de equilíbrio ou psiquiátricos pedem avaliação clínica prévia. Q: Uma pessoa que nunca usou tecnologia consegue usar? A: Sim. Com vídeo 360° não há comandos nem jogo: a pessoa só olha à volta. Quem escolhe o conteúdo, pausa e para é a equipa, num tablet ou computador. Q: Quanto tempo deve durar uma sessão? A: Poucos minutos chegam, sobretudo nas primeiras vezes. A sessão acaba sempre que a pessoa quiser ou mostrar desconforto. Q: A realidade virtual substitui as atividades ou os cuidados da instituição? A: Não. É um complemento não farmacológico, usado sob supervisão da equipa, e não substitui avaliação, tratamento nem cuidados clínicos. Q: O RVer é só para idosos? A: Não. O RVer é usado com utentes dos 10 aos 100 anos, em hospitais e clínicas, lares, centros de dia e cuidados paliativos. ### Dia Mundial da Terapia Ocupacional 2026: participar quando já não se pode sair URL: https://rver.pt/blog/dia-mundial-da-terapia-ocupacional-2026-participar-sem-sair/ Date: 11 October 2026 A participação faz-se de papéis e rotinas: pôr a mesa, ir à missa, tratar da horta. Quando a pessoa deixa de poder sair, a pergunta da terapia ocupacional continua a mesma. A 27 de outubro assinala-se o **Dia Mundial da Terapia Ocupacional**. Em 2026 é uma terça-feira, e escolas de saúde, serviços de medicina física e de reabilitação, lares e associações profissionais aproveitam a data para mostrar o que a profissão faz. ## O que é o Dia Mundial da Terapia Ocupacional 2026 O dia é promovido pela World Federation of Occupational Therapists (WFOT), a federação internacional das associações de terapia ocupacional. O tema de 2026, anunciado a 30 de abril, é **«Participation Matters»**: a participação importa. Na apresentação do tema, a WFOT põe o acento nas atividades, nos papéis e nas rotinas do dia a dia como suporte da saúde, do bem-estar e da qualidade de vida. E lembra que a terapia ocupacional promove a participação atuando sobre fatores físicos, cognitivos, emocionais, ambientais e sociais, para que a pessoa se envolva nas ocupações que quer, precisa ou se espera que faça ([WFOT](https://wfot.org/news/2026/launch-of-the-world-occupational-therapy-day-2026-theme)). É uma definição que qualquer terapeuta ocupacional reconhece. O tema deste ano tem o mérito de a dizer em duas palavras. ## Participar é mais do que ter uma atividade Num lar, num internamento longo ou numa unidade de cuidados continuados, é fácil confundir participação com ocupação do tempo. Uma pessoa sentada numa sessão de grupo está presente. Pode não estar a participar em nada que lhe diga respeito. A terapia ocupacional olha para outra coisa: que papel tinha esta pessoa, e o que resta dele. A senhora que fazia o almoço de domingo para a família inteira. O homem que tratava da horta e sabia o tempo pelo céu. A professora que ainda corrige a gramática de toda a gente. A participação começa quando a atividade reencontra um desses papéis, mesmo em pequeno. Escrevemos sobre esta ideia em [atividade significativa: como se escolhe um cenário](/blog/atividade-significativa-como-se-escolhe-um-cenario/). ## Quando a pessoa já não pode sair Há um momento em que a rua deixa de ser possível. Pela mobilidade, pelo oxigénio, pelo risco de queda, pela demência avançada, por uma fase de doença que obriga à cama. A missa de domingo, o café da esquina, a feira, a praia de agosto ficam do lado de fora. As equipas não ficam paradas perante isso. Terapeutas ocupacionais e animadores sociocomunitários trazem para dentro aquilo que a pessoa já não vai buscar: - objetos e cheiros de outros tempos, em caixas de memórias; - vasos e floreiras à altura da cadeira de rodas, para quem tratava da terra; - a música da terra, as cantigas, os programas de rádio de antigamente; - fotografias da família e da aldeia, que dão assunto para uma tarde inteira; - passeios curtos, adaptados, sempre que são possíveis. Nada disto é novo, e é trabalho que muitas vezes passa despercebido fora da instituição. Uma boa parte do que se faz num plano de atividades está descrita em [plano de atividades num lar](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). ## Onde um vídeo 360° pode entrar Um vídeo 360° filmado num lugar real é mais uma ferramenta desta caixa. Não leva a pessoa à rua. Permite-lhe olhar à volta, durante uns minutos, num sítio que conhece ou que sempre quis ver: o adro de uma igreja, um mercado, uma praia do norte, uma aldeia do interior, uma romaria. Para o terapeuta ocupacional, o interesse está no que acontece **depois**. O pescador que reconhece o porto pode começar a falar das redes. A senhora que vê o santuário pode lembrar-se da promessa que lá foi pagar há cinquenta anos. A sessão serve de ponto de partida para uma conversa, uma memória, às vezes um pedido («quero ir lá outra vez») que a equipa pode transformar noutra atividade. Há coisas que só o terapeuta pode decidir, e o sistema deve respeitá-lo: - **quem** beneficia, e quem não, por razões clínicas, sensoriais ou simplesmente porque não quer; - **que lugar** escolher, a partir da história de vida e não do catálogo; - **quanto tempo**, e quando parar; - **o que fazer a seguir** com o que a pessoa disse. Quando o lugar da pessoa não está na biblioteca, há caminhos que explicámos em [quando o lugar da pessoa não está na biblioteca](/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/). ## O que o trabalho com as equipas nos ensinou No trabalho com as equipas aprendemos que o equipamento é o menos importante. O que conta é a escolha do conteúdo, a preparação da pessoa e a conversa que vem depois. Numa aula aberta com futuros terapeutas ocupacionais, a regra de segurança que fechou a sessão foi simples: quem sentir desconforto tira o headset e diz ([relato aqui](/blog/aula-aberta-terapia-ocupacional-universidade-leiria-oeste/)). Também aprendemos que a participação não termina quando a pessoa está acamada. Escrevemos sobre isso a propósito da [Semana Europeia da Mobilidade](/blog/semana-europeia-mobilidade-quem-nao-sai-da-cama/). ## Onde o RVer entra O RVer é uma biblioteca de vídeos 360° filmados em lugares reais, com natureza, cidades, música, religião e atividades do dia a dia, pensada para ser usada pela equipa com utentes dos 10 aos 100 anos. A equipa escolhe e controla a sessão a partir da app Companion, há modo deitado para quem não se senta, e os conteúdos funcionam sem internet. É usado para reminiscência, estimulação, relaxamento e conforto. Não substitui a saída real, nem a atividade com as mãos, nem a relação com o terapeuta. O enquadramento para [lares residenciais](/solucoes/lar-residencial/) e para [hospitais](/solucoes/hospital/) está nas páginas de cada contexto. ## Em resumo - O Dia Mundial da Terapia Ocupacional 2026 é a 27 de outubro, com o tema «Participation Matters», da WFOT. - Participar é recuperar papéis e rotinas, e não apenas ocupar o tempo. - Quando a pessoa já não sai, as equipas trazem o lado de fora para dentro, com o que têm. - Um vídeo 360° pode ser mais uma ferramenta, se for o terapeuta a decidir quem, o quê, quanto tempo e o que fazer a seguir. O produto base do RVer é um dispositivo médico Classe I, registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição e complementam o trabalho da equipa; não substituem avaliação nem intervenção de terapia ocupacional. --- **Fonte:** [Launch of the World Occupational Therapy Day 2026 Theme](https://wfot.org/news/2026/launch-of-the-world-occupational-therapy-day-2026-theme), World Federation of Occupational Therapists, 30 de abril de 2026. Q: Quando é o Dia Mundial da Terapia Ocupacional 2026? A: A 27 de outubro de 2026, uma terça-feira. É promovido pela World Federation of Occupational Therapists (WFOT). Q: Qual é o tema do Dia Mundial da Terapia Ocupacional 2026? A: «Participation Matters», ou seja, a participação importa. A WFOT destaca o papel das atividades, papéis e rotinas do dia a dia na saúde, no bem-estar e na qualidade de vida. Q: A realidade virtual substitui uma saída ou uma atividade real? A: Não. Um vídeo 360° pode abrir uma conversa ou trazer uma memória quando a pessoa já não pode sair, mas não substitui a saída, a atividade com as mãos nem a relação com o terapeuta. Q: Quem decide se um utente faz uma sessão com o RVer? A: A equipa da instituição, muitas vezes o terapeuta ocupacional, a partir da história de vida, do estado clínico e da vontade da pessoa. A sessão para quando a pessoa quiser. ### Dia Europeu de Sensibilização para a Dor 2026: o custo que não cabe na consulta URL: https://rver.pt/blog/dia-europeu-de-sensibilizacao-para-a-dor-2026-o-custo-escondido/ Date: 11 October 2026 A dor tem um preço que não aparece na fatura da consulta. Paga-se em dias de trabalho, em noites mal dormidas e no tempo de quem está à volta. A 21 de outubro assinala-se o **Dia Europeu de Sensibilização para a Dor**. É um dia recente, sem nome português consolidado: muita gente procura-o como dia europeu da dor ou dia da dor crónica. ## O que é o Dia Europeu de Sensibilização para a Dor 2026 O dia é promovido pela European Pain Federation EFIC e marca-se todos os anos na terceira quarta-feira de outubro. Em 2026 calha a 21. A EFIC começou a construí-lo em 2024, na sequência do Global Day Against Pain, que a IASP e a EFIC organizaram pela primeira vez em 2004, com o copatrocínio da Organização Mundial da Saúde ([EFIC](https://europeanpainfederation.eu/european-day-on-pain-awareness/)). O tema de 2026 é **«The Hidden Cost of Pain»**, o custo escondido da dor. A EFIC olha este ano para a dor crónica pelo lado do emprego e da produtividade, e para o que os governos podem fazer para manter as pessoas com dor no trabalho e reduzir o peso que a dor tem no resto da sociedade. Segundo a mesma página, a dor crónica afeta cerca de 20% dos adultos na Europa, perto de 150 milhões de pessoas. ## O que a dor custa fora do consultório Em Portugal, o retrato mais completo continua a ser um estudo nacional feito pela Faculdade de Medicina da Universidade do Porto, com mais de 5 mil adultos inquiridos por telefone entre 2007 e 2008. Os dados têm idade, e convém dizê-lo, mas vêm de uma amostra representativa da população adulta. Nesse estudo, **36,7%** dos adultos tinham dor crónica, e quase metade dos que a tinham (49%) disse que a dor interferia com o trabalho. A incapacidade mais alta aparecia nas responsabilidades da casa e da família, nas atividades de lazer, no trabalho e no sono ([Azevedo et al., 2012](https://doi.org/10.1016/j.jpain.2012.05.012)). Um segundo artigo, com uma subamostra do mesmo estudo, calculou o custo. Os custos anuais da dor crónica em Portugal foram estimados em cerca de 4,6 mil milhões de euros, o equivalente a **2,71% do PIB** de 2010. E 57,3% desse valor eram custos indiretos: faltas, perda de produtividade, reformas antecipadas ([Azevedo et al., 2016](https://doi.org/10.1007/s10198-014-0659-4)). É exatamente o custo escondido de que fala o tema deste ano. Há ainda o que nenhum estudo económico apanha bem. O cônjuge que deixa de sair porque o outro não aguenta a viagem. O filho que pede dias ao patrão para levar a mãe às consultas. A pessoa que desiste de uma atividade de que gostava porque já não tem energia depois do dia de trabalho. ## A dor que também se vive no hospital O tema de 2026 é a dor crónica e o trabalho. Mas quem trabalha num hospital, numa unidade de cuidados continuados ou num lar conhece outra parte do custo, mais curta e mais frequente: a dor e a ansiedade dos procedimentos e das esperas. A punção venosa de quem tem veias difíceis. O penso de uma ferida que se faz dia sim, dia não. A colheita numa criança que já sabe o que vem aí. A hora na sala de espera antes de um exame. A sessão de tratamento que dura uma manhã inteira. Nestes momentos as equipas usam há muito tempo estratégias não farmacológicas, ao lado da analgesia e nunca em vez dela: conversar, explicar o que vai acontecer, posicionar bem, música, respiração, a mão de um familiar, um vídeo no telemóvel. Em pediatria, a distração faz parte da rotina de muitas equipas. Nada disto é periférico. Faz parte do cuidado. A literatura sobre distração em procedimentos é das mais consistentes no campo da realidade virtual em saúde, sobretudo em dor aguda e procedimentos curtos. Resumimos o essencial em [medo de agulhas e dor em procedimentos](/blog/realidade-virtual-medo-de-agulhas-procedimentos/). Na dor crónica, o tema deste dia, a evidência é mais heterogénea, e dissemo-lo em [consulta da dor: onde entra a realidade virtual, e onde não entra](/blog/consulta-da-dor-onde-entra-a-realidade-virtual/). ## O que não se deve prometer Falar de dor obriga a cuidado com as palavras. A distração ajuda muitas pessoas a atravessar um procedimento com menos ansiedade, e pode ajudar a gerir a dor desse momento. Não é analgesia, não substitui nenhum medicamento, não altera doses e não tira nenhuma decisão à equipa. E a resposta varia de pessoa para pessoa: há quem prefira olhar para o que lhe estão a fazer. Também não faz sentido apresentar uma solução de conforto como resposta ao custo económico da dor crónica. Esse custo resolve-se com acesso a consultas da dor, com reabilitação, com adaptação do trabalho, com o que a EFIC pede aos governos neste dia. Escrevemos sobre o peso do farmacológico e o espaço que sobra em [«Congresso da Dor 2026: onde entra o não farmacológico»](/blog/congresso-da-dor-2026-onde-entra-o-nao-farmacologico/). ## Onde o RVer entra O RVer é uma biblioteca de vídeos 360° filmados em lugares reais, usada pela equipa como complemento não farmacológico em momentos concretos: durante um penso, uma punção, uma sessão de tratamento longa, uma espera antes de um exame. A pessoa olha à volta numa praia, num jardim ou numa cidade, enquanto a equipa faz o seu trabalho e controla a sessão a partir da app Companion. Há modo deitado, e os conteúdos funcionam sem internet. Usa-se com utentes a partir dos 10 anos. O RVer ajuda a gerir a dor e a ansiedade nesses momentos. Não promete menos dor, nem trata a dor crónica. Os estudos que conhecemos sobre realidade virtual em dor e ansiedade estão reunidos em [estudos](/estudos/), e o enquadramento para serviços está na página de [hospitais](/solucoes/hospital/). ## Em resumo - O Dia Europeu de Sensibilização para a Dor 2026 é a 21 de outubro, promovido pela EFIC, com o tema «The Hidden Cost of Pain». - Em Portugal, o estudo nacional disponível encontrou dor crónica em 36,7% dos adultos e um custo de 2,71% do PIB, mais de metade em custos indiretos. - Nos hospitais há outro custo, mais curto: a dor e a ansiedade de procedimentos e esperas. - A distração não farmacológica é um complemento que as equipas já usam. Não é analgesia. O produto base do RVer é um dispositivo médico Classe I, registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, tratamento ou analgesia. --- **Fontes:** [European Day on Pain Awareness](https://europeanpainfederation.eu/european-day-on-pain-awareness/), European Pain Federation EFIC; Azevedo L. F. et al., [Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal](https://doi.org/10.1016/j.jpain.2012.05.012), The Journal of Pain, 2012; Azevedo L. F. et al., [The economic impact of chronic pain: a nationwide population-based cost-of-illness study in Portugal](https://doi.org/10.1007/s10198-014-0659-4), European Journal of Health Economics, 2016. Q: Quando é o Dia Europeu de Sensibilização para a Dor 2026? A: A 21 de outubro de 2026, uma quarta-feira. O dia marca-se na terceira quarta-feira de outubro e é promovido pela European Pain Federation EFIC. Q: Qual é o tema do Dia Europeu de Sensibilização para a Dor 2026? A: «The Hidden Cost of Pain», o custo escondido da dor. A EFIC foca a dor crónica do ponto de vista do emprego e da produtividade, e o que os governos podem fazer para manter as pessoas com dor no trabalho. Q: Quantas pessoas têm dor crónica em Portugal? A: O estudo nacional de Azevedo e colegas, com dados de 2007 e 2008, encontrou dor crónica em 36,7% dos adultos portugueses. São dados antigos, mas de uma amostra representativa da população adulta. Q: A realidade virtual reduz a dor? A: O RVer não faz essa promessa. É usado como distração durante procedimentos e esperas, e ajuda a gerir a dor e a ansiedade desses momentos. Não é analgesia e não substitui nenhum medicamento nem decisão da equipa. ### Dia Mundial do AVC 2026: os dias de internamento que vêm depois da urgência URL: https://rver.pt/blog/dia-mundial-do-avc-2026-os-dias-de-internamento/ Date: 11 October 2026 A campanha mundial chega aos 20 anos a ouvir quem passou por um AVC. Muitos falam menos do dia em que tudo aconteceu e mais das semanas que vieram a seguir. A 29 de outubro assinala-se o **Dia Mundial do AVC**. Em 2026 a data cai numa quinta-feira, e quem prepara ações em hospitais, unidades de AVC, centros de saúde e escolas está a fazê-lo por estes dias. ## O que é o Dia Mundial do AVC 2026 O dia é promovido pela World Stroke Organization (WSO). A campanha continua centrada em reconhecer os sinais de AVC e agir depressa, com o lema «Every M1nute Counts»: cada minuto conta. Para 2026 a WSO **não anunciou um tema novo**. O que marca este ano é outra coisa: a campanha mundial faz 20 anos e a organização decidiu assinalá-lo com as pessoas que viveram um AVC. Chama-se [20 Voices Changing Stroke](https://www.world-stroke.org/world-stroke-day-campaign/life-after-stroke/20-voices-changing-stroke/). Em abril a WSO abriu nomeações para pessoas com experiência vivida de AVC que mudaram alguma coisa na sensibilização, nos serviços, nas políticas ou na investigação. A WSO previa anunciar os 20 distinguidos a 1 de outubro e, no próprio dia 29, o primeiro prémio global para uma voz com experiência vivida. A escala explica porque a data importa: segundo a [WSO](https://www.world-stroke.org/world-stroke-day-campaign), mais de 100 milhões de pessoas vivas hoje já tiveram um AVC. A maioria passou, em algum momento, por um internamento. ## Depois da urgência, os dias são compridos A primeira parte da história é contada muitas vezes: os sinais, o 112, a via verde, o tempo até ao tratamento. É a parte certa para uma campanha de sensibilização, porque é onde os minutos decidem. A segunda parte é menos falada. Depois da fase aguda vêm semanas de internamento, numa unidade de AVC, numa enfermaria ou numa unidade de reabilitação. As sessões com a fisioterapia, a terapia ocupacional e a terapia da fala ocupam uma parte do dia. O resto é cama, cadeirão, televisão do quarto e espera. Quem passou por isso descreve-o sem rodeios. Uma revisão sistemática de 31 estudos qualitativos sobre a experiência de internamento em reabilitação depois do AVC encontrou relatos negativos em todos eles, entre os quais aborrecimento, frustração e perda de controlo. Um dos temas tinha um nome curto: **aborrecido e sozinho** ([Luker et al., 2015](https://doi.org/10.1016/j.apmr.2015.03.017)). Outro dizia que a recreação também faz parte da reabilitação. O humor também pesa. Uma meta-análise de 61 estudos, com mais de 25 mil pessoas, estimou que cerca de 31% das pessoas têm depressão em algum momento depois do AVC ([Hackett e Pickles, 2014](https://doi.org/10.1111/ijs.12357)). A deteção e o tratamento são trabalho clínico. O ambiente em que a pessoa passa os dias também conta, e as equipas de internamento conhecem bem os seus limites: o quarto é o quarto, e a rotina hospitalar não se escolhe. ## O que as equipas já fazem entre terapias Nenhuma equipa de AVC precisa que lhe expliquem que a tarde é longa. Enfermeiros levantam o doente para o cadeirão e para a janela. Terapeutas ocupacionais trazem para a enfermaria tarefas que a pessoa reconhece. A psicologia, quando existe no serviço, acompanha o choque de acordar com um corpo que já não responde como antes. Voluntários, capelania e animação passam pelos quartos. Há serviços que organizam refeições em conjunto e pequenos grupos. Tudo isto depende de tempo e de pessoas, e o tempo nunca chega para todos. Escrevemos sobre o custo de ficar parado em [«A imobilidade custa mais do que a doença que trouxe o doente»](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/). ## A família também passa os dias no hospital O AVC muda a vida de mais gente do que a pessoa internada. O marido que vem todos os dias à hora da visita. A filha que trabalha e só chega ao fim da tarde. O neto que não sabe o que dizer. Quando o AVC afeta a fala, a visita fica mais difícil. A conversa encurta, as perguntas ficam sem resposta, e muita gente acaba sentada ao lado da cama em silêncio, sem saber se está a ajudar. Uma das coisas que as equipas de terapia da fala e de enfermagem fazem é dar à família formas de comunicar que não dependem só de palavras: apontar, mostrar fotografias, falar de um lugar conhecido. É também aqui que a experiência vivida, o foco da campanha deste ano, tem uma tradução prática. Perguntar à pessoa, e a quem a conhece, como eram os dias dela antes. Que sítio é o dela. Que música ouvia. Isso serve para a terapia, e serve para a hora da visita. ## Onde o RVer entra, e onde não entra O RVer é uma biblioteca de vídeos 360° filmados em lugares reais: praias, aldeias, cidades portuguesas, santuários, música, natureza. Num internamento depois de um AVC é usado para **conforto, calma e reminiscência**, em sessões curtas conduzidas pela equipa. Uma pessoa que passou três semanas a olhar para o mesmo teto pode voltar, durante uns minutos, à praia onde ia todos os verões, e falar disso a seguir com quem estiver ao lado. Alguns pormenores contam num serviço de AVC. O [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/) permite a sessão a quem não se pode sentar. A equipa controla o headset a partir da app Companion, acompanha a sessão no ecrã e pode pará-la de imediato. Os conteúdos estão no equipamento e funcionam sem internet. A família pode acompanhar a sessão por [chamada](/blog/videochamadas-familia-realidade-virtual/), vendo o mesmo lugar. O que o RVer **não** é, num serviço de AVC: não é reabilitação motora nem cognitiva. Os módulos de movimento e de cognição do RVer estão em desenvolvimento e validação, fora do registo do dispositivo, e não fazem parte do que aqui se descreve. Não substitui nenhuma terapia, nem ocupa o lugar de uma sessão de fisioterapia. Quem decide se e quando faz sentido é a equipa que segue a pessoa, tendo em conta o estado clínico, a visão, o equilíbrio sentado e o cansaço. O uso em reminiscência está descrito em [voltar a um lugar familiar](/blog/reminiscencia-lugares-familiares-realidade-virtual/). O enquadramento para serviços hospitalares está na página de [hospitais](/solucoes/hospital/). ## Em resumo - O Dia Mundial do AVC 2026 é a 29 de outubro. Não há tema novo: a WSO assinala 20 anos de campanha e dá destaque a quem viveu um AVC. - Depois da urgência há semanas de internamento, e quem as viveu fala de aborrecimento, solidão e perda de controlo. - As equipas já preenchem esse tempo com o que têm. Falta sempre tempo e falta sempre gente. - A família também está lá, e a visita fica difícil quando a fala é afetada. - O RVer pode ser um momento de conforto e de conversa, decidido pela equipa. Não é reabilitação. O produto base do RVer é um dispositivo médico Classe I, registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, tratamento ou reabilitação. --- **Fontes:** [World Stroke Campaign](https://www.world-stroke.org/world-stroke-day-campaign), World Stroke Organization; [20 Voices Changing Stroke](https://www.world-stroke.org/world-stroke-day-campaign/life-after-stroke/20-voices-changing-stroke/), World Stroke Organization; Luker J. et al., [Stroke survivors' experiences of physical rehabilitation: a systematic review of qualitative studies](https://doi.org/10.1016/j.apmr.2015.03.017), Archives of Physical Medicine and Rehabilitation, 2015; Hackett M. L., Pickles K., [Part I: frequency of depression after stroke](https://doi.org/10.1111/ijs.12357), International Journal of Stroke, 2014. Q: Quando é o Dia Mundial do AVC 2026? A: A 29 de outubro de 2026, uma quinta-feira. É promovido pela World Stroke Organization. Q: Qual é o tema do Dia Mundial do AVC 2026? A: A World Stroke Organization não anunciou um tema novo para 2026. A campanha mantém o lema «Every M1nute Counts», sobre os sinais de AVC, e assinala 20 anos dando destaque às pessoas com experiência vivida de AVC, com a iniciativa 20 Voices Changing Stroke. Q: A realidade virtual do RVer faz reabilitação depois de um AVC? A: Não. O RVer é usado para conforto, calma e reminiscência durante o internamento, em sessões conduzidas pela equipa. Os módulos de movimento e cognição estão em desenvolvimento e validação, fora do registo, e não substituem nenhuma terapia. Q: Uma pessoa acamada depois de um AVC pode usar o headset? A: O modo deitado permite sessões a quem não se pode sentar. A decisão é sempre da equipa que acompanha a pessoa, conforme o estado clínico, a visão e o cansaço. ### O RVer está registado na EUDAMED. O que muda, e o que não muda URL: https://rver.pt/blog/rver-registado-na-eudamed/ Date: 10 October 2026 O produto base do RVer passou a constar da base de dados europeia de dispositivos médicos. É um registo, não uma aprovação, e é verificável por qualquer pessoa. A 10 de outubro de 2026, o produto base do RVer, a biblioteca de vídeo, ficou registado na **EUDAMED**, a base de dados europeia de dispositivos médicos. Passa assim a ser um dispositivo médico Classe I, com marcação CE ao abrigo do MDR 2017/745, **registado no INFARMED e na EUDAMED**. Fica aqui o que isso quer dizer, sem exagerar nem diminuir. ## Os números São estes os identificadores do registo, tal como constam da EUDAMED: - **Basic UDI-DI:** 56006195127RVERTZ, que identifica o modelo do dispositivo. - **UDI-DI:** 05600619512700, o mesmo que já estava na etiqueta. - **Fabricante:** Amplified Creations - Informática e Gestão, Lda., com o **SRN** PT-MF-000059840. - **Estado:** Registado. Qualquer pessoa pode confirmar: a [ficha do RVer na EUDAMED](https://ec.europa.eu/tools/eudamed/#/screen/search-device/64482b6d-2238-4ec8-bdf7-b488437aa6ae) é pública. O registo no INFARMED mantém-se, com o mesmo número de sempre: **CDM 94571546**. ## O que é a EUDAMED A EUDAMED é a base de dados europeia de dispositivos médicos prevista no Regulamento (UE) 2017/745. Reúne, num só sítio, informação sobre os operadores económicos, os dispositivos e a vigilância, e foi pensada para tornar o mercado europeu de dispositivos médicos mais transparente e rastreável. O registo de dispositivos na EUDAMED passou a ser obrigatório a 28 de maio de 2026. Os dispositivos que já estavam no mercado tinham até 28 de novembro de 2026 para o fazer. :::note A EUDAMED é uma base de dados de registo, não uma aprovação. Estar registado na EUDAMED quer dizer que o dispositivo e o fabricante estão identificados e são consultáveis à escala europeia. Não acrescenta nenhuma alegação sobre o que o dispositivo faz. ::: ## Porque dizemos INFARMED e EUDAMED Pode parecer redundante, mas são dois registos diferentes, cada um com o seu número. - **INFARMED (CDM 94571546)** é o registo nacional, junto da autoridade competente portuguesa para os dispositivos médicos. É o que um júri de concurso ou uma direção clínica em Portugal reconhece à primeira. - **EUDAMED (Basic UDI-DI 56006195127RVERTZ)** é o registo europeu. É o que faz sentido para quem está fora de Portugal e não conhece o INFARMED. O INFARMED também tem um papel na EUDAMED: foi o INFARMED que atribuiu ao fabricante o SRN, quando este se registou como operador. Mas a EUDAMED não substitui o registo nacional, e o n.º CDM do INFARMED não é um número da EUDAMED. Por isso dizemos os dois. ## O que muda para quem compra Pouco no dia a dia, e isso é bom sinal: o produto é o mesmo. O que muda é a **facilidade de verificar**. - **Qualquer pessoa pode confirmar o registo**, sem nos pedir nada, no portal público da EUDAMED, pelo Basic UDI-DI ou pelo nome do fabricante. - **Num caderno de encargos**, quando se pede o número de registo do dispositivo, passa a haver dois para indicar: o CDM do INFARMED e o Basic UDI-DI da EUDAMED. - **Os identificadores batem certo** entre a etiqueta, o manual, a aplicação (que mostra o UDI completo no rodapé do ecrã principal) e a EUDAMED. ## O que não muda - **A classe.** Continua a ser um dispositivo médico Classe I, a classe de menor risco, com marcação CE ao abrigo do MDR 2017/745. - **O âmbito.** O registo abrange o **produto base**: a biblioteca de vídeo. O RVer Motion, o RVer Neuro e o RVer Exposure são módulos em desenvolvimento e não estão abrangidos pelo registo de dispositivo médico Classe I. - **O que o RVer é.** Um complemento não farmacológico para conforto, distração, atividade orientada e bem-estar, sempre sob supervisão da equipa de saúde. Não trata, não diagnostica e não substitui cuidados médicos. Nenhum registo muda isso, e não queremos que pareça que muda. ## Onde encontrar tudo por escrito Os números estão na página de [ciência e enquadramento](/ciencia/), na lista de documentos do [dossiê de aquisição](/aquisicao/) e no [manual de utilização](/manual/). Se precisar deles num formato próprio para um processo de compra, escreva-nos. Q: O RVer está registado na EUDAMED? A: Sim. Desde 10 de outubro de 2026, o produto base do RVer está registado na EUDAMED com o Basic UDI-DI 56006195127RVERTZ e o UDI-DI 05600619512700. O fabricante, Amplified Creations - Informática e Gestão, Lda., tem o SRN PT-MF-000059840. Q: Estar registado na EUDAMED é uma aprovação da União Europeia? A: Não. A EUDAMED é uma base de dados de registo. Torna o dispositivo e o fabricante identificáveis e consultáveis à escala europeia, mas não é uma aprovação e não acrescenta nenhuma alegação sobre o que o dispositivo faz. Q: O registo no INFARMED continua válido? A: Sim. São dois registos diferentes: o nacional, no INFARMED, com o n.º CDM 94571546, e o europeu, na EUDAMED. O produto base está registado nos dois. Q: Os módulos RVer Motion, RVer Neuro e RVer Exposure também ficaram registados? A: Não. O registo de dispositivo médico Classe I abrange o produto base, a biblioteca de vídeo. Os módulos estão em desenvolvimento e não estão abrangidos. ### Porque é que a pessoa com demência repete as mesmas perguntas, e o que ajuda URL: https://rver.pt/blog/demencia-repete-as-mesmas-perguntas-o-que-ajuda/ Date: 8 October 2026 «Quando vem a minha filha?» Às dez, às dez e um quarto, às dez e meia. Repetir a mesma pergunta é das coisas mais comuns na demência e das que mais cansam quem cuida. Há razões para acontecer, e há respostas que costumam ajudar mais do que outras. Este artigo é para quem responde: a família em casa e as equipas de lares, centros de dia, apoio domiciliário e hospitais. Primeiro o porquê, depois o que costuma ajudar, e depois quando a repetição é sinal para falar com o médico. ## Porque é que a pergunta volta **A resposta não chega a ficar guardada.** Na demência, e sobretudo na doença de Alzheimer, a memória de acontecimentos recentes é das primeiras a falhar. A pessoa ouviu a resposta, percebeu-a, e minutos depois ela já não está lá. Para ela, a pergunta é nova. Não sabe que já a fez, e por isso não está a testar a paciência de ninguém. **O tempo deixa de ter pontos de apoio.** Sem a memória do que aconteceu há pouco, é difícil saber que dia é, se o almoço já foi ou quanto falta para a visita. «Que dia é hoje?» e «já almocei?» são muitas vezes uma tentativa de se orientar. **A pergunta leva uma emoção.** É o ponto mais importante e o mais fácil de perder. «Quando vem a minha filha?» raramente é só um pedido de horário: pode querer dizer «estou sozinha», «tenho medo», «não sei bem onde estou». A [Alzheimer's Society](https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/dementia-symptoms/repetitive-behaviour) nota que, muitas vezes, quem repete a mesma pergunta precisa de uma resposta emocional e não factual, porque se sente confuso ou ansioso. A [Alzheimer's Association](https://www.alz.org/help-support/caregiving/stages-behaviors/repetition) descreve o mesmo: a repetição pode ser uma forma de exprimir uma preocupação, pedir ajuda ou lidar com frustração, ansiedade ou insegurança. **O que está à volta também conta.** Uma sala barulhenta, um dia sem nada para fazer, dor, fome ou cansaço fazem a pergunta voltar com mais frequência. Vale a pena reparar a que horas e em que situações acontece mais: muitas vezes há um padrão, como na [agitação ao fim da tarde](/blog/agitacao-fim-da-tarde-demencia-sundowning/). ## Perguntas repetidas, perseveração e ecolalia Nem toda a repetição é igual, e a diferença ajuda a perceber o que se está a ver: - **Perguntas repetidas.** A pessoa faz uma pergunta com sentido, recebe a resposta e esquece-a. É a forma mais comum e é sobretudo um problema de memória recente. - **Perseveração.** Ficar preso a uma palavra, um gesto ou uma ideia e repeti-lo mesmo quando a conversa já mudou. É o termo que os profissionais usam muitas vezes para a repetição de ações e palavras em geral. - **Ecolalia.** Repetir palavras ou frases que acabou de ouvir, de outra pessoa ou da televisão. Aparece mais em fases avançadas e nas formas de demência que afetam a linguagem. Não é preciso dar nome ao que se vê para responder bem, mas a distinção é útil na conversa com a equipa clínica. Sobre o que muda de um diagnóstico para outro, escrevemos sobre os [tipos de demência](/blog/tipos-de-demencia-o-que-muda-numa-sessao/). ## O que costuma ajudar **Responder com calma, como se fosse a primeira vez.** Para a pessoa, é. Uma resposta curta, simples, no mesmo tom. O cansaço na voz passa mesmo quando as palavras não passam. **Responder à emoção, e não só à pergunta.** «A sua filha vem ao fim da tarde. Tem saudades dela, não tem?» Reconhecer o sentimento costuma acalmar mais do que repetir a hora. Às vezes ajuda falar da filha, mostrar uma fotografia, perguntar como era ela em pequena. **Evitar o «já te disse».** Lembrar à pessoa que já perguntou não a faz lembrar-se da resposta. Mostra-lhe que falhou, e isso aumenta a ansiedade que estava por trás da pergunta. **Pôr a resposta à vista.** Enquanto a pessoa consegue ler e perceber, uma pista visual faz parte do trabalho que a memória já não faz: um calendário grande com o dia assinalado, um relógio bem visível, um quadro branco com o plano do dia, um papel escrito à mão («A Ana vem às 18h. Hoje é terça.»). A Alzheimer's Association inclui notas, relógios, calendários e fotografias entre as ajudas de memória. Num lar, o quadro da sala com o dia e a atividade seguinte serve a todos. **Rotina.** A mesma sequência, à mesma hora, todos os dias. Quando o dia é previsível, há menos coisas por perguntar. **Passar a uma atividade calma.** Depois de responder, propor outra coisa: um chá, dobrar toalhas, ver fotografias, uma música conhecida, uma volta curta. Não é calar a pergunta, é dar à pessoa algo que ocupe o lugar da preocupação. A ferramenta [História de vida](/ferramentas/historia-de-vida/) ajuda a reunir os temas, lugares e pessoas que costumam resultar com cada utente. **Aceitar o que não faz mal.** Se a repetição não causa sofrimento a ninguém, pode simplesmente ficar. ## Cuidar de quem responde Responder à mesma pergunta trinta vezes por dia cansa, e ninguém o faz sempre bem. Irritar-se de vez em quando não faz de ninguém um mau cuidador. O que ajuda são pausas reais: alternar quem responde, sair da sala uns minutos, pedir apoio a tempo. Em casa, a [Linha de Apoio na Demência](https://alzheimerportugal.org/linha-de-apoio-na-demencia-2/) da Alzheimer Portugal dá informação e apoio a pessoas com demência e a cuidadores formais e informais, nos dias úteis. Nas equipas, falar na passagem de turno da pergunta que se repete ajuda a combinar uma resposta igual para todos: se cada pessoa responde de maneira diferente, a pergunta volta com mais força. ## Quando falar com o médico A repetição que aumenta devagar, ao longo de meses, faz em geral parte da evolução da doença. Outra coisa é uma mudança rápida, em horas ou dias: mais confusão do que o habitual, sonolência ou agitação novas, desatenção, a pessoa a não reconhecer quem conhecia na semana anterior. Isso pode ser **delirium**, um estado de confusão aguda com uma causa física: uma infeção (a urinária é frequente), dor, desidratação, obstipação ou efeitos de medicação. O [NHS](https://www.nhs.uk/symptoms/confusion/) lembra que as infeções urinárias são uma causa comum de confusão em pessoas com demência e que confusão súbita precisa de avaliação urgente. Em Portugal, na dúvida, contacte o SNS 24 (808 24 24 24); numa emergência, o 112. E se ainda não há diagnóstico e as perguntas repetidas são novidade, isso merece consulta com o médico de família. Repetir perguntas é um dos sinais que levam a avaliar a memória, e há outras causas possíveis além da demência, algumas tratáveis. ## Onde o RVer pode entrar, e onde não Há uma parte disto em que trabalhamos, e convém ser exato sobre o que é. O RVer é uma biblioteca de vídeos 360° usada por equipas de saúde e de cuidado. Um cenário (uma praia, um jardim, a aldeia, uma igreja conhecida) pode ser um momento calmo e acompanhado e, sobretudo, um ponto de partida para conversa: quem volta a ver a praia onde passava os verões costuma ter coisas para contar. É [reminiscência a partir de lugares familiares](/blog/reminiscencia-lugares-familiares-realidade-virtual/), ao lado da música, das fotografias e da conversa. Três coisas, com clareza: - Não é tratamento. Não afirmamos que reduza a repetição de perguntas nem qualquer sintoma da demência. É mais uma opção de atividade calma. - A sessão é sempre acompanhada, curta, e para quando a pessoa quiser. Nem toda a gente aceita o headset, e a [recusa respeita-se](/blog/quando-o-utente-recusa-realidade-virtual/). - Faz sentido onde há uma equipa a conduzir a sessão: lar, centro de dia, apoio domiciliário, hospital. Para a família em casa, o que está nas secções acima vale mais do que qualquer equipamento. ## Em resumo - A pergunta volta porque a resposta não fica guardada, e não por teimosia. - Muitas vezes leva uma emoção: responder também a ela. - Responder com calma, como se fosse a primeira vez, e evitar o «já te disse». - Pôr a resposta à vista: calendário, relógio, quadro, um papel escrito. - Rotina, e uma atividade calma depois de responder. - Uma mudança súbita pede avaliação médica, não mais paciência. :::note Este artigo é informativo e não substitui avaliação clínica. Uma alteração rápida da confusão ou do comportamento merece observação médica: pode ser infeção, dor ou efeito de medicação. As decisões sobre terapêutica são da equipa clínica. O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. ::: Sobre o uso em demência, ver [reminiscência, calma e momentos de presença](/blog/realidade-virtual-demencia-alzheimer/). Para equipas, ver a solução para [lar residencial](/solucoes/lar-residencial/). Q: Porque é que a pessoa com demência repete sempre a mesma pergunta? A: Sobretudo porque a memória recente falha: a pessoa ouve a resposta e, minutos depois, já não a tem, por isso a pergunta parece-lhe nova. Muitas vezes a pergunta também leva uma emoção, como insegurança ou ansiedade, ou é uma tentativa de se orientar no tempo. Q: O que se deve responder quando a pergunta se repete? A: Responder com calma, como se fosse a primeira vez, com frases curtas, e responder também à emoção por trás da pergunta. Evitar dizer «já te disse», pôr a resposta à vista (calendário, relógio, quadro, um papel escrito) e, depois de responder, passar a uma atividade calma. Q: Qual é a diferença entre perguntas repetidas, perseveração e ecolalia? A: Nas perguntas repetidas a pessoa faz uma pergunta com sentido e esquece a resposta. A perseveração é ficar preso a uma palavra, gesto ou ideia mesmo quando a conversa já mudou. A ecolalia é repetir palavras ou frases que acabou de ouvir, e aparece mais em fases avançadas e nas formas de demência que afetam a linguagem. Q: Quando é que a repetição é sinal para ir ao médico? A: Quando há uma mudança rápida, em horas ou dias: mais confusão do que o habitual, sonolência ou agitação novas, desatenção. Pode ser delirium, causado por infeção, dor, desidratação ou medicação. Na dúvida, contacte o SNS 24 (808 24 24 24); numa emergência, o 112. Se ainda não há diagnóstico, perguntas repetidas novas merecem consulta com o médico de família. ### Porque é que o RVer usa o Meta Quest 3: os critérios, por ordem URL: https://rver.pt/blog/porque-o-rver-usa-o-meta-quest-3/ Date: 7 October 2026 Há uma pergunta que ouvimos em quase todas as reuniões: porquê a Meta? Porque não o Vision Pro, ou um Pico? A instituição nunca escolhe nem compra os headsets, porque são nossos e vêm com o serviço. Mas a escolha foi pesada e testada, e quem pergunta merece a resposta técnica completa. ## Porque fizemos esta página A instituição que usa o RVer não escolhe os headsets. [São nossos](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/), chegam configurados, e a manutenção é nossa. Mesmo assim, a pergunta aparece sempre: porque é que o RVer corre no Meta Quest 3, e não noutro? A resposta curta é que foi uma escolha ponderada e analisada, não a primeira que estava à mão. Temos praticamente um de cada um destes modelos para testar. Do Pico temos uns seis. A resposta longa está numa página nova, [Porquê o Meta Quest 3](/equipamento/): os headsets de realidade virtual lado a lado, ficha técnica contra ficha técnica, com o motivo por que cada um ficou de fora. Este artigo explica como a lemos. ## O primeiro critério eliminou quase metade A biblioteca RVer tem perto de 300 GB: cerca de 50 vídeos em 360°, com uma média de 6 GB cada. É esse tamanho que permite mostrar o vídeo com a qualidade que um utente precisa para se sentir lá, e não a ver um ecrã. Todos os vídeos ficam no próprio equipamento, para a sessão nunca depender da rede do lar ou do hospital. Por isso, um equipamento com 256 GB ou menos, e sem cartão de memória, fica logo de fora. Foi o que aconteceu ao Meta Quest 3S, ao Pico 4 Ultra, ao Samsung Galaxy XR, ao Meta Quest 2 e aos headsets para smartphone. O Pico 4 Ultra merece uma nota: foi o segundo classificado. Tem boa imagem e lentes pancake, mas só existe com 256 GB. ## Depois do espaço, cinco critérios Por ordem de importância: - **Preço.** Os headsets entram no custo do serviço. Um modelo que custa seis vezes mais não torna a sessão seis vezes melhor para o utente, só a fatura mais pesada para a instituição. - **Sem cabo obrigatório.** O Apple Vision Pro e o Samsung Galaxy XR não funcionam sem uma bateria externa ligada por cabo. Numa sessão com um utente sentado, deitado ou acamado, um cabo é mais uma coisa a gerir. O Quest 3 tem bateria externa opcional, só para sessões de mais de duas horas e meia. - **Imagem nítida.** Lentes pancake e 2064 × 2208 píxeis por olho. Uma imagem pouco definida cansa a vista e aumenta o risco de [enjoo](/blog/conforto-e-enjoo-realidade-virtual/). - **Peso.** 515 g. Acima dos 650 g, como o HTC Vive Focus Vision ou o Vision Pro, o peso começa a notar-se, sobretudo em quem tem pouca força no pescoço. - **Óculos graduados.** As lentes do Quest 3 afastam-se da cara e o equipamento fica por cima dos óculos de cada utente. Muitos utentes usam óculos, sobretudo os mais velhos. O Galaxy XR e o Vision Pro só funcionam com lentes graduadas compradas à parte, uma para cada pessoa. ## Os que tinham espaço e ficaram de fora Cinco modelos tinham espaço para a biblioteca e mesmo assim não passaram: - **Apple Vision Pro:** quase 4 000 €, cabo obrigatório, sem óculos graduados, e corre visionOS. A app RVer é Android. - **HTC Vive Focus Vision:** 785 g na cabeça, lentes Fresnel, menos autonomia do que o Quest 3 e mais de 1 000 €. - **Steam Frame:** chegou em setembro de 2026 e corre SteamOS, não Android. A versão com espaço para a biblioteca custa mais do dobro do Quest 3. - **Play For Dream MR:** cerca de 650 g, e precisa de bateria externa para passar de uma hora. - **DPVR P2:** comum em projetos de saúde, mas só acompanha a rotação da cabeça (3DoF) e pesa 690 g. ## O vermelho é igual para todos Na tabela, uma célula a vermelho quer dizer sempre o mesmo: o modelo fica aquém de um critério escrito por baixo da tabela. Por exemplo, 650 g ou mais, cabo obrigatório, não se usar com óculos, menos resolução ou menos autonomia do que o Quest 3, ou não ser Android. Não há células pintadas à mão. Se um modelo melhorar, o vermelho sai. :::note Os preços da comparação são de venda ao público, só o equipamento. Não são o que a RVer paga nem o que a instituição paga: cada kit RVer leva ainda estojo rígido, capa de silicone lavável e outros acessórios, e o equipamento vem incluído no serviço. As especificações são as fichas públicas dos fabricantes, verificadas em outubro de 2026. ::: ## O que muda se o mercado mudar A escolha não é para sempre. Quando sair um equipamento com espaço para a biblioteca, que custe menos ou pese menos sem perder imagem, testamo-lo, como testámos estes. A página [Porquê o Meta Quest 3](/equipamento/) é atualizada quando isso acontecer, e diz a data da última verificação. Q: Que headset de realidade virtual usa o RVer? A: O Meta Quest 3, com 512 GB. Os headsets são da RVer e vêm com o serviço: a instituição não os escolhe nem os compra. Q: Porque não o Meta Quest 3S, que é mais barato? A: Porque fica pelos 256 GB, e a biblioteca RVer já vai perto dos 300 GB. Além disso, usa lentes Fresnel e tem menos resolução por olho do que o Quest 3. Q: Os utentes podem usar os seus óculos graduados? A: Sim. As lentes do Quest 3 afastam-se da cara e o equipamento fica por cima dos óculos. Não é preciso comprar lentes graduadas à parte. ### Cinco ferramentas gratuitas para quem cuida, e porque as fizemos URL: https://rver.pt/blog/ferramentas-gratuitas-para-quem-cuida/ Date: 6 October 2026 Há uma semana numa instituição que não aparece em lado nenhum: a de quem organiza as atividades, escolhe o momento, conhece a pessoa e prepara o equipamento. Fizemos cinco ferramentas para essa semana. São gratuitas, não pedem registo, e nada do que se escreve sai do computador. ## Porque fizemos isto Nas conversas com equipas de lares, hospitais e centros de dia, a realidade virtual nunca aparece sozinha. Aparece ao lado da ginástica de terça-feira, do bingo, da visita da família, do dia mundial que alguém quer assinalar e da limpeza do equipamento entre utentes. O RVer é uma atividade no plano de uma instituição, não a única. Por isso fizemos ferramentas para o resto do plano. Estão todas em [rver.pt/ferramentas](/ferramentas/), funcionam no browser, e seguem três regras: - **Sem registo.** Abre-se e usa-se. Não pedimos email nem conta. - **Nada sai do computador.** O que se escreve fica no browser, até se imprimir ou guardar em PDF. - **Feitas para imprimir.** Para afixar na sala, levar à reunião de equipa ou entregar à família. E são para utentes dos 10 aos 100 anos: lar, internamento, pediatria, saúde mental, cuidados paliativos e reabilitação. ## 1. Gerador de atividades O [gerador de atividades](/ferramentas/atividades/) responde à pergunta de todas as semanas: o que é que fazemos hoje, com estas pessoas, neste tempo? Escolhe-se quem vai participar e quanto tempo há, por idade, contexto, mobilidade (anda sozinho, cadeira de rodas, acamado), formato (individual ou em grupo), tempo disponível e foco: memória, movimento, convívio, sensorial, linguagem, calma ou criatividade. O gerador devolve as atividades que servem, de uma caixa de memórias a um bowling com garrafas, de histórias em cadeia a uma massagem às mãos. Cada uma das 35 atividades traz os materiais, os passos e as adaptações: o que muda com défice cognitivo, com uma criança, com alguém acamado. No fim imprime-se a seleção inteira. As nove primeiras são sessões RVer, todas a partir de vídeos da biblioteca: «um lugar conhecido», «uma pausa», «um concerto», «um sítio onde nunca esteve», «um trabalho de antigamente», «uma visita guiada», «uma festa ou tradição», «um passeio de carro» e «um momento de fé». Estão em primeiro lugar porque são a nossa ferramenta. Mas as outras 26 não precisam de equipamento nenhum. ## 2. Calendário de dias mundiais da saúde O Dia Mundial da Doença de Alzheimer, o Dia Mundial da Saúde Mental, o Dia Mundial dos Cuidados Paliativos, o Dia Internacional da Pessoa Idosa, o Dia Mundial da Criança. São datas que as equipas querem assinalar, e que costumam ser lembradas na véspera. O [calendário](/ferramentas/dias-mundiais/) reúne 37 dias, de outubro de 2026 a outubro de 2027, cada um com uma ideia de atividade concreta. Filtra-se por tema (envelhecimento, saúde mental, crianças e jovens, doença e prevenção, cuidar, música e dança), e o próximo dia aparece sempre em destaque, com a contagem dos dias que faltam. Cada dia tem um botão para a agenda, e há outro para pôr todos de uma vez. O ficheiro abre no Google Calendar e no Outlook, e é gerado no próprio browser. ## 3. Ficha de história de vida A [ficha de história de vida](/ferramentas/historia-de-vida/) é a ferramenta de que mais gostamos, porque é o ponto de partida de tudo o resto. Preenche-se com o utente e com quem o conhece bem: como gosta de ser chamado, de onde vem, o trabalho que fez, as pessoas importantes, as músicas, as comidas, os lugares, as rotinas, o que acalma e o que incomoda. Tem duas versões: uma para adultos e pessoas mais velhas, e outra para crianças e jovens, com escola, amigos, passatempos e «o que ajuda quando tem medo». Esta é a única ferramenta que não guarda nada, nem no próprio browser. São dados pessoais num computador que, numa instituição, é quase sempre partilhado. Preenche-se, imprime-se ou guarda-se em PDF, e a ficha fica com a instituição, que é quem responde por ela à luz do RGPD. Com o Headset RVer, a ficha tem um uso direto: a pessoa nasceu na Nazaré, e a equipa pode levá-la ao mar. ## 4. Planeador semanal O [planeador semanal](/ferramentas/planeador-semanal/) monta a semana de atividades um dia de cada vez. Toca-se no dia, depois na manhã ou na tarde, e depois nas atividades: as do gerador, com a Sessão RVer em destaque. Também se pode arrastar, para mudar a ordem, para passar uma atividade da manhã para a tarde, ou da lista diretamente para o dia. Há um botão para repetir um dia de segunda a sexta, que é como muitas semanas se constroem. A semana fica guardada no browser (não tem dados pessoais), e ao imprimir sai a semana inteira numa tabela, pronta a afixar. ## 5. Checklist de higiene A [checklist de higiene](/ferramentas/higiene/) é para o equipamento que passa de mão em mão: Headset RVer, tablets e auscultadores. Para cada um, os passos de antes de começar, entre utentes e no fim do dia, com caixas para ir marcando. Com a opção «utente imunodeprimido» acrescentam-se os passos extra, como a capa individual ou o equipamento acabado de limpar. No Headset RVer há duas regras que vêm do fabricante e que vale a pena ter afixadas: as lentes limpam-se só com um pano de microfibra seco, sem líquidos nem álcool, e o equipamento nunca fica ao sol. A checklist não substitui o protocolo da instituição: o produto de limpeza é o aprovado pela Comissão de Controlo de Infeção, e em caso de dúvida é esse protocolo que manda. ## O que estas ferramentas não fazem Nenhuma destas ferramentas avalia, mede ou diagnostica. Não há escalas, pontuações nem registos clínicos. São apoio à organização do trabalho da equipa, e não substituem orientação clínica nem o plano individual de cuidados. ## E o RVer? As ferramentas são gratuitas e continuam a ser, use-se ou não o RVer. Mas foram feitas por quem faz o RVer, e ligam-se a ele com naturalidade: a ficha diz onde a pessoa cresceu, o calendário dá o tema, o planeador marca a hora, a checklist prepara o headset. O resto é a sessão, com a equipa ao lado. Falta uma ferramenta à sua equipa? [Diga-nos](mailto:hi@rver.pt?subject=Sugest%C3%A3o%20de%20ferramenta). As próximas vão sair das sugestões de quem está no terreno. Q: As ferramentas são mesmo gratuitas? A: Sim. Não pedem registo, email nem conta, e não têm versão paga. Continuam gratuitas use-se ou não o RVer. Q: O que escrevo nas ferramentas fica guardado em algum sítio? A: Não sai do computador. A ficha de história de vida não guarda nada, nem no browser: imprime-se ou guarda-se em PDF. O planeador guarda a semana só no próprio browser, e não tem dados pessoais. Q: Preciso do RVer para usar as ferramentas? A: Não. Das 35 atividades do gerador, nove são sessões RVer, e o calendário, a ficha, o planeador e a checklist servem qualquer equipa. Q: Para que idades servem? A: Para utentes dos 10 aos 100 anos, em lares, centros de dia, internamento, pediatria, saúde mental, cuidados paliativos e reabilitação. O gerador e a ficha têm adaptações para crianças e jovens. ### Quando é a câmara municipal a levar a realidade virtual às instituições do concelho URL: https://rver.pt/blog/camaras-municipais-realidade-virtual-instituicoes-do-concelho/ Date: 2 October 2026 Um lar com vinte camas raramente contrata tecnologia sozinho. Uma câmara municipal pode fazê-lo pelo concelho inteiro, e o formato é mais simples do que parece. A maior parte das instituições que cuidam de pessoas idosas num concelho são pequenas. Um lar com vinte camas, um centro de dia, um serviço de apoio domiciliário. Têm equipas dedicadas e orçamentos contados, e raramente têm alguém cujo trabalho seja avaliar tecnologia. É por isso que a pergunta "e se fosse a câmara?" aparece cada vez mais nas nossas conversas. Uma câmara municipal pode contratar pelo concelho aquilo que cada instituição, sozinha, dificilmente contrataria. ## O que já é papel da câmara A câmara não parte do zero. Desde o [Decreto-Lei n.º 55/2020](https://diariodarepublica.pt/dr/detalhe/decreto-lei/55-2020-140087205), os municípios têm competências próprias na ação social: elaboram a carta social municipal, dão parecer sobre a criação de equipamentos sociais com apoio público, e desenvolvem programas de conforto habitacional para pessoas idosas. E coordenam a Rede Social do concelho, onde as instituições já se sentam à mesma mesa. Ou seja, a câmara já sabe quantas instituições tem, onde estão e o que lhes falta. Falta-lhe, muitas vezes, uma resposta concreta para o tempo que as pessoas passam sem nada para fazer. ## Como funciona o formato - **A câmara contrata, as instituições usam.** A licença é da câmara; cada instituição aderente recebe o seu equipamento e começa a usá-lo com a sua equipa. - **Ninguém compra hardware.** [Os equipamentos são nossos](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/) e vão incluídos na licença. Se um avaria, é substituído; se o concelho precisa de mais, juntam-se mais. - **Onde fica cada equipamento decide-se com as instituições.** Quem regista as sessões guarda os dados de cada utente cifrados no próprio equipamento, sem internet, e aí o equipamento fica nessa instituição: a circular, misturava dados de pessoas diferentes. Muitas instituições usam os headsets sem registar nada, para o utente relaxar ou se sentir bem, e nesse caso o mesmo equipamento pode servir mais do que uma. - **Tudo o resto vem incluído.** Sessões sem limite, a biblioteca de cenários, a app de gestão para a equipa, formação e suporte. ## Quem vê os dados A câmara não vê dados de utentes. Quando a instituição regista as sessões, quem esteve, o que viu e quanto tempo esteve fica na instituição que cuida da pessoa, cifrado no equipamento. É a mesma regra que se aplica quando é a própria instituição a contratar, e não muda por o contrato ser municipal. ## O que o formato não resolve - **Não substitui a equipa.** Cada sessão precisa de um profissional ao lado. Uma instituição sem ninguém disponível para isso não vai usar o equipamento, seja quem for que o pague. - **Não é uma compra de um dia.** A licença é anual. Convém que caiba no orçamento de mais do que um ano, para as instituições não começarem uma rotina que acaba em dezembro. - **Não dispensa a contratação pública.** A câmara contrata por procedimento público, como para qualquer outro serviço. Escrevemos sobre [o que pôr num caderno de encargos](/blog/caderno-de-encargos-realidade-virtual-saude/) e sobre [comprar tecnologia de saúde a uma empresa pequena](/blog/comprar-tecnologia-de-saude-a-uma-empresa-pequena/). ## Por onde começar 1. **Perguntar às instituições.** Quais querem, e quem, em cada uma, vai conduzir as sessões. Sem esta resposta, o resto não interessa. 2. **Começar por poucas.** Três ou quatro instituições com equipa disponível valem mais do que vinte com o equipamento numa gaveta. 3. **Decidir onde fica cada equipamento.** Em que instituição e, dentro dela, em que serviço. 4. **Falar connosco com esse mapa.** A proposta desenha-se a partir dele: quantas instituições, quantos equipamentos, que serviços. :::note O RVer é um complemento não farmacológico, usado sob supervisão de profissionais. Não substitui cuidados de saúde, avaliação clínica nem qualquer terapêutica prescrita. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Q: A câmara municipal compra os equipamentos? A: Não. Os equipamentos são da RVer e vão incluídos na licença. A câmara contrata a licença e as instituições do concelho usam os equipamentos. Q: A câmara tem acesso aos dados dos utentes? A: Não. Quando a instituição regista as sessões, os dados de cada utente ficam cifrados no equipamento, na instituição que cuida da pessoa. O contrato ser municipal não muda isso. Q: Quanto custa para um concelho? A: Depende de quantas instituições aderem e de quantos equipamentos são precisos. O preço é sob consulta e a proposta é desenhada a partir desse mapa. ### Há pessoas que não podemos mostrar URL: https://rver.pt/blog/ha-pessoas-que-nao-podemos-mostrar/ Date: 2 October 2026 Fizemos um filme sobre o RVer. Tem dois minutos, abre a preto e não mostra nenhum utente. Não é por falta de imagens nem por pudor estético: é a regra com que trabalhamos, e decidimos fazer dela o filme. :::filme ## Porque não aparece nenhum utente Quem usa o RVer está, quase sempre, num momento frágil. Um residente num lar, uma pessoa em cuidados paliativos, alguém a meio de um tratamento que custa. Uma imagem dessa pessoa com o equipamento na cabeça diz muito mais do que «esteve aqui»: diz onde está, em que estado, porquê. Isso é informação de saúde, e o RGPD trata-a como uma categoria especial, com razão. Podíamos procurar consentimentos, escolher ângulos, desfocar caras. Preferimos não o fazer. A dignidade de quem está do outro lado não é um obstáculo à comunicação de uma empresa de saúde: é o ponto de partida. Por isso o filme começa exatamente aí: > *Há pessoas que não podemos mostrar.* > *E é exatamente assim que deve ser.* ## O que mostramos em vez disso > *Mas podemos mostrar-lhe o que experienciam.* Se não podemos mostrar quem usa, podemos mostrar o que vê. O resto do filme são os cenários da biblioteca base do RVer, filmados por nós em 360°: a procissão de 13 de Maio em Fátima, a praia ao fim do dia, um passeio de carro, as Fragas de São Simão, os moliceiros em Aveiro, a vindima, uma atuação de música popular. As imagens aparecem esticadas, curvadas nas pontas. Não é defeito: é o formato de um vídeo 360° quando se abre num ecrã plano — à frente ao centro, atrás nas extremidades. Deixámo-las assim de propósito, para se perceber que aquilo não é um enquadramento escolhido por nós: é o lugar inteiro à volta de quem tem o equipamento posto. Um lugar que conhecem. Um lugar de que se lembram. Às vezes, um lugar onde nunca poderiam estar. ## A pessoa de silhueta No início e no fim do filme há uma figura em contraluz. É uma pessoa amiga da equipa, não um utente, e não lhe dizemos o nome. Não por segredo: porque o nome não interessa. Está ali no lugar de todas as pessoas que não podemos mostrar, e o filme só funciona se puder ser qualquer uma delas. ## Não é sobre a tecnologia > *Para nós, é tecnologia. Para eles, é uma experiência.* É fácil fazer um vídeo sobre realidade virtual que é, na verdade, um vídeo sobre headsets: o equipamento, os ecrãs, os números. Este não é sobre o utente nem sobre a tecnologia. É sobre o que a tecnologia provoca em quem a usa: voltar a um sítio conhecido, chegar a um onde já não se consegue ir, ou simplesmente estar noutro lado durante uns minutos. O equipamento, o backoffice, a supervisão clínica e o resto do sistema existem para que isso aconteça com segurança. Mas não são o que fica na memória de quem vive a sessão, e por isso também não são o filme. ## Para que serve - **Palestras e congressos.** Para abrir uma apresentação antes de falarmos do sistema, numa sala escura, com som. - **Comunicação institucional.** É o filme da marca: está nesta página, na página *Sobre* e na sala de imprensa. - **Jornalistas e meios digitais.** Há algum tempo que nos pedem um vídeo nosso para acompanhar artigos. Aqui está. Se precisar dele em 4K, peça-nos. ## Como foi feito Foi filmado e montado pela equipa do RVer. As imagens 360° são as mesmas que os utentes veem na biblioteca base. Existe em português e em inglês, e tem dois minutos. Q: Porque é que o filme não mostra utentes a usar o RVer? A: Porque uma imagem de alguém em contexto de cuidados revela informação de saúde, e a privacidade e a dignidade dessa pessoa vêm primeiro. Escolhemos mostrar o que os utentes veem, não quem são. Q: As imagens do filme são as que os utentes veem? A: Sim. São cenários da biblioteca base do RVer, filmados em 360°. Aparecem no formato esticado de propósito, para se ver o lugar inteiro de uma vez. Q: Posso usar o filme numa apresentação ou num artigo? A: Pode. Peça-nos por email, diga-nos onde vai ser usado, e enviamos a versão em 4K. ### Sala Snoezelen e realidade virtual: como as duas cabem na mesma sala URL: https://rver.pt/blog/sala-snoezelen-e-realidade-virtual-na-mesma-sala/ Date: 1 October 2026 Em agosto comparámos as duas como se fosse preciso escolher. Numa reunião recente, a pergunta veio ao contrário: e se a realidade virtual entrar na sala que já existe? Em agosto escrevemos sobre [sala Snoezelen ou realidade virtual](/blog/sala-snoezelen-ou-realidade-virtual-lares/), a pensar em quem ainda não tem nenhuma das duas. A conclusão já apontava para aqui: muitas instituições acabam por usar as duas. Numa reunião recente, a pergunta chegou ao contrário. A instituição já tem a sala, já tem a equipa habituada a usá-la, e quer saber se a realidade virtual entra lá dentro ou fica à porta. Entra, e há uma forma de o fazer que respeita o que a sala já faz bem. ## De onde vem a sala Snoezelen O conceito nasceu nos Países Baixos no fim dos anos 70, com Jan Hulsegge e Ad Verheul, num centro para pessoas com deficiência intelectual. O nome junta duas palavras neerlandesas: *snuffelen*, explorar, e *doezelen*, dormitar. A ideia era um espaço sem objetivo de desempenho, onde a pessoa explora e acalma ao seu ritmo, sempre acompanhada. Com os anos, a sala passou para lares, centros de dia e unidades de cuidados continuados. O princípio manteve-se: luz, som, textura e cheiro controlados, e alguém ao lado. ## O que a sala dá à sessão de realidade virtual Uma sessão de realidade virtual pede quase as mesmas condições que uma sala Snoezelen já oferece: - **Um sítio calmo.** Luz baixa, pouca passagem de pessoas, nada de campainhas a meio. A pessoa não é interrompida. - **Uma rotina.** Quem frequenta a sala já sabe que ali se faz uma pausa. O headset entra numa rotina que existe, em vez de criar uma nova. - **Um lugar sentado e confortável.** As sessões fazem-se sentado, e as salas costumam ter os melhores cadeirões da casa. - **Uma equipa que acompanha sem pressa.** Quem conduz a sala já sabe observar a pessoa e parar quando é preciso. É exatamente o que uma sessão com headset pede. ## O que o headset acrescenta à sala A sala tem luz, som e textura. Não tem lugares. Uma praia, a aldeia onde a pessoa cresceu, o [santuário de Fátima](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/): isso é o que a realidade virtual traz para dentro da sala. E traz mais duas coisas que a sala não tem: - **Muda de ambiente sem obras.** O cenário de hoje não tem de ser o de amanhã. - **Pode deixar registo.** Se a instituição quiser, fica escrito o que foi feito, com quem e durante quanto tempo. O headset não fica preso à sala. Quem não consegue lá chegar, porque está acamado ou não sai do quarto, continua a poder ter a sessão onde está. ## Como montar, na prática - **Um canto, não a sala inteira.** Um cadeirão afastado das colunas de bolhas e dos objetos pendurados, para a pessoa poder mexer a cabeça à vontade. - **O som da sala baixa.** O headset tem o seu próprio som ambiente. Dois sons ao mesmo tempo confundem mais do que acalmam. - **Luz baixa, mas não escuro.** A pessoa com o headset não vê a sala; quem acompanha precisa de ver a pessoa. - **Um estímulo de cada vez.** Nada de headset em cima de uma cadeira vibratória ou de uma cama de água. Se a pessoa reage, a equipa tem de saber a quê. - **A sala serve para chegar e para sair.** Uns minutos na sala antes de pôr o headset, e uns minutos depois de o tirar. Voltar de um cenário para uma sala de luz suave é diferente de voltar para um corredor. - **Uma pessoa no headset, as outras na sala.** A realidade virtual é individual. Enquanto uma pessoa está no cenário, as outras continuam com o resto da sala, e a equipa acompanha a sessão no telemóvel ou no tablet. ## Onde não resulta - **Quem não tolera nada na cabeça.** Para essa pessoa, fica a sala, e está bem assim. - **Sessões de grupo.** A sala é partilhável, o headset não. Se a sala é sobretudo usada em grupo, o headset encaixa antes ou depois, não durante. - **Uma sala sempre ocupada.** Se já há fila para a sala, pôr lá o headset só aumenta a fila. Nesse caso, o headset rende mais onde a pessoa está. :::note Nenhuma das duas é um tratamento. São ambientes de conforto e estimulação, usados sob supervisão de quem cuida. Não substituem avaliação clínica nem qualquer terapêutica prescrita, e a decisão sobre o plano de cuidados é sempre da equipa. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Sobre como encaixar as sessões na semana, ver [plano de atividades num lar](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). Sobre quem consegue usar o equipamento, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Q: Pode usar-se a realidade virtual dentro de uma sala Snoezelen? A: Sim. Funciona bem num canto da sala, com a pessoa sentada, o som da sala baixo e um estímulo de cada vez. A sessão é sempre acompanhada por alguém da equipa. Q: Se já temos a sala, ainda faz sentido ter realidade virtual? A: Faz, porque fazem coisas diferentes. A sala dá toque, movimento e partilha; o headset dá lugares e pode deixar registo da sessão. E o headset continua a poder ir ao quarto de quem não chega à sala. Q: Quem tem de estar presente durante a sessão? A: Um profissional da equipa, ao lado da pessoa, do princípio ao fim. É a mesma regra da sala Snoezelen. ### Dia Mundial da Saúde Mental 2026: ouvir quem vive a experiência URL: https://rver.pt/blog/dia-mundial-saude-mental-2026-ouvir-quem-vive/ Date: 30 September 2026 O tema de 2026 lê-se depressa como slogan. Lido devagar, diz uma coisa prática: ouvir é perguntar, escrever o que a pessoa disse e deixar que isso mude a sessão seguinte. A 10 de outubro assinala-se o Dia Mundial da Saúde Mental. A Federação Mundial para a Saúde Mental escolheu para 2026 o tema *Lived Experiences Heard: Real Voices, Real Change*: experiências vividas, ouvidas; vozes reais, mudança real. Pede também que as iniciativas do dia apoiem o trabalho da Organização Mundial da Saúde sobre desinstitucionalização. É um tema que se lê depressa como slogan. Vale a pena lê-lo devagar, porque tem uma consequência prática para qualquer serviço: ouvir não é perguntar uma vez. É perguntar, escrever o que a pessoa disse, e deixar que isso mude o que se faz a seguir. ## Ouvir começa antes da sessão Numa atividade não farmacológica, a primeira pergunta é a mais simples e a que mais vezes se salta: o que é que esta pessoa quer? Não o que costuma resultar com os outros residentes, nem o que a equipa acha calmante. Num sistema de realidade virtual, como o que se usa em [lares e ERPI](/solucoes/lar-residencial/), isto tem uma forma concreta: quem escolhe o cenário. Se for sempre a equipa, a sessão é uma atividade feita à pessoa. Se for a pessoa, ou alguém que a conhece bem (a [ficha de história de vida](/ferramentas/historia-de-vida/) ajuda), é uma atividade feita com ela. Escrevemos sobre como se escolhe em [atividade significativa: como se escolhe um cenário](/blog/atividade-significativa-como-se-escolhe-um-cenario/). ## Ouvir durante: parar quando a pessoa quer A sessão acaba quando a pessoa quer que acabe, e não quando o cenário termina. Parece óbvio. Na prática exige que quem acompanha esteja a olhar para a pessoa e não para o ecrã, e que parar a meio não seja visto como uma falha. ## Ouvir depois: escrever as palavras dela, não as nossas É aqui que o tema do dia se torna verificável. Depois de uma sessão, o que fica escrito? - Uma nota útil regista o que a pessoa disse e fez: «Pediu o mar. Falou da Nazaré e do pai. Quis repetir amanhã.» - Uma nota inútil diz «realizada sessão». - Uma nota que não se deve escrever tira conclusões que ninguém mediu: «a sessão reduziu a ansiedade». O equipamento não avalia nem mede estados emocionais. O que regista é operacional: o que foi reproduzido, quando, durante quanto tempo, se foi interrompido. As palavras da pessoa só ficam se alguém as escrever. Explicámos como em [«A sessão e o processo clínico do doente»](/blog/a-sessao-e-o-processo-clinico-do-doente/). ## Ouvir tem de mudar alguma coisa A segunda metade do tema, «mudança real», é a que se esquece. Se a pessoa disse que o mar a aborrece e na semana seguinte volta a ter praia, foi ouvida e ninguém fez nada com isso. Uma regra simples para a equipa: antes de cada sessão, ler a nota da anterior. ## O que isto não é Uma sessão de conforto em realidade virtual não é psicoterapia, e não deve ser apresentada como tal. A diferença, e porque importa, está em [realidade virtual e saúde mental: duas coisas diferentes](/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/). O lugar do não farmacológico no sistema português ficou escrito em [saúde mental em Portugal](/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/). O mesmo 10 de outubro é o [Dia Mundial dos Cuidados Paliativos](/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/), este ano dedicado à dor. ## Em resumo - O tema de 2026 é ouvir quem vive a experiência, e fazer alguma coisa com isso. - Ouvir começa na escolha: quem escolhe o cenário? - A sessão acaba quando a pessoa quer. - Escreva as palavras da pessoa, não conclusões que ninguém mediu. - Leia a nota anterior antes da sessão seguinte. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, tratamento ou acompanhamento clínico. Q: Quando é o Dia Mundial da Saúde Mental 2026? A: A 10 de outubro de 2026, um sábado. É promovido pela Federação Mundial para a Saúde Mental. Q: Qual é o tema do Dia Mundial da Saúde Mental 2026? A: «Lived Experiences Heard: Real Voices, Real Change», escolhido pela Federação Mundial para a Saúde Mental: ouvir as pessoas com experiência vivida e deixar que isso mude a forma como os serviços funcionam. Q: A realidade virtual trata problemas de saúde mental? A: O RVer não. É um sistema de conforto e atividade significativa, conduzido pela equipa da instituição, que complementa os cuidados. Não é psicoterapia nem terapia de exposição. ### Dia Mundial dos Cuidados Paliativos 2026: a dor é o tema URL: https://rver.pt/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/ Date: 30 September 2026 O tema de 2026 é a dor, tratada no seu todo. É a ideia de dor total, e ajuda a perceber onde entra, e onde não entra, uma intervenção não farmacológica. O Dia Mundial dos Cuidados Paliativos celebra-se no segundo sábado de outubro: em 2026, a 10 de outubro, o mesmo dia do Dia Mundial da Saúde Mental. A Worldwide Hospice Palliative Care Alliance escolheu como tema *Pain Management: An Essential Part of Palliative Care*, a gestão da dor como parte essencial dos cuidados paliativos. A aliança justifica a escolha com a dor tratada no seu todo: física, psicológica, social e espiritual. É uma ideia com mais de meio século, e continua a ser a mais útil para pensar o tema. ## A dor total O conceito de dor total vem de Cicely Saunders, fundadora do movimento moderno dos cuidados paliativos. Numa doença grave, a dor raramente é só física: junta-se o medo, a solidão, as contas por resolver, as perguntas sobre sentido. As componentes interagem, e tratar uma deixando as outras de lado deixa o doente com dor. Para uma equipa, a consequência prática é que a pergunta «tem dores?» é necessária e insuficiente. ## As quatro componentes, na prática Uma avaliação que só usa a [escala numérica da dor](/glossario/escala-numerica-da-dor/) mede a primeira. As outras três pedem outras perguntas: - **Física**: a intensidade, onde dói, o que alivia e o que piora. É a parte que as escalas captam. - **Psicológica**: o medo do que vem, a ansiedade, a sensação de perder o controlo. - **Social**: a família longe, o isolamento, o papel que a pessoa deixou de ter em casa. - **Espiritual**: as perguntas sobre sentido, o que ficou por dizer, as despedidas. Ninguém responde às quatro sozinho. É por isso que os cuidados paliativos são trabalho de equipa, e que o tema deste ano pede que a dor se veja no seu todo. ## Onde entra o não farmacológico, e onde não entra O controlo da dor física é farmacológico e é da equipa médica. Nada do que vem a seguir o substitui ou altera. O não farmacológico entra ao lado, e é aí que uma sessão de realidade virtual pode ajudar a gerir alguns momentos: - **Momentos de dor previsível**, como mobilizações ou pensos, em que a distração imersiva é uma das ferramentas estudadas. O mecanismo está em [realidade virtual na gestão da dor](/blog/realidade-virtual-gestao-da-dor/). - **A componente social**: a família que não pode estar. A chamada de família permite a quem está longe ver o que o doente vê e falar com ele. Escrevemos sobre isso em [videochamadas com a família](/blog/videochamadas-familia-realidade-virtual/). - **A componente biográfica e espiritual**: voltar a um sítio que conta. Não é por acaso que [o destino mais pedido é Fátima](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/). O que isto não é: não é analgesia, não é controlo de sintomas e não se apresenta como tal. Quem decide se faz sentido, e quando, é a equipa que segue o doente. Os estudos publicados sobre realidade virtual em cuidados paliativos estão reunidos em [estudos: cuidados paliativos](/estudos/tema/paliativos/). ## Uma sessão curta, que para quando a pessoa quer Em cuidados paliativos o tempo é curto e conhecido. A sessão faz-se deitado, se for preciso, dura o que a pessoa quiser e acaba a pedido dela. Com quem já não comunica, a decisão é da equipa e da família: ver [doente que já não comunica: vale a pena a sessão?](/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/). ## Três perguntas para a equipa, no dia 10 - Na última avaliação de dor, perguntámos pelas outras três componentes, ou só pela física? - O que é que acalma esta pessoa, e está escrito num sítio que o próximo turno leia? - Há alguém da família que queria estar e não pode? ## Em resumo - 10 de outubro de 2026: o tema é a gestão da dor como parte essencial dos cuidados paliativos. - A dor total tem quatro componentes: física, psicológica, social e espiritual. - O controlo da dor física é farmacológico e da equipa médica. - O não farmacológico entra ao lado: distração em momentos previsíveis, a família, os lugares que contam. - A sessão para quando a pessoa quer. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, tratamento ou acompanhamento clínico. Q: Quando é o Dia Mundial dos Cuidados Paliativos 2026? A: A 10 de outubro de 2026. Celebra-se no segundo sábado de outubro, por iniciativa da Worldwide Hospice Palliative Care Alliance. Q: Qual é o tema do Dia Mundial dos Cuidados Paliativos 2026? A: «Pain Management: An Essential Part of Palliative Care»: a gestão da dor como parte essencial dos cuidados paliativos, nas suas componentes física, psicológica, social e espiritual. Q: O que é a dor total? A: Um conceito de Cicely Saunders: numa doença grave, a dor junta componentes físicas, psicológicas, sociais e espirituais, que interagem entre si. Q: A realidade virtual substitui a medicação para a dor? A: Não. O controlo da dor física é farmacológico e da equipa médica. O RVer é uma intervenção não farmacológica que complementa os cuidados e não altera o plano terapêutico. ### Vidas mais longas pedem outros sistemas: o Dia das Pessoas Idosas 2026 URL: https://rver.pt/blog/dia-das-pessoas-idosas-2026-vidas-longas-pedem-outros-sistemas/ Date: 30 September 2026 Ganhámos anos de vida. A pergunta que o tema deste ano faz é o que fazemos com eles. Amanhã, 1 de outubro, é o Dia Internacional das Pessoas Idosas. Em 2026 a ONU escolheu como tema **«a era da longevidade: repensar os sistemas para vidas mais longas»**: como é que a saúde, a proteção social, a habitação e as finanças se adaptam a pessoas que vivem muito mais tempo. É um tema de ministérios e de organizações internacionais. Mas os sistemas também existem numa escala mais pequena: a de um lar, de um centro de dia, de uma unidade de cuidados continuados. ## O sistema às três da tarde Um lar tem sistemas para quase tudo: para a medicação, para as refeições, para a higiene, para as quedas. Estão escritos, têm horários, têm responsáveis. O que costuma não ter sistema é a tarde. Entre o almoço e o lanche há horas que ficam por conta do que houver: da animadora, se estiver, da televisão, se não estiver. Numa vida mais longa, essas horas somam anos. ## Repensar não é comprar A tentação, quando se fala em repensar sistemas, é procurar uma tecnologia que resolva. Não resolve. Nenhum equipamento substitui uma equipa com tempo, nem uma família presente. O que uma tecnologia pode fazer é encaixar num sistema que já existe: uma sessão marcada na semana, conduzida por quem conhece a pessoa, com um registo do que aconteceu. Sem isso, é mais um aparelho numa gaveta. ## Onde entra o RVer O RVer foi desenhado para esse encaixe, e não para ser a peça principal. A instituição não compra equipamento: contrata um serviço, e [os equipamentos continuam a ser nossos](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/). A equipa clínica conduz as sessões. O conteúdo é escolhido para uso clínico, e o que acontece fica registado. É uma atividade complementar, não farmacológica. Não acrescenta anos a ninguém. Pode acrescentar alguma coisa a algumas tardes: um sítio conhecido, uma memória, vinte minutos que não são iguais aos outros. ## Uma pergunta para amanhã Se quiser assinalar o dia de forma útil, faça na sua instituição a pergunta que o tema da ONU faz aos governos, em ponto pequeno: «o nosso sistema está pensado para quem cá vive dez anos, ou só para quem cá passa dez dias?» Q: Qual é o tema do Dia Internacional das Pessoas Idosas de 2026? A: «A era da longevidade: repensar os sistemas para vidas mais longas», definido pela ONU (UN DESA). Q: O RVer substitui atividades feitas pela equipa? A: Não. É uma atividade complementar que encaixa no plano da instituição e é conduzida pela equipa clínica. ### Dia do Coração: numa sessão de realidade virtual, os sinais que não se veem URL: https://rver.pt/blog/dia-mundial-do-coracao-os-sinais-que-nao-se-veem/ Date: 29 September 2026 Com o headset posto, a pessoa não vê quem está na sala. E quem está na sala deixa de lhe ver os olhos. O Dia Mundial do Coração assinala-se a 29 de setembro. Em 2026, a Federação Mundial do Coração continua a campanha **«Don't Miss a Beat»**, dedicada a reconhecer os sintomas de doença cardiovascular que passam despercebidos. Não temos nada a dizer sobre o coração: a realidade virtual não é uma intervenção cardíaca, e não fazemos alegações nesse sentido. Mas a ideia da campanha aplica-se a uma coisa que conhecemos bem: numa sessão de realidade virtual, os sinais mais importantes são os que não se veem à primeira. ## O que o headset esconde Numa conversa normal, percebe-se como alguém está pelos olhos. Com um headset de realidade virtual, os olhos ficam tapados. A pessoa também não vê quem está com ela, e pode não perceber que pode interromper. Isto muda o trabalho de quem acompanha. Deixa de se poder confiar no olhar, e passa a ser preciso ler o resto. ## Os sinais que contam **A respiração.** Se acelera, se fica presa, se muda de ritmo de repente. **As mãos.** Mãos que agarram o lençol ou o braço da cadeira dizem mais do que qualquer resposta a «está tudo bem?». **A postura.** Um corpo que se encolhe, que recua, que fica rígido. **A pele.** Palidez, suor, um rubor que não estava lá. **O silêncio.** Uma pessoa que falava e deixa de falar pode estar tranquila, ou pode estar a aguentar. Nenhum destes sinais pede diagnóstico. Pedem uma coisa só: parar, tirar o headset com calma e perguntar. ## A regra é parar primeiro Na dúvida, a sessão para. Retomar é fácil; recuperar a confiança de alguém que se sentiu mal e não foi ouvido é muito mais difícil. É também por isso que a escolha do conteúdo é da equipa clínica. Para quem tem uma condição cardíaca, ou qualquer outra condição que a equipa considere relevante, há cenários que fazem mais sentido do que outros: mais calmos, mais lentos, sem alturas nem velocidade. A decisão é clínica, caso a caso. ## Não perder um batimento A campanha pede que não se ignorem sinais pequenos. Numa sessão, é exatamente o mesmo pedido: estar na sala a sério, a olhar para a pessoa e não para o ecrã. Q: A realidade virtual é uma intervenção cardíaca? A: Não. O RVer é uma atividade complementar e não farmacológica. Não fazemos alegações sobre efeitos no coração. Q: O que se faz se a pessoa mostrar sinais de mal-estar durante a sessão? A: Para-se. Tira-se o headset com calma e pergunta-se como está. Na dúvida, a sessão para sempre. ### Dia do Acesso à Informação: o que a família pode saber sobre uma sessão URL: https://rver.pt/blog/acesso-a-informacao-o-que-a-familia-pode-saber-da-sessao/ Date: 28 September 2026 «O que é que a minha mãe viu hoje?» É uma pergunta simples. Merece uma resposta que não seja «não sei». O Dia Internacional do Acesso Universal à Informação assinala-se a 28 de setembro. É um dia da UNESCO, pensado para o direito de cada pessoa a saber o que lhe diz respeito. Numa instituição de saúde, esse direito tem uma forma muito concreta. Um filho chega ao lar ao fim da tarde e pergunta: «o que é que a minha mãe fez hoje?». Se a mãe teve uma sessão de realidade virtual, a resposta devia ser mais do que «esteve com o headset». ## O que fica registado No RVer, cada sessão deixa um registo: quando aconteceu, quanto tempo durou e o que foi visto. É informação simples, e é essa a ideia. O registo **não avalia a pessoa, não lhe dá uma nota e não faz diagnósticos**. Diz o que aconteceu, não o que significa. A leitura clínica (se a sessão correu bem, se vale a pena repetir) é da equipa, que estava na sala. ## Explicar sem prometer A tentação, ao falar com uma família, é enfeitar. «Fez-lhe muito bem», «ficou outra pessoa». Às vezes é verdade no momento. Mas uma frase dessas, repetida, transforma uma atividade numa promessa de resultado. O que se pode dizer com segurança é mais útil: onde a pessoa «esteve», quanto tempo, como reagiu enquanto a equipa observava. «Pediu para ver o mar outra vez» diz mais a um filho do que «fez-lhe bem». ## Quem pode ver o quê Os dados de uma sessão dizem respeito à pessoa que a fez. O acesso segue as mesmas regras de qualquer outra informação de saúde da instituição: a própria pessoa, ou quem a representa legalmente, tem direito a saber o que está registado sobre si, nos termos do RGPD. O que a instituição decide é o circuito: quem da equipa consulta os registos e como se partilha a informação com a família. Vale a pena decidi-lo antes da primeira pergunta, e não no momento em que ela é feita. ## Uma regra simples Se a família pergunta, responde-se. Com o que aconteceu, dito com clareza, sem esconder e sem enfeitar. É isso, no fundo, o acesso à informação: não é um formulário, é uma conversa honesta ao fim da tarde. Q: O que fica registado numa sessão do RVer? A: Quando aconteceu, quanto tempo durou e o que foi visto. O registo não avalia, não pontua e não diagnostica. Q: A família pode aceder ao registo? A: O acesso segue as regras de qualquer informação de saúde da instituição e do RGPD: a pessoa, ou o seu representante legal, tem direito a saber o que está registado sobre si. ### Dia Mundial do Turismo: o destino mais pedido é Fátima URL: https://rver.pt/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/ Date: 27 September 2026 A ONU Turismo escolheu o digital para tema deste ano. Há pessoas para quem ele é a única forma de viajar que resta. O Dia Mundial do Turismo assinala-se a 27 de setembro. Em 2026, a ONU Turismo escolheu como tema a **agenda digital e a inteligência artificial** ao serviço do turismo, e El Salvador é o país anfitrião. Fala-se de reservas automáticas, de guias virtuais, de roteiros feitos por algoritmos. É o turismo de quem ainda viaja, a ficar mais digital. Há pessoas para quem o digital não é uma tendência. É a única forma de viajar que lhes resta. ## Quem não pode ir Uma pessoa acamada, uma pessoa internada há semanas, alguém num lar que já não consegue fazer uma viagem de carro. O turismo, para elas, acabou, não por falta de vontade, mas porque o corpo deixou de acompanhar. Para estas pessoas, uma sessão de realidade virtual pode levar a um sítio durante vinte minutos. Não é o mesmo que ir. Nunca vamos dizer que é. ## O destino mais pedido Quando os Cuidados Paliativos de Leiria começaram a usar o sistema, a [SIC foi ver](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) e contou qual era o lugar mais pedido. Era Fátima. Não era uma praia tropical, nem Paris, nem uma montanha nevada. Era um sítio a meia hora de Leiria, que muitas daquelas pessoas já tinham visitado dezenas de vezes. ## O que isto diz sobre viajar O turismo de catálogo vende o novo: o sítio onde nunca se esteve. No fim da vida, a vontade costuma ir no sentido contrário. As pessoas pedem para voltar: à igreja onde casaram, à praia dos verões da infância, ao santuário onde se fez uma promessa. É por isso que, num contexto clínico, a escolha do cenário não se faz por ser bonito. Faz-se por ter sentido para aquela pessoa, e é a equipa, com ela, que o descobre. ## Um tema para o ano que vem Se o turismo quer ser mais digital, podia também ser mais acessível: pensar em quem já não sai de casa, ou da cama, como parte do público. Não como caridade: como viajantes a quem só mudou a forma de ir. Q: Qual é o tema do Dia Mundial do Turismo de 2026? A: A agenda digital e a inteligência artificial ao serviço do turismo. El Salvador é o país anfitrião. Q: Uma sessão de realidade virtual substitui uma viagem? A: Não. Leva a pessoa a ver um sítio durante a sessão, com a equipa presente. É uma experiência diferente, e é assim que a apresentamos. ### Dia Europeu das Línguas: a sessão fala a língua de quem está lá dentro URL: https://rver.pt/blog/dia-europeu-das-linguas-a-sessao-fala-a-lingua-do-utente/ Date: 26 September 2026 A língua de uma sessão não é a do menu. É a da pessoa que tem o headset posto. O Dia Europeu das Línguas assinala-se a 26 de setembro. Foi criado pelo Conselho da Europa para lembrar que o continente fala dezenas de línguas, e que isso é uma riqueza e não um obstáculo. Numa sessão de realidade virtual, a pergunta sobre línguas tem uma resposta menos óbvia do que parece. ## Muitos cenários não precisam de palavras Grande parte do que uma pessoa vê numa sessão não tem texto nem narração: o mar a bater nas rochas, o sino de uma igreja, um mercado cheio de gente. O som ambiente não se traduz, e não precisa. É uma vantagem prática. Um cenário sem palavras serve a mesma pessoa em Leiria ou em Fortaleza, e serve alguém que já não acompanha frases longas. ## As palavras que contam são as da equipa A parte falada de uma sessão acontece fora do headset. É a equipa que explica o que vai acontecer, que pergunta como a pessoa se sente, que diz que pode parar quando quiser. Essas frases têm de estar na língua da pessoa. Não na língua do sistema, nem na de quem instalou o equipamento, na dela. Uma instrução de segurança dita numa língua que a pessoa não domina não é uma instrução de segurança. ## Quando a primeira língua volta Quem trabalha com pessoas com demência conhece um fenómeno: alguém que viveu a vida adulta noutra língua pode voltar, com o tempo, à língua da infância. Um emigrante que falou francês durante quarenta anos pode, num lar, responder apenas em português. Quando isso acontece, a sessão acompanha. A equipa fala a língua que a pessoa entende hoje, que pode não ser a que está na ficha de admissão. ## Português dos dois lados do Atlântico Desde este mês, a RVer tem [um parceiro no Brasil](/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/). É a mesma língua, e não é a mesma língua: há palavras, sotaques e referências que mudam, e um cenário que evoca uma memória em Portugal pode não evocar nada em Fortaleza. É por isso que o plano para o Brasil inclui, a prazo, conteúdos pensados para quem vive lá. A língua não é só o que se diz. É também o que se reconhece. Q: Quando é o Dia Europeu das Línguas? A: A 26 de setembro. Foi instituído pelo Conselho da Europa. Q: Os cenários do RVer têm narração? A: Muitos não têm: são ambientes com som natural, que não precisam de tradução. A parte falada da sessão é conduzida pela equipa, na língua da pessoa. ### Dia do Farmacêutico: não-farmacológico não quer dizer contra os medicamentos URL: https://rver.pt/blog/dia-do-farmaceutico-nao-farmacologico-nao-e-contra/ Date: 25 September 2026 «Não farmacológico» descreve o que uma coisa é. Não diz que está contra os medicamentos. O Dia Mundial do Farmacêutico assinala-se a 25 de setembro. É um bom dia para desfazer uma confusão que aparece muitas vezes quando se fala de realidade virtual em saúde. Dizemos que o RVer é uma intervenção **não farmacológica** e **complementar**. Há quem ouça nisso uma crítica aos medicamentos, como se o objetivo fosse tirar comprimidos a alguém. Não é. ## Complementar quer dizer ao lado «Não farmacológico» descreve o que a coisa é: uma atividade, não uma substância. «Complementar» descreve onde fica: ao lado do plano terapêutico, não no lugar dele. Nenhuma sessão de realidade virtual justifica mudar uma prescrição. Essa decisão é médica, e continua a sê-lo. O que a sessão pode fazer é ocupar um espaço no dia da pessoa que não é ocupado pela medicação (uma atividade com sentido), sem mexer no que já está decidido. ## As perguntas do farmacêutico Quem trabalha com pessoas mais velhas conhece a polimedicação: muitas pessoas tomam vários medicamentos por dia, receitados ao longo dos anos. Alguns têm efeitos que interessam diretamente a uma sessão de realidade virtual. **Há medicamentos que dão tonturas?** Uma pessoa com tendência para tonturas pode sentir-se pior dentro do headset. A sessão faz-se sentada ou deitada, com conteúdos mais calmos, e a equipa está atenta. **Há medicamentos que dão sonolência?** Então a hora da sessão importa. Marcar para logo a seguir a uma toma que dá sono é marcar uma sessão que não vai correr bem. **Houve alterações recentes?** Uma mudança de medicação nos últimos dias é uma boa razão para a equipa olhar com mais cuidado para a sessão seguinte. Nenhuma destas perguntas é para a equipa de realidade virtual responder sozinha. São perguntas para fazer ao farmacêutico e ao médico, e é por isso que vale a pena envolvê-los. ## Um aliado, não um adversário O farmacêutico que acompanha um lar ou um serviço conhece a lista de medicação de cada pessoa melhor do que ninguém. Envolvê-lo na forma como se conduzem as sessões não é burocracia: é pôr na sala mais alguém que sabe o que pode correr mal. Q: Uma sessão de realidade virtual pode substituir medicação? A: Não. É complementar e não farmacológica. Qualquer decisão sobre medicação continua a ser médica. Q: Porque é que a medicação importa numa sessão de realidade virtual? A: Porque alguns medicamentos dão tonturas ou sonolência, o que influencia a forma e a hora da sessão. O farmacêutico e o médico são quem melhor o pode dizer. ### O outono também chega aos lares: quando o jardim fecha às cinco URL: https://rver.pt/blog/outono-nos-lares-quando-o-jardim-fecha-cedo/ Date: 24 September 2026 No verão, a tarde num lar passa-se no jardim. Em novembro, às cinco já é noite. O outono começou esta semana. Para a maior parte das pessoas é uma mudança de roupa. Num lar é uma mudança de rotina. No verão, parte da tarde passa-se lá fora: no jardim, no pátio, à porta. A partir de outubro chove mais, e em novembro às cinco já está escuro. O mundo de quem vive num lar, que já era pequeno, encolhe mais uns metros. ## O que desaparece não é só o sol Quando o jardim fecha, desaparecem coisas que ninguém tinha escrito num plano de atividades: a conversa no banco, o caminho até ao portão, ver quem passa na rua. Eram atividades sem nome, e por isso ninguém as substitui quando deixam de existir. É aqui que a expressão «atividade significativa» ganha peso. Não é ocupar tempo. É garantir que, nos meses de dentro, cada pessoa continua a ter coisas que lhe dizem respeito, e não apenas as mesmas horas de televisão na sala comum. ## Planear o inverno em setembro As equipas de animação e de terapia ocupacional sabem isto de cor. O que costuma faltar é tratá-lo como plano e não como improviso: saber, antes de começar a chover, o que vai substituir o jardim para cada pessoa. Para umas será a oficina, para outras a música, para outras a visita da família marcada ao domingo. A realidade virtual pode ser uma das opções da lista, e só isso. ## Onde a realidade virtual entra, e onde não entra Uma sessão pode levar uma pessoa ao mar numa tarde de chuva, ou ao sítio onde cresceu. [A escolha do cenário](/blog/atividade-significativa-como-se-escolhe-um-cenario/) é feita pela equipa com a pessoa, a pensar no que tem sentido para ela. O que a realidade virtual não faz é substituir a saída real quando ela é possível. Um dia de sol em dezembro continua a ser melhor passado no jardim. A sessão é para os dias em que a porta está fechada, e o outono tem muitos. ## Uma pergunta para a reunião de equipa Antes de novembro, vale a pena fazer uma pergunta simples para cada residente: «o que é que esta pessoa fazia lá fora, e o que é que vai fazer quando não puder?». A resposta é o plano de inverno. Q: A realidade virtual substitui as saídas ao exterior? A: Não. Quando sair é possível, sair é melhor. A sessão é uma opção para os dias em que não é. Q: Quem escolhe o cenário numa sessão? A: A equipa clínica, com a pessoa, a pensar no que tem significado para ela, e não num catálogo genérico. ### Esta noite há headsets novos. A sua instituição não tem de se preocupar URL: https://rver.pt/blog/meta-connect-2026-headset-novo-e-a-instituicao/ Date: 23 September 2026 Hoje à noite a Meta apresenta novidades. Amanhã alguém na sua instituição vai perguntar se o equipamento já está desatualizado. A Meta Connect 2026 decorre a 23 e 24 de setembro. A apresentação principal é hoje, às 16h da Califórnia (meia-noite em Lisboa). Espera-se falar de inteligência artificial, óculos inteligentes e realidade virtual. Não sabemos o que vai ser anunciado, e este texto não depende disso. Depende de uma pergunta que vai aparecer amanhã numa reunião qualquer: «o equipamento que temos já está ultrapassado?» ## O calendário do fabricante não é o seu Os fabricantes de eletrónica de consumo lançam modelos novos ao ritmo do mercado de consumo: um ou dois anos. Uma instituição de saúde decide a outro ritmo: orçamento anual, procedimento de compra, parecer da informática, formação da equipa. Se cada lançamento obrigar a reabrir a decisão, a instituição fica presa num ciclo em que está sempre a comprar e nunca a usar. ## Porque é que não vendemos equipamento É uma das razões pelas quais, no RVer, [os equipamentos são nossos](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/). A instituição contrata um serviço; o equipamento vem com ele. Na prática, a pergunta «este modelo ainda serve?» deixa de ser da instituição. É nossa. Se um equipamento deixar de servir, é substituído no âmbito do serviço, sem procedimento de compra novo, sem inventário de hardware a abater. ## O que não muda com o modelo A parte que interessa a uma equipa clínica não está no headset. Está no que corre nele e à volta dele: - a **biblioteca de conteúdos**, escolhida para uso clínico; - a **forma de conduzir a sessão**: quem está presente, como se para, o que se regista; - o **registo** do que aconteceu em cada sessão. Nada disto começa do zero por causa de um anúncio. É por isso que um lançamento de hardware, por mais interessante que seja, é uma notícia de tecnologia e não uma decisão clínica. ## Ver com curiosidade, decidir com calma Vale a pena ver o que a Meta apresenta. Alguns avanços (ecrãs mais nítidos, equipamentos mais leves) podem vir a fazer diferença para quem usa um headset durante vinte minutos numa cama. Quando fizerem, a atualização chega pelo serviço, testada, e não por impulso. Q: Quando é a Meta Connect 2026? A: A 23 e 24 de setembro de 2026. A apresentação principal é a 23, às 16h da Califórnia (meia-noite em Lisboa). Q: A instituição tem de comprar equipamento novo quando sai um modelo? A: Não, no modelo RVer. Os equipamentos são da RVer e vêm com o serviço; a substituição, quando necessária, é feita por nós. ### «Quem sentir desconforto tira e diz» URL: https://rver.pt/blog/aula-aberta-terapia-ocupacional-universidade-leiria-oeste/ Date: 22 September 2026 Demos hoje formação certificada a futuros terapeutas ocupacionais, a duzentos metros do hospital onde o sistema já é usado. O último slide não era um resumo. Era uma instrução de segurança. Hoje de manhã, na **Escola Superior de Saúde da Universidade de Leiria e Oeste**, demos uma formação a futuros terapeutas ocupacionais: **«RVer: Realidade Virtual na (re)habilitação de crianças a idosos»**. Gratuita, certificada, organizada pelo **aTOPlab**, Assistive Technology and Occupational Performance Laboratory, com a licenciatura em **Terapia Ocupacional**. A sala tinha cinquenta lugares. Apareceram sessenta pessoas. ## O slide que interessa [Image: Escola Superior de Saúde da Universidade de Leiria e Oeste, Campus 5, 22 de setembro de 2026. Slide 26 de 26.] Está lá escrito: > Perguntas, e agora quem quiser experimentar um pouco do sistema, vamos a isso. Quem sentir desconforto tira e diz. Três decisões em duas linhas, e nenhuma é de marketing. **A demonstração vem no fim.** Primeiro explica-se o que a coisa é, onde encaixa e o que não faz. Quem põe o headset primeiro passa o resto da sessão a falar do efeito, e não do trabalho. **Experimenta quem quer.** Numa sala com sessenta pessoas há sempre quem não queira, e ninguém tem de justificar porquê. **Quem sentir desconforto tira e diz.** É a parte que mais vezes se omite. Uma pessoa com um headset de realidade virtual não vê o resto da sala e não sabe se pode interromper: por isso diz-se-lhe, antes, que pode. Numa aula, isto é boa educação. Numa sessão com um utente, é prática clínica: o conforto não é um pormenor da experiência, é a primeira decisão que se toma. ## Porque é que isto se faz numa escola de saúde Porque quem conduz uma sessão com o RVer não somos nós. É a equipa clínica. O sistema é gerido à distância, o conteúdo fica no equipamento, e a sessão corre sem depender de ligação à internet. Nada disso é a parte difícil. A parte difícil é a que não se resolve com software: escolher um cenário para uma pessoa em concreto, perceber quando parar, e encaixar vinte minutos de sessão num turno que já está cheio. Isso aprende-se com quem estuda terapia ocupacional, e ensina-se a quem a vai praticar. Daí a formação ser com o aTOPlab e com a licenciatura, e não uma apresentação comercial numa sala emprestada. ## O hospital fica ao lado O Campus 5 não é o pólo principal da universidade: fica afastado, **porta com porta com o Hospital de Leiria**. Nos Cuidados Paliativos da ULS Leiria o sistema é usado com utentes: foi o que a [SIC](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) e o [Jornal de Leiria](https://www.jornaldeleiria.pt/noticia/tecnologia-permite-aos-utentes-dos-cuidados-paliativos-viajar-sem-sair-do-lugar) mostraram em 2024. Dar formação a futuros terapeutas a duzentos metros do serviço onde o sistema já está a ser usado não é coincidência bonita: é a única forma de isto não ficar a ser uma tecnologia à procura de um problema. Quem vai usar está do outro lado da rua. ## O que uma aula destas nos dá Perguntas de quem vai usar aquilo. Não são as perguntas de quem compra: essas já as conhecemos. São as de quem vai ter o equipamento na mão a meio de uma tarde, com um utente à frente e outro à espera. Cada uma delas é uma coisa a tornar mais simples, e a lista que sai de uma manhã destas vale mais do que uma semana a adivinhar em Leiria. Foi a segunda vez que levámos o sistema a uma instituição de ensino. A primeira foi no [ISLA Santarém](https://www.islasantarem.pt/pt/isla-media/eventos/realidade-virtual-terapeutica), em junho de 2024. Se houver uma terceira, contamos essa também. Q: O que é o aTOPlab? A: O Assistive Technology and Occupational Performance Laboratory, da Escola Superior de Saúde da Universidade de Leiria e Oeste. Foi quem organizou a formação, com a licenciatura em Terapia Ocupacional. Q: A formação foi certificada? A: Sim, e gratuita. Foi dirigida a estudantes e profissionais de terapia ocupacional, no Campus 5 da universidade. Q: Porque é que a demonstração é sempre no fim? A: Porque quem experimenta primeiro passa o resto da sessão a falar do efeito e não do trabalho clínico. Primeiro explica-se o que o sistema é, onde encaixa e o que não faz; experimentar é o último passo, e é voluntário. Q: O IPLeiria mudou de nome? A: Sim. Em 2026 o Instituto Politécnico de Leiria passou a Universidade de Leiria e Oeste. A escola de saúde é a Escola Superior de Saúde, e esta sessão foi no Campus 5, ao lado do Hospital de Leiria. ### A RVer tem parceiro no Brasil: Instituto Gabriel Benício URL: https://rver.pt/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/ Date: 21 September 2026 Há oito dias dissemos que não havia nada assinado no Brasil, e que quando houvesse diríamos quem era. Há. Há oito dias escrevemos um artigo sobre o Brasil que dizia, com todas as letras, que não havia nada assinado, e que quando houvesse, diríamos quem era. Há. É o **Instituto Gabriel Benício**, em Fortaleza, no Ceará. ## O que foi assinado Hoje, 21 de setembro de 2026, a RVer e o Instituto Gabriel Benício assinaram um acordo de **revenda e distribuição** da plataforma no Brasil. Para já é **exclusivo** no país: o Instituto representa a RVer em território brasileiro, e é o único que o faz. Está previsto ir mais longe do que distribuir. A fase seguinte é a **criação de conteúdos específicos para o mercado brasileiro**: cenários filmados lá, para quem vive lá. Uma biblioteca de vídeo imersivo pensada em Portugal serve muita coisa no Brasil e não serve tudo: a paisagem que devolve uma memória a um utente de Leiria não é a mesma que devolve uma memória a um utente de Fortaleza. Isso ainda não existe. O que existe hoje é o acordo, e o primeiro serviço a usar a plataforma no país. ## O que é o Instituto Gabriel Benício [Image: O logótipo do Instituto Gabriel Benício.] É uma entidade de **inclusão e desenvolvimento**, sediada em Fortaleza, que trabalha com **crianças com deficiência e as suas famílias**. O trabalho com a RVer entra pelo **projeto MoviMente**, do Instituto. [Image: A camisola do projeto MoviMente que o Instituto Gabriel Benício ofereceu à equipa da RVer. É por aqui que o trabalho começa.] O Instituto é **parceiro e cliente ao mesmo tempo**, e isso não é uma contradição: quem representa a plataforma num país também a usa com os seus utentes, como qualquer instituição. É, aliás, a melhor forma de a representar. Quem vende uma coisa que não usa acaba a descrevê-la mal. ## O headset que ficou em Fortaleza Em setembro levámos um equipamento de demonstração de Portugal para o Brasil. Está na fotografia do [artigo anterior](/blog/a-rver-no-brasil-o-que-ja-e-e-o-que-ainda-nao-e/): um headset em cima de uma caixa, numa varanda com vista para o mar. Esse equipamento **ficou lá**. Deixou de ser a unidade de demonstração e passou a ser o primeiro equipamento RVer em serviço no Brasil. Hoje correram nele as primeiras sessões: duas, no dia em que o acordo foi assinado. O modelo não muda por atravessar o Atlântico: **os equipamentos continuam a ser nossos**. A instituição contrata um serviço e o equipamento vem com ele: [explicámos porquê aqui](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/). A diferença prevista para o Brasil é a origem: à medida que houver mais serviços, os headsets são comprados no país e **configurados à distância**, sem frota a atravessar a alfândega nem custo de importação somado ao serviço. ## O que continua a não ser O artigo de setembro pôs os limites à frente. Continuam lá, e vale a pena repeti-los em vez de os deixar cair agora que há assinatura. A RVer **não tem registo na ANVISA**. O registo que temos é de **Dispositivo Médico Classe I no INFARMED e na EUDAMED**, cobre o produto base, e vale onde foi emitido: tem efeitos no espaço europeu, não uma credencial mundial. É um processo que vamos tratar em breve, agora que existe o parceiro brasileiro que ele pressupõe. Enquanto isso não acontecer, mantém-se a regra interna: **nada de alegação terapêutica no Brasil**. O que se apresenta a uma instituição brasileira é o que o produto faz (atividade significativa, conforto, ocupação, registo do que aconteceu na sessão) sem prometer efeito clínico. A regulação segue a finalidade alegada, não o tipo de comprador. E continua a não haver empresa brasileira, escritório nem equipa local. Há um parceiro, que é coisa diferente e, para já, melhor. ## Portugal, Brasil, e o que vem depois Este é o primeiro passo da internacionalização, e o plano é haver mais. Portugal, agora o Brasil, e a seguir outros: há conversas a decorrer noutros mercados. Não os nomeamos. Foi a regra em setembro, quando o Brasil ainda era uma agenda de reuniões, e não faz sentido mudá-la agora que ela funcionou: **anunciar conversas como se fossem acordos é a forma mais rápida de as estragar**. Quando houver assinatura, dizemos quem é. Foi o que aconteceu hoje. O que dá para explicar é o critério, que não é o do tamanho do mercado. **Primeiro, a necessidade dos utentes.** Vamos onde há trabalho por fazer, não onde há mais população. **Depois, alguém no terreno.** Ou criamos equipa, ou fazemos parceria com quem já lá está, e quem já lá está tem de ter ligação à saúde, à tecnologia, ou às duas. Não basta saber vender. **Distância não é obstáculo.** A plataforma é gerida à distância por desenho: o conteúdo fica no equipamento, a sessão corre sem depender de ligação à internet, e a configuração faz-se de Leiria. Não é preciso estar no país para o sistema funcionar no país. É preciso estar no país para perceber quem o vai usar, e é para isso que serve um parceiro. É por isso que a ordem é esta: parceiro primeiro, operação depois. Hoje ficou fechada a primeira. Q: A RVer é agora uma empresa brasileira? A: Não. A RVer é uma empresa portuguesa com um parceiro no Brasil. Não há entidade constituída no país, nem escritório, nem equipa local. O Instituto Gabriel Benício representa a RVer em território brasileiro ao abrigo de um acordo de revenda e distribuição. Q: A RVer tem registo na ANVISA? A: Não. O registo que a RVer tem é de Dispositivo Médico Classe I no INFARMED e na EUDAMED, cobre o produto base e vale onde foi emitido: tem efeitos no espaço europeu. O processo junto da ANVISA será tratado em breve. Até lá mantém-se a regra interna de não fazer alegação terapêutica no Brasil. Q: O acordo é exclusivo? A: Para já, sim: o Instituto Gabriel Benício é o único representante da RVer no Brasil. Q: As instituições brasileiras compram os equipamentos? A: Não. O modelo é o mesmo que em Portugal: a instituição contrata um serviço e o equipamento vem com ele, continuando a ser da RVer. À medida que houver mais serviços no Brasil, os headsets passam a ser comprados no país e configurados à distância. Q: Que outros países se seguem? A: Há conversas noutros mercados, e não os nomeamos enquanto não houver assinatura. O critério não é o tamanho do mercado: é a necessidade dos utentes e a existência de alguém no terreno com ligação à saúde, à tecnologia, ou às duas. ### Setembro Dourado: o que muda numa sessão quando o utente é uma criança URL: https://rver.pt/blog/setembro-dourado-criancas-sessao-realidade-virtual/ Date: 20 September 2026 Uma sessão com uma criança não é uma sessão de adulto em ponto pequeno. Setembro é o mês internacional de sensibilização para o cancro pediátrico: o Setembro Dourado, pela cor da fita. É o mês em que se fala de crianças que passam meses em hospitais, entre tratamentos, análises e esperas. A realidade virtual aparece muitas vezes nessas conversas, quase sempre pela mesma porta: a distração durante procedimentos. Não é disso que queremos falar aqui, e não fazemos alegações sobre dor nem sobre ansiedade. Queremos falar do que muda na própria sessão quando quem põe o headset é uma criança. ## Quem decide são duas pessoas Com um adulto há um consentimento. Com uma criança há dois: o dos pais ou representantes, e o assentimento da própria criança. O segundo não é uma formalidade. Uma criança que diz que sim porque os adultos à volta querem que diga sim não está a escolher. Perguntar-lhe de outra maneira, «queres ver o mar ou preferes ficar a desenhar?», e aceitar a resposta faz parte da sessão. ## O equipamento tem idade mínima Os fabricantes de headsets de realidade virtual definem uma idade mínima de utilização e indicam como ajustar o equipamento a caras mais pequenas. Antes de qualquer sessão pediátrica, confirma-se o que o fabricante indica para o modelo em uso, e isso decide, antes de qualquer outra coisa, se a sessão acontece. ## Mais curta, e com alguém a segurar a mão As sessões com crianças são mais curtas. A atenção é outra, o cansaço de um dia de hospital é outro, e o objetivo não é aguentar até ao fim. E há sempre um adulto conhecido na sala: um pai, uma mãe, a enfermeira de referência. Uma criança com o headset não vê quem está ao lado. Saber que a mão que segura a dela é a mesma de antes de pôr o headset é o que torna a sessão segura para ela. ## A criança escolhe o conteúdo Dentro do que a equipa considera adequado, quem escolhe é a criança. Os animais, a praia, a neve que nunca viu. Poder escolher alguma coisa, num sítio onde quase tudo é decidido por outros, conta. ## Dos 10 aos 100 anos, mas não da mesma maneira O RVer é usado dos 10 aos 100 anos. Isso não quer dizer que a sessão seja igual para todos: quer dizer que as regras de cada idade estão escritas antes de a sessão começar. Q: O que é o Setembro Dourado? A: É o mês internacional de sensibilização para o cancro pediátrico, identificado pela fita dourada. Q: Há idade mínima para usar um headset de realidade virtual? A: Sim. Os fabricantes definem uma idade mínima e indicações de ajuste. Antes de uma sessão pediátrica confirma-se sempre o que o fabricante indica para o modelo em uso. ### O RVer no Jornal de Leiria URL: https://rver.pt/blog/rver-jornal-de-leiria-setembro-2026/ Date: 19 September 2026 O Jornal de Leiria publicou hoje uma peça sobre o RVer. Aproveitamos para deixar por escrito, do nosso lado, as três coisas que a notícia levanta. ## O que a peça conta A jornalista Daniela Franco Sousa escreve sobre a Amplified Creations (empresa de Leiria, fundada em 2015, cinco pessoas) e sobre o RVer, o sistema de realidade virtual para uso clínico que registámos no INFARMED e na EUDAMED como dispositivo médico. A peça resume os três usos que o sistema tem no terreno: conforto e distração durante procedimentos, redução da ansiedade antes de exames, e atividade de estimulação com residentes de lares. É a mesma descrição que usamos nas propostas. Não há aqui nenhuma novidade a anunciar, e é isso que nos agrada na peça. ## A frase que interessa Da notícia: «Quem conduz a sessão é sempre um profissional de saúde da própria instituição.» Se houvesse uma só linha a sair daqui para fora, era esta. O RVer não é um leitor de vídeo 360° que se entrega a um utente e se deixa a andar. É um sistema clínico assistido: a equipa de saúde da instituição escolhe o conteúdo, conduz a sessão, para quando é preciso parar, e regista. O equipamento é o menos interessante do conjunto. Daí vem também aquilo que o sistema não faz. Não trata, não diagnostica, não avalia, e não substitui cuidado médico nenhum. É um complemento não farmacológico, sempre sob supervisão da equipa de saúde. ## Onde estamos, ao certo A peça fala em expansão nacional e internacional, e isso é verdade: é o plano. Sobre a geografia atual, o mapa é este: a sede é em Leiria, há um espaço da empresa em Lisboa para reuniões, e a instalação e a formação fazem-se à distância. Quanto aos clientes, as instituições que usam o sistema estão espalhadas por vários pontos do país e não se concentram numa região, ainda que hoje fiquem todas de Lisboa para cima. As reuniões são por vídeo e o sistema fica instalado na própria instituição, por isso a geografia condiciona pouco quem pode trabalhar connosco. ## Não é a primeira vez Vale a pena ver isto em série, e não como notícia avulsa: - **2022**: o Jornal de Leiria acompanha [os utentes da Casa das Janelas Verdes, em Alpedriz](https://www.jornaldeleiria.pt/index.php/noticia/idosos-de-alpedriz-espreitam-o-mundo-atraves-da-realidade-virtual). O sistema ainda não tinha o nome que tem hoje. - **2024**: a [SIC Notícias](https://sicnoticias.pt/pais/2024-06-06-video-nos-paliativos-de-leiria-e-possivel-viajar-atraves-da-realidade-virtual-local-mais-pedido-e-fatima-1d30e369) e o [Jornal de Leiria](https://www.jornaldeleiria.pt/noticia/tecnologia-permite-aos-utentes-dos-cuidados-paliativos-viajar-sem-sair-do-lugar) vão aos Cuidados Paliativos de Leiria. O destino mais pedido é Fátima. Nesse mesmo mês, o Diário de Leiria publica a sua própria peça em papel: «Utentes dos Cuidados Paliativos viajam sem sair do lugar». - **2026**: [a peça de hoje](https://www.jornaldeleiria.pt/noticia/amplified-creations-aplica-realidade-virtual-na-saude), já com o registo de dispositivo médico feito. Quatro anos entre a primeira reportagem e esta. Foi o tempo que levou a transformar uma coisa que funcionava numa coisa que se pode instalar, documentar e defender perante um regulador. ## Ler a peça [Amplified Creations aplica realidade virtual na saúde](https://www.jornaldeleiria.pt/noticia/amplified-creations-aplica-realidade-virtual-na-saude), Jornal de Leiria, 19 de setembro de 2026. :::note Notícias não são evidência clínica. O que existe de estudos sobre realidade virtual em contexto de saúde está reunido, com as ressalvas todas, na nossa [biblioteca de estudos](/estudos/). ::: Q: O RVer é um dispositivo médico? A: A biblioteca de vídeo, que é o produto base, está registada como Dispositivo Médico Classe I no INFARMED (n.º CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), com marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Q: Quem conduz as sessões de realidade virtual? A: Um profissional de saúde da própria instituição. A equipa escolhe o conteúdo, conduz a sessão e interrompe-a quando é preciso. Não colocamos pessoal nosso a conduzir sessões clínicas. ### Semana da Mobilidade: e quem não sai da cama? URL: https://rver.pt/blog/semana-europeia-mobilidade-quem-nao-sai-da-cama/ Date: 18 September 2026 Esta semana fala-se de ciclovias e transportes. Para uma pessoa acamada, o mundo tem o tamanho de um quarto. A Semana Europeia da Mobilidade decorre todos os anos de 16 a 22 de setembro. Fala-se de ciclovias, de transportes públicos, de ruas sem carros. É uma semana sobre como nos deslocamos. Há pessoas para quem essa pergunta deixou de existir. Uma pessoa acamada numa unidade de cuidados paliativos, ou num lar, não se desloca. O mundo dela tem o tamanho do quarto, e a paisagem é o teto e a janela, quando há janela. ## Não é devolver o que se perdeu A realidade virtual não devolve mobilidade a ninguém. Não é reabilitação motora, e dizer o contrário seria enganar quem está a decidir se a quer usar. O que faz é mais pequeno: durante vinte minutos, muda aquilo que está à frente dos olhos. A pessoa continua na mesma cama, com a mesma equipa ao lado. O quarto é que deixa de ser a única coisa que existe. ## Um horizonte, para quem só vê o teto Para quem passa o dia deitado, o que falta muitas vezes não é um sítio concreto: é a distância. O olhar bate sempre no teto, na parede, na cortina. Por isso, para estas pessoas, a equipa escolhe muitas vezes cenários com horizonte: o mar ao fundo, um campo aberto, uma praça com gente a passar ao longe. O importante não é ser espetacular. É poder olhar para longe outra vez, e ser a pessoa a decidir, com a equipa, para onde. ## O movimento que aparece sozinho Há um pormenor que as equipas notam. Uma pessoa que não se mexe há dias roda a cabeça para acompanhar o que vê. Às vezes junta as mãos, diante de um altar. Não chamamos a isto terapia, e não o prometemos. É o mínimo de movimento que um sítio com sentido pede, e é a equipa clínica quem decide se esse movimento é bem-vindo ou se a sessão deve ficar mais quieta. ## O que a semana podia incluir Uma semana sobre mobilidade podia lembrar-se, uma vez, de quem já não sai. Não para lhes vender uma solução, mas para reconhecer que a pergunta «para onde é que esta pessoa pode ir?» continua a fazer sentido, mesmo quando a resposta é um quarto. Q: Quando é a Semana Europeia da Mobilidade? A: Todos os anos, de 16 a 22 de setembro. Q: A realidade virtual devolve mobilidade a pessoas acamadas? A: Não. Não é reabilitação motora. Muda o que a pessoa vê durante a sessão, com a equipa clínica presente, e mais nada se deve prometer. ### Segurança do doente: numa doença crónica, a sessão repete-se URL: https://rver.pt/blog/seguranca-do-doente-doenca-cronica-sessao-que-se-repete/ Date: 17 September 2026 A primeira sessão corre bem quase sempre. A pergunta de segurança é outra: a trigésima corre igual? O Dia Mundial da Segurança do Doente assinala-se a 17 de setembro. Em 2026 a Organização Mundial da Saúde dedicou-o às **doenças não transmissíveis** (diabetes, doença cardiovascular, doença respiratória crónica, cancro), com o lema «Safe care for life!». A razão do tema está no calendário destas doenças. Não se tratam numa consulta: acompanham-se durante anos, em sítios diferentes, por equipas diferentes. Cada passagem é um sítio onde alguma coisa pode falhar. ## A primeira sessão não é a que preocupa Numa sessão de realidade virtual, a primeira vez é a mais vigiada. Toda a gente está atenta, a pessoa é observada, pergunta-se como se sente. Numa doença crónica a sessão não acontece uma vez. Repete-se (semanalmente, durante meses) e é aí que a atenção desce. A segurança de uma sessão que já correu vinte vezes depende de a vigésima primeira seguir o mesmo guião que a primeira, e não de a equipa se lembrar. ## O que tem de ser igual todas as vezes **Quem está na sala.** Uma pessoa com um headset de realidade virtual não vê o que a rodeia. Há sempre alguém da equipa presente, e esse alguém não está a fazer outra coisa ao mesmo tempo. **Como se para.** A pessoa sabe, antes de começar, que pode tirar o headset quando quiser, e que dizer que não está bem não é falhar a sessão. **O que se regista.** Quantas vezes, quanto tempo, o que foi visto. O registo não avalia nem diagnostica; serve para que uma mudança lenta (sessões cada vez mais curtas, por exemplo) se veja no papel antes de se ver na pessoa. **Quem decide o conteúdo.** A equipa clínica escolhe o cenário para aquela pessoa, naquele dia. Um conteúdo que ontem era calmo pode não o ser hoje. ## Vários sítios, a mesma regra O tema da OMS fala de cuidados que passam por vários lugares. Uma pessoa pode fazer sessões numa unidade de internamento, depois num lar, depois em casa com apoio domiciliário. Se cada sítio fizer à sua maneira, a segurança passa a depender de onde a pessoa está. O que queremos é o contrário: que a sessão tenha as mesmas regras em qualquer sítio onde o equipamento esteja, porque o equipamento e a forma de o usar vêm juntos. ## O que isto não é Nada disto torna a realidade virtual um tratamento para uma doença crónica. É uma atividade complementar, não farmacológica, conduzida pela equipa clínica. A segurança de que falamos é a da própria sessão: não substitui o plano de cuidados, e não o pretende melhorar. Q: Qual é o tema do Dia Mundial da Segurança do Doente de 2026? A: A OMS dedicou-o aos cuidados seguros para pessoas com doenças não transmissíveis, com o lema «Safe care for life!». Q: A realidade virtual trata doenças crónicas? A: Não. No RVer é uma atividade complementar e não farmacológica, conduzida pela equipa clínica. Não substitui nenhum tratamento. ### A RVer no Brasil: o que já é, o que ainda não é, e o que a ANVISA tem a ver com isto URL: https://rver.pt/blog/a-rver-no-brasil-o-que-ja-e-e-o-que-ainda-nao-e/ Date: 16 September 2026 Em setembro passámos quinze dias no Brasil, a conhecer distribuidores e parceiros. Quando este artigo saiu não havia nada assinado, e o registo que temos em Portugal não vale lá. *Atualização, 21 de setembro: assinámos o primeiro acordo no Brasil, com o Instituto Gabriel Benício. [Ler a notícia](/blog/primeiro-parceiro-no-brasil-instituto-gabriel-benicio/).* A 14 de setembro, a RVer chegou ao Brasil para quinze dias de reuniões com distribuidores, instituições e potenciais parceiros, e este artigo existe porque a notícia é fácil de contar mal. Então vamos contá-la com os limites à frente. ## O que já é Somos uma **empresa portuguesa a entrar no mercado brasileiro**. Não somos uma empresa brasileira, ainda não. Não há entidade constituída no Brasil, não há escritório, não há equipa local. Começámos por Fortaleza. O que há é uma agenda: percorrer o país durante duas semanas a conhecer quem distribui tecnologia de saúde, quem gere instituições de longa permanência, e quem já percebeu que a parte não-farmacológica do cuidado tem pouca oferta séria. ## O que ainda não é **Não há nada assinado.** Nenhum contrato, nenhuma exclusividade, nenhum acordo de distribuição. É precisamente por isso que este texto não nomeia ninguém do lado brasileiro: estamos a avaliar parceiros, e anunciar conversas como se fossem acordos é a forma mais rápida de as estragar. Quando houver assinatura, dizemos quem é. ## A parte regulamentar, que é a que interessa O registo que a RVer tem é um **registo de Dispositivo Médico Classe I no INFARMED e na EUDAMED**, e cobre o **produto base**: a biblioteca de vídeo imersivo. É um registo com efeitos no espaço europeu. Não é uma credencial mundial e não se transporta numa mala. No Brasil, quem regula dispositivos médicos é a **ANVISA**. A RVer **não tem registo na ANVISA**. Daí decorrem três consequências práticas, e são regra interna, não sugestão: 1. **Não invocamos o registo do Infarmed no Brasil** como se valesse lá. Vale onde foi emitido. 2. **Não fazemos alegação terapêutica no Brasil.** O que se apresenta a uma instituição brasileira é o que o produto faz: atividade significativa, conforto, ocupação, registo do que aconteceu na sessão, sem prometer efeito clínico. A regulação segue a finalidade alegada: é a alegação que puxa o produto para dentro do regime, não o tipo de comprador. 3. **A porta da ANVISA abre-se com um parceiro brasileiro**, quando o caminho o exigir. Pelo que apurámos, o processo pressupõe um detentor com presença legal no país: o que é mais uma razão para a ordem ser esta, parceiro primeiro, registo depois, e não ao contrário. Para quem quiser o enquadramento do lado europeu, está em [«O que é um Dispositivo Médico Classe I»](/blog/dispositivo-medico-classe-1-realidade-virtual/). ## Como é que uma empresa pequena chega a um país onde não está Esta é a parte que torna a viagem possível, e não é comercial: é operacional. **Os equipamentos continuam a ser nossos.** O modelo é o mesmo que em Portugal: a instituição não compra hardware, contrata um serviço e o equipamento vem com ele: ver [os equipamentos são nossos](/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/). A diferença prevista para o Brasil está na origem do equipamento: **quando houver contrato assinado, os headsets são comprados no país**, no mesmo modelo, e **configurados à distância**. Não há frota a atravessar a alfândega, nem custo de importação a somar ao serviço. Hoje ainda não é nada disso. O único equipamento nosso em solo brasileiro é o da fotografia acima: o headset de demonstração, que veio de Portugal nesta viagem, porque ainda não há operação lá que justifique outra coisa. Configurar à distância não é um improviso: é como a plataforma foi desenhada desde o início. O conteúdo fica no equipamento e a sessão corre sem depender de ligação à internet, ver [conteúdo no equipamento](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/), e a gestão faz-se pela aplicação de acompanhamento, ver [controlo remoto da sessão](/blog/app-companion-controlo-remoto-realidade-virtual/). O resultado é que a distância deixa de ser um problema de logística e passa a ser o que sempre foi: um problema de pessoas. Alguém tem de estar na sala com o utente. Essa parte não se resolve à distância, nem cá nem lá. ## Onde vamos perder, e é melhor ficar escrito **A biblioteca é europeia.** A maior parte dos cenários foi filmada em Portugal e na Europa. Para atividade, conforto e conversa, funciona em qualquer lado. Para **reminiscência**, que depende de a pessoa reconhecer o sítio, não funciona da mesma maneira com quem nunca cá viveu. Está desenvolvido em [quando o lugar da pessoa não está na biblioteca](/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/). **A plataforma está em português europeu e em inglês.** Serve-se, lê-se, mas não é a mesma coisa que estar escrita na língua de quem a usa todos os dias. **E não temos histórico no Brasil.** Todas as instalações, todos os utentes e todo o registo de utilização que podemos mostrar são europeus. Quem avaliar a RVer aí vai avaliar uma empresa estrangeira sem referências locais, e esse é um argumento legítimo contra nós até deixar de o ser. ## O que procuramos nestes quinze dias Distribuidores com trabalho feito em instituições de saúde e de longa permanência. Parceiros clínicos dispostos a fazer um piloto a sério, com critério definido antes de começar: a receita está em [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/). E interlocutores que nos digam onde é que o modelo europeu não encaixa, que é a informação mais valiosa que se pode trazer de uma viagem destas. Não prometemos datas. Quando houver, escrevemo-lo aqui. ## O papel do RVer O **produto base** da RVer é uma biblioteca de vídeo imersivo, registada como Dispositivo Médico Classe I no INFARMED e na EUDAMED: um registo sem efeitos fora do espaço europeu. **RVer Motion e RVer Neuro são módulos em desenvolvimento, não abrangidos por esse registo.** A plataforma regista a sessão: não avalia, não classifica, não diagnostica e não substitui a avaliação clínica nem a decisão da equipa. Q: A RVer abriu empresa no Brasil? A: Não. A RVer é uma empresa portuguesa a entrar no mercado brasileiro. Não há entidade constituída no Brasil, escritório ou equipa local. Desde 14 de setembro de 2026 estamos no país durante quinze dias, em reuniões com distribuidores, instituições e potenciais parceiros. Q: Por onde começou a viagem? A: Por Fortaleza, a 14 de setembro de 2026. São quinze dias no país, com reuniões em mais do que uma cidade. Q: Já há parceiro ou distribuidor no Brasil? A: Não há nada assinado: nenhum contrato, exclusividade ou acordo de distribuição. Por isso não nomeamos ninguém do lado brasileiro: estamos a avaliar parceiros, e anunciar conversas como se fossem acordos estraga-as. Quando houver assinatura, dizemos quem é. Q: O registo de Dispositivo Médico Classe I do Infarmed vale no Brasil? A: Não. É um registo com efeitos no espaço europeu, e cobre o produto base: a biblioteca de vídeo imersivo. No Brasil quem regula dispositivos médicos é a ANVISA, e a RVer não tem registo na ANVISA. Não invocamos o registo europeu como se valesse lá. Q: Então como é que a RVer se apresenta no Brasil? A: Pelo que o produto faz: atividade significativa, conforto, ocupação e registo do que aconteceu na sessão, sem alegação terapêutica. A regulação segue a finalidade alegada, e é a alegação que puxa um produto para dentro do regime de dispositivo médico, não o tipo de comprador. Q: E o registo na ANVISA, fica para quando? A: Para quando o caminho o exigir, e com um parceiro brasileiro. Pelo que apurámos, o processo pressupõe um detentor com presença legal no país: mais uma razão para a ordem ser parceiro primeiro, registo depois. Q: Como é que os equipamentos chegam lá? A: Hoje, o único equipamento nosso no Brasil é o headset de demonstração, levado de Portugal para esta viagem. O modelo previsto é outro: quando houver contrato assinado, os headsets são comprados no país, no mesmo modelo, e configurados à distância, continuando a ser da RVer, como em Portugal. O conteúdo fica no equipamento e a sessão corre sem depender de internet, que é a razão técnica pela qual isto funciona à distância. Q: A biblioteca serve utentes brasileiros? A: Para atividade, conforto e conversa, sim. Para reminiscência, não da mesma maneira: a maior parte dos cenários foi filmada em Portugal e na Europa, e a reminiscência depende de a pessoa reconhecer o sítio. Além disso, a plataforma está em português europeu e em inglês, e não temos histórico de instalações no Brasil. ### Os equipamentos são nossos: porque é que a RVer não vende hardware URL: https://rver.pt/blog/os-equipamentos-sao-nossos-porque-e-que-isso-importa/ Date: 15 September 2026 «Quantos equipamentos temos de comprar?» Nenhum. Os headsets são nossos e vêm com o serviço, o que decide quem carrega o risco de uma tecnologia que envelhece depressa. Há uma pergunta que aparece cedo em quase todas as reuniões, e normalmente não é feita assim: *quantos equipamentos temos de comprar?* A resposta é **nenhum**. Os equipamentos são nossos. O cliente não compra hardware à RVer, nem no primeiro ano nem no quinto. Contrata um serviço anual, e os equipamentos vêm com ele. Isto não é um detalhe de contrato. Decide quem carrega o risco de uma tecnologia que envelhece depressa, e vale a pena explicar porquê, incluindo a parte em que o modelo é pior para o cliente. ## O hardware envelhece mais depressa do que o processo de compra Um headset comprado hoje é, daqui a três anos, um modelo descontinuado com acessórios que já ninguém fabrica. Uma instituição que o tenha comprado como imobilizado fica com um bem em inventário, uma depreciação a correr, e nenhuma forma simples de o trocar, porque trocar significa abrir outro processo de aquisição. Quando o equipamento é nosso, a substituição é uma decisão operacional, não um concurso. ## A responsabilidade fica onde está o conhecimento Se o equipamento é nosso, a avaria é nossa, a atualização é nossa, a substituição é nossa e a bateria que já não segura uma tarde é nossa. Ninguém na instituição tem de aprender a gerir uma frota de headsets, nem de decidir quando um deles já não presta. Este é o ponto que mais muda o dia a dia. A alternativa (o cliente é dono e nós damos apoio) cria sempre a mesma conversa: *isto é avaria ou é mau uso?* Com o equipamento do nosso lado, a conversa não existe. ## O que se contrata é o serviço, não a caixa O valor não está no headset. Está na biblioteca validada, nas atualizações, na configuração à distância, na formação da equipa e no registo de sessões. Ver [o que a equipa clínica vê no registo de sessão](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/). Um headset sem nada disto é um brinquedo caro que fica numa gaveta, e é exatamente esse o destino de boa parte do equipamento de saúde comprado em campanha. ## Não é despesa de capital Para muitas instituições, a diferença entre comprar equipamento e contratar um serviço é a diferença entre um processo de investimento e uma rubrica de funcionamento. Não é um truque contabilístico: é a razão pela qual alguns projetos arrancam em semanas e outros esperam pelo orçamento do ano seguinte. O ponto está desenvolvido em [quem paga não é quem poupa](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/). [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## O que isto nos obriga a fazer O modelo tem uma contrapartida óbvia, e é justo escrevê-la: - substituímos equipamento avariado, sem discutir de quem é a culpa; - mantemos os equipamentos atualizados durante todo o contrato; - quando o contrato acaba, os equipamentos são recolhidos. A última linha é a que interessa ao comprador cuidadoso. ## Onde o cliente perde **No fim, não fica com nada.** Se a instituição parar o serviço ao fim de três anos, não tem headsets no armário. Quem comprou hardware fica com hardware: velho, mas seu. Há instituições para quem isso é decisivo, normalmente por regras internas de património ou por financiamento que exige um bem inventariável no fim. Para essas, o nosso modelo é o modelo errado, e é melhor sabê-lo na primeira reunião do que na terceira. **A segunda perda é de controlo.** O equipamento vem configurado por nós, em modo de utilização controlada. Não é um tablet onde se instala o que se quiser. Para a equipa clínica isso é uma vantagem (ver [onde vive o equipamento](/blog/onde-vive-o-equipamento-realidade-virtual-hospital/) e [higiene e segurança](/blog/higiene-seguranca-equipamento-realidade-virtual/)), mas é, ainda assim, menos liberdade do que ter a coisa em nome próprio. ## E o preço? Não é público, e não é por mistério: o número depende do número de serviços e de equipamentos, e um preço solto sem essa estrutura leva a comparações erradas. O que se pode dizer aqui é a forma (**assinatura anual por serviço, com equipamento incluído**) e que a análise de retorno não se faz com o preço do headset, como está em [custo e ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/). ## O papel do RVer O **produto base** da RVer é uma biblioteca de vídeo imersivo, registada como Dispositivo Médico Classe I no INFARMED e na EUDAMED. **RVer Motion e RVer Neuro são módulos em desenvolvimento, não abrangidos por esse registo.** A plataforma regista a sessão: não avalia, não classifica, não diagnostica e não substitui a avaliação clínica nem a decisão da equipa. Q: A instituição tem de comprar os equipamentos? A: Não. Os equipamentos são da RVer e vêm incluídos no serviço anual. O cliente não compra hardware: nem no primeiro ano, nem depois. Q: Quem paga uma avaria ou a substituição de um headset? A: A RVer. Como o equipamento é nosso, a avaria, a atualização e a substituição são nossas, e não há a conversa sobre se foi avaria ou mau uso. A instituição não gere frota nem decide quando um equipamento já não presta. Q: O que acontece aos equipamentos quando o contrato acaba? A: São recolhidos. A instituição não fica com headsets no armário. É a contrapartida direta de nunca ter pago hardware, e convém saber isso na primeira reunião. Q: Em que casos este modelo é o modelo errado? A: Em dois. Quando regras internas de património ou uma linha de financiamento exigem um bem inventariável no fim: aí, comprar é que serve. E quando a instituição quer liberdade total sobre o equipamento: o nosso chega configurado em modo de utilização controlada, não é um tablet onde se instala o que se quiser. Q: Isto conta como despesa de investimento ou de funcionamento? A: Contratar o serviço é uma rubrica de funcionamento, não um processo de investimento em equipamento. Para muitas instituições é a diferença entre arrancar em semanas e esperar pelo orçamento do ano seguinte. A validação é sempre com os serviços financeiros da própria instituição. Q: Qual é o preço? A: Não é público. O valor depende do número de serviços e de equipamentos, e um número solto sem essa estrutura leva a comparações erradas. A forma é uma assinatura anual por serviço, com equipamento incluído. ### Défice cognitivo ligeiro: primeiro usável, só depois útil URL: https://rver.pt/blog/defice-cognitivo-ligeiro-primeiro-usavel-depois-util/ Date: 14 September 2026 Parece o estudo que se faz quando falta coragem para medir eficácia. É o contrário disso. Há ensaios em curso a estudar reabilitação cognitiva e física em realidade virtual em pessoas com **défice cognitivo ligeiro**: o estado intermédio entre o envelhecimento normal e a demência. E o que esses ensaios estão a medir, nesta fase, não é o que a maior parte das pessoas espera. Medem **viabilidade, usabilidade e aceitabilidade**. Ou seja: a pessoa consegue usar aquilo? Quer voltar? A equipa consegue integrar aquilo no que já faz? ## Porque é que isso não é um resultado menor À primeira vista parece o estudo que se faz quando não se tem coragem de medir eficácia. Não é. Num dispositivo que se põe na cabeça de alguém de 78 anos, a viabilidade **é** a questão. Se metade das pessoas desiste ao segundo minuto, se o peso incomoda, se a interface exige coordenação que não está lá, ou se a equipa leva quinze minutos a pôr aquilo a funcionar num turno em que não tem quinze minutos, nenhuma pergunta sobre eficácia chega sequer a ser respondível. A ordem correta é essa: primeiro é utilizável, depois é útil. Um campo que salta a primeira pergunta produz resultados bonitos em condições que não existem em lado nenhum. :::note Quase todos os equipamentos que ficam na arrecadação de uma instituição falharam na primeira pergunta, não na segunda. ::: ## O que aprendemos com isto, na prática Não temos ensaio nosso, e não vamos fingir que temos. O que temos é uso em contexto real (mais de 50 000 sessões em instituições portuguesas) e algumas lições que se parecem muito com o que estes ensaios procuram medir: - **A colocação é o momento crítico.** Quem conduz a sessão tem de saber pôr o equipamento na cabeça de alguém com pouca mobilidade cervical, sem óculos amassados e sem sustos. - **A primeira sessão decide a segunda.** Se a pessoa se assustou, não há cenário que compense. - **A recusa é um resultado legítimo.** Escrevemos sobre isso em [quando o utente recusa a realidade virtual](/blog/quando-o-utente-recusa-realidade-virtual/): insistir é o erro mais caro que se comete nesta área. - **A duração não é a que se imagina.** O assunto dá um artigo inteiro: [duração e frequência de uma sessão](/blog/duracao-frequencia-sessao-realidade-virtual/). ## E o cybersickness É a objeção que aparece sempre, e com razão: enjoo em realidade virtual é real e é frequente em conteúdos gerados por computador com movimento de câmara livre. A escolha que fizemos foi outra: **vídeo real filmado**, com a câmara maioritariamente estática, em vez de ambientes 3D com deslocação. Não temos casos de cybersickness reportados até hoje. Isso não é um ensaio clínico e não é apresentado como tal: é o que observámos em uso, e a razão pela qual a indicação de parar perante tonturas, náusea ou desconforto está em todos os guias de implementação. ## O que isto significa para uma instituição hoje Que a pergunta certa, antes de perguntar «resulta?», é: **as nossas pessoas conseguem usar isto na semana em que já vivem?** Se a resposta for não, o resto é conversa. Se for sim, então vale a pena discutir o que medir, com quem, e durante quanto tempo. --- **Fonte:** ensaio registado em [ClinicalTrials.gov](https://clinicaltrials.gov/study/NCT07638748) sobre viabilidade, usabilidade e aceitabilidade de reabilitação cognitiva e física baseada em realidade virtual em pessoas com défice cognitivo ligeiro. Q: Porque é que os ensaios medem viabilidade e não eficácia? A: Porque num dispositivo colocado na cabeça de uma pessoa mais velha a viabilidade é a primeira questão. Se a pessoa desiste, se o equipamento incomoda ou se a equipa não o consegue integrar no turno, nenhuma pergunta sobre eficácia chega a ser respondível. Q: A RVer provoca enjoo? A: Não temos casos de cybersickness reportados até hoje, o que é uma observação de uso e não um ensaio clínico. A escolha de vídeo real filmado com câmara maioritariamente estática reduz a exposição ao movimento que causa enjoo. A indicação é parar imediatamente perante tonturas, náusea ou desconforto. Q: A RVer trata défice cognitivo? A: Não. É usada por equipas clínicas em contextos de estimulação cognitiva. Não avalia, não classifica, não diagnostica e não substitui qualquer avaliação clínica. ### A investigação em RV clínica quase quadruplicou. O que isso prova URL: https://rver.pt/blog/investigacao-em-rv-quadruplicou-o-que-isso-prova/ Date: 13 September 2026 Quase quatro vezes mais artigos em dez anos. Volume de publicações e qualidade de evidência são eixos diferentes. Uma revisão bibliométrica publicada este ano contou a literatura sobre terapia de exposição em realidade virtual: **76 publicações em 2015, 281 em 2025**, uma taxa de crescimento anual de cerca de 14%. Quase quatro vezes mais artigos em dez anos. É um número bom para um slide e é um número perigoso para uma decisão de compra. Vale a pena separar as duas coisas. ## O que o número diz Diz que o campo deixou de ser marginal. Há dez anos, propor realidade virtual numa reunião clínica era uma conversa sobre ficção científica; hoje há literatura suficiente para uma revisão sistemática ter trabalho a fazer. Diz também onde está concentrada: a exposição gradual em perturbações de ansiedade e em stress pós-traumático é, de longe, a área mais estudada. É onde há protocolos, ensaios aleatorizados e meta-análises. ## O que o número não diz **Não diz que os resultados são bons.** Volume de publicações e qualidade de evidência são eixos diferentes. Um campo pode crescer depressa porque é fácil publicar estudos pequenos, com amostras de trinta pessoas e sem grupo de controlo ativo. **Não diz que se aplica ao que quer fazer.** A maior parte desta literatura é sobre exposição terapêutica: ambientes construídos para confrontar gradualmente um medo específico, conduzidos por um psicólogo, dentro de um protocolo. Isso é uma coisa muito diferente de pôr um senhor de 84 anos a ver a Ribeira do Porto numa tarde de quinta-feira. Nós próprios mantemos essa distinção explícita, e ela dá nome a um artigo inteiro: [realidade virtual e saúde mental são duas coisas diferentes](/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/). :::note Citar a literatura da exposição para justificar uma sessão de relaxamento é a mesma manobra que citar ensaios de morfina para vender chá. Os dois são consumidos por via oral. ::: ## O que fazer com isto numa decisão de compra Três perguntas que qualquer fornecedor deve conseguir responder sem se enrolar: 1. **Os estudos que me está a mostrar são sobre o mesmo uso que me propõe?** Exposição terapêutica, distração durante procedimento e atividade significativa em demência são três literaturas distintas. 2. **O produto está registado para quê?** A RVer é dispositivo médico Classe I (produto base) registado no INFARMED e na EUDAMED. O registo abrange o produto base: os módulos em desenvolvimento não estão abrangidos, e dizemos isso em todo o lado, incluindo quando não ajuda a venda. 3. **O que é que o fornecedor afirma por escrito?** Uma afirmação de eficácia escrita num folheto é uma afirmação regulamentar, não uma frase de marketing. Se está lá, tem de ser sustentada. ## A posição que tomamos A RVer não afirma tratar, reduzir sintomas ou substituir cuidados. É um sistema de realidade virtual para uso clínico, usado por equipas clínicas em contextos de dor, reabilitação, ansiedade, estimulação cognitiva, cuidados paliativos e saúde mental. Quem decide para que serve, em que doente e em que momento, é o clínico. O crescimento da literatura é uma boa notícia para o campo. Não é uma prova sobre um produto, nem sobre o nosso. --- **Fonte:** revisão sistemática e análise bibliométrica das aplicações clínicas e tendências de investigação em terapia de exposição em realidade virtual, [*Frontiers in Virtual Reality*](https://www.frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2026.1826777/full), 2026. Q: Mais publicações significa melhor evidência? A: Não. São eixos diferentes. Um campo pode crescer depressa porque é fácil publicar estudos pequenos, com amostras reduzidas e sem grupo de controlo ativo. Q: A literatura da exposição justifica outros usos da realidade virtual? A: Não. Exposição terapêutica, distração durante procedimento e atividade significativa em demência são literaturas distintas, com populações e desenhos diferentes. Q: O que é que a RVer afirma? A: Que é um sistema de realidade virtual para uso clínico, registado como dispositivo médico Classe I (produto base) no INFARMED e na EUDAMED, e usado por equipas clínicas. Não afirma tratar, reduzir sintomas ou substituir cuidados. ### Quando o cuidado sai da instituição URL: https://rver.pt/blog/quando-o-cuidado-sai-da-instituicao-sad-mais-saude/ Date: 12 September 2026 Apoio social e cuidados de saúde a entrar pela mesma porta. Cinco instituições não mudam o país: o desenho muda. O projeto-piloto SAD+Saúde junta apoio domiciliário social e cuidados de saúde para pessoas em situação de dependência, incapacidade ou deficiência que não conseguem, temporária ou permanentemente, assegurar as necessidades básicas ou os cuidados de saúde. Arrancou com protocolos entre o Instituto da Segurança Social e cinco entidades do setor social e solidário, uma por região do continente: a Associação de Solidariedade de S. Pedro (Norte), a Santa Casa da Misericórdia de Arganil (Centro), a Fundação AFID Diferença (Lisboa e Vale do Tejo), a Santa Casa da Misericórdia de Mora (Alentejo) e a Santa Casa da Misericórdia de Portimão (Algarve). Os serviços incluem refeições, cuidados de higiene, apoio à medicação, tratamento de roupa, limpeza da casa, acompanhamento ao exterior (farmácia, supermercado) e apoio psicossocial. As equipas são multidisciplinares, das áreas sociais, do comportamento e da saúde. ## O que isto sinaliza Cinco instituições não mudam o país. O que muda é o desenho: pela primeira vez num piloto com esta forma, **o apoio social e o cuidado de saúde entram pela mesma porta**, em casa da pessoa. Quem trabalha nesta área conhece a fronteira absurda que isto tenta apagar. A senhora tem apoio domiciliário da Misericórdia, que lhe leva o almoço e lhe dá banho. Tem uma equipa de saúde do centro de saúde, que passa quando passa. As duas raramente falam. A pessoa é a mesma e o problema é o mesmo, mas os registos são dois e as decisões são tomadas às cegas de cada lado. :::note A integração de cuidados não falha por falta de vontade. Falha porque há dois orçamentos, duas tutelas e dois sistemas de informação, e a pessoa está no meio. ::: ## O que isto significa para quem pensa em tecnologia Uma coisa incómoda, e vale a pena dizê-la: **o domicílio é o contexto mais difícil para qualquer equipamento.** Num lar há uma sala, uma tomada conhecida, uma pessoa responsável e uma rotina. Em casa há escadas, há um sofá encostado à janela, há um cuidador que já está exausto, e há um técnico que fica quarenta minutos e tem mais seis visitas nesse dia. Já escrevemos sobre o que a tecnologia faz, e sobretudo o que não faz, em [cuidador informal: o que a tecnologia faz em casa](/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/). A conclusão mantém-se: em casa, a coisa mais valiosa raramente é um aparelho novo. É tempo de alguém, e é informação que atravessa a fronteira entre o social e a saúde. ## Onde é que a RVer se encaixa nisto Com honestidade: hoje, não é no domicílio individual. O sistema é usado por equipas clínicas em instituições: hospitais, clínicas, lares, unidades de cuidados continuados e paliativos. É lá que existe a rotina, a formação e a pessoa responsável que uma sessão acompanhada exige. O que o SAD+Saúde sinaliza, e que interessa a médio prazo, é outra coisa: o cuidado está a deslocar-se para casa. Quem desenha ferramentas para este setor tem de assumir que a sala de atividades não vai ser o único sítio onde elas são usadas, e que uma ferramenta que só funciona com internet, com configuração técnica e com um informático por perto não vai lá chegar. É uma das razões pelas quais a reprodução funciona sem internet e o modo de utilização é de quiosque. Não foi pensado para o domicílio; foi pensado para instituições onde a rede é má e ninguém tem tempo. Acontece que a segunda condição descreve bem a primeira. --- **Fontes:** [Governo lança projeto-piloto SAD+Saúde](https://portugal.gov.pt/gc25/comunicacao/noticias/governo-lanca-projeto-piloto-sadsaude-para-apoiar-pessoas-dependentes-em-casa), XXV Governo Constitucional; [Projeto SAD+SAÚDE](https://www.afid.pt/projetos/projeto-sadsaude-a-decorrer/), Fundação AFID Diferença. Q: Que instituições participam no piloto? A: Cinco entidades do setor social e solidário, uma por região do continente: Associação de Solidariedade de S. Pedro, Santa Casa da Misericórdia de Arganil, Fundação AFID Diferença, Santa Casa da Misericórdia de Mora e Santa Casa da Misericórdia de Portimão. Q: A RVer é usada em domicílio? A: Não. O sistema é usado por equipas clínicas em instituições (hospitais, clínicas, lares e unidades de cuidados continuados e paliativos) onde existe a rotina, a formação e a pessoa responsável que uma sessão acompanhada exige. Q: Porque é que o sistema funciona sem internet? A: Porque foi pensado para instituições onde a rede é má e ninguém tem tempo para configuração técnica. A reprodução é offline e o equipamento corre em modo quiosque. ### «Centrado no doente» mede-se à quinta-feira à tarde URL: https://rver.pt/blog/cuidados-paliativos-centrado-no-doente-e-quinta-a-tarde/ Date: 11 September 2026 Ninguém escreve num plano que os seus cuidados são centrados na instituição. A diferença aparece noutro sítio. O Plano Estratégico para os Cuidados Paliativos assenta em quatro eixos: organização e integração dos cuidados, cuidados centrados no doente, formação e qualidade. Lido assim, parece a lista que qualquer plano teria. Vale a pena olhar para o segundo eixo com atenção, porque é o mais difícil de auditar e o mais fácil de invocar. ## «Centrado no doente» é uma expressão gasta Toda a gente diz que os seus cuidados são centrados no doente. Ninguém escreve num plano que são centrados na instituição. A diferença aparece no detalhe: **quem decide o que acontece à quinta-feira à tarde.** Se a resposta for «depende do que o doente quiser, e sabemos o que ele quer porque perguntámos e ficou escrito», o eixo está vivo. Se for «temos atividades marcadas», o eixo é um cabeçalho. Nos cuidados paliativos isto pesa mais do que em qualquer outro sítio, por uma razão simples: o tempo de que a pessoa dispõe é curto e conhecido. Uma tarde mal escolhida não se recupera na semana seguinte. ## O que é difícil de organizar A Rede Nacional de Cuidados Continuados Integrados tem unidades de convalescença, de média duração e reabilitação, de longa duração e manutenção, e equipas domiciliárias. Os cuidados paliativos atravessam tudo isto, e é aí que a integração custa: a pessoa muda de sítio, muda de equipa, e o que se sabia sobre ela (o que a acalma, o que a irrita, o que quer e o que já disse que não quer) fica frequentemente para trás. :::note Um doente transferido chega com a medicação certa e sem a história de quem é. A primeira viaja no processo; a segunda viaja na cabeça de quem ficou para trás. ::: Isto não se resolve com equipamento. Resolve-se com registo: o mesmo argumento que fizemos em [«A sessão e o processo clínico do doente»](/blog/a-sessao-e-o-processo-clinico-do-doente/). ## Onde entra uma sessão imersiva, e onde não entra Em cuidados paliativos, a RVer é usada para proporcionar experiências significativas: voltar a um sítio que a pessoa conhece, ver um lugar que sempre quis ver, estar num ambiente que reconhece. A sessão é curta, é acompanhada, e para quando a pessoa quiser. O que isto **não é**: não é tratamento, não é controlo de sintomas, não substitui nem altera qualquer parte do plano terapêutico. Quem decide se faz sentido, e quando não faz, é a equipa que segue o doente. Há uma pergunta que nos fazem com frequência e que merece resposta honesta: vale a pena com um doente que já não comunica? Escrevemos sobre isso em [doente que já não comunica: vale a pena a sessão?](/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/). A resposta curta é que a decisão é da equipa e da família, e que a ausência de resposta verbal não é, por si, um critério. ## A família, que também está no plano O plano fala de doente **e família**. Numa unidade, a família está lá. Em casa, ou a 300 quilómetros, não está. É por isso que a chamada de família existe no sistema: alguém que não pode estar presente vê o que o seu está a ver, e fala com ele. Não é uma funcionalidade clínica e não se apresenta como tal. É uma forma de encurtar uma distância que, naquele momento, custa mais do que noutro qualquer. ## Duas perguntas para uma equipa 1. **O que é que sabemos sobre esta pessoa que não está escrito em lado nenhum?** Se a resposta for muita coisa, o próximo turno vai começar do zero. 2. **Quem pergunta, e quando?** «Centrado no doente» sem um momento marcado para perguntar é uma intenção. --- **Fonte:** [Plano Estratégico para os Cuidados Paliativos](https://www.sns.min-saude.pt/wp-content/uploads/2026/03/MS_Plano-Est-Cuid-Paliativos-2025_26.pdf), Direção Executiva do SNS; [Rede Nacional de Cuidados Continuados Integrados](https://diariodarepublica.pt/dr/detalhe/decreto-lei/101-2006-353934), SNS. Q: A realidade virtual é usada como controlo de sintomas? A: Não. Em cuidados paliativos a RVer é usada para proporcionar experiências significativas, em sessões curtas e acompanhadas. Não é tratamento, não é controlo de sintomas e não substitui nem altera qualquer parte do plano terapêutico. Q: Vale a pena com um doente que já não comunica? A: É uma decisão da equipa e da família. A ausência de resposta verbal não é, por si só, um critério para não fazer nem para fazer. Q: O que é a chamada de família? A: Permite que alguém que não pode estar presente veja o que o seu familiar está a ver e fale com ele durante a sessão. Não é uma funcionalidade clínica e não se apresenta como tal. ### Congresso da Dor 2026: onde entra o não farmacológico URL: https://rver.pt/blog/congresso-da-dor-2026-onde-entra-o-nao-farmacologico/ Date: 10 September 2026 Farmacoterapia, dor neuropática, ortóteses, referenciação. Nenhuma sessão sobre não farmacológico, e há uma boa razão para isso. O Congresso Multidisciplinar da Dor acontece a 16, 17 e 18 de setembro, no Porto, na Fundação António Cupertino de Miranda. Vale a pena olhar para o programa antes, porque ele diz uma coisa sobre o estado da matéria. ## O que está no programa Avaliação multidisciplinar da dor. Dor pediátrica. Exame físico musculoesquelético. Ortóteses. Farmacoterapia: anti-inflamatórios, corticoides, opióides, paracetamol, fármacos adjuvantes. Dor neuropática. Referenciação para ortopedia e para medicina física e reabilitação. O papel da medicina geral e familiar. É um programa sólido e é um programa **maioritariamente farmacológico**. Não há, no programa público, uma sessão dedicada a abordagens não farmacológicas ou a tecnologia. Isto não é uma crítica ao congresso. É um retrato fiel de onde está o centro de gravidade da consulta da dor em Portugal, e quem vende ou compra outra coisa faz melhor em saber disso do que em fingir que não é assim. ## A pergunta que sobra Se a dor é multidisciplinar o suficiente para juntar ortopedia, medicina física, pediatria e medicina geral e familiar na mesma sala, porque é que o não farmacológico costuma entrar só pela porta da fisioterapia? Parte da resposta é boa: a farmacoterapia tem décadas de ensaios, doses, contraindicações e escalas comparáveis. É conhecimento acumulado, e não se despacha com entusiasmo. Parte da resposta é menos boa: o não farmacológico chega frequentemente embrulhado em promessas que não sustenta. Quem já ouviu «isto reduz a dor em 40%» de um vendedor sem um ensaio atrás fica, com razão, com o pé atrás na vez seguinte. :::note A escala de quem prescreve não é entusiasmo, é evidência. Uma ferramenta que exagera hoje paga-o durante anos, em todas as conversas seguintes. ::: ## O que a realidade virtual é, nesta conversa É um foco alternativo de atenção durante um procedimento ou um tratamento. Nada mais do que isto, e nada menos. O que a RVer faz é pôr a pessoa dentro de um ambiente filmado, com som ambisónico, enquanto a equipa faz o que tem a fazer. Não é analgesia. Não substitui fármaco nenhum, não altera dose nenhuma e não dispensa decisão clínica nenhuma. Quem decide se faz sentido naquele doente, naquele momento, é quem o segue. Escrevemos com mais detalhe sobre onde isto se encaixa, e onde não se encaixa, em [consulta da dor: onde entra a realidade virtual](/blog/consulta-da-dor-onde-entra-a-realidade-virtual/) e em [realidade virtual nas urgências](/blog/realidade-virtual-nas-urgencias-o-que-respondemos/). ## Se for ao congresso, três perguntas úteis Não para fazer aos oradores. Para levar de volta ao serviço: 1. **Quais são os procedimentos em que o tempo de espera e a antecipação pesam mais?** São esses, e não «a dor» em geral, que definem onde uma abordagem não farmacológica se experimenta primeiro. 2. **Quem fica responsável por conduzir e registar?** Sem nome, qualquer piloto acaba em gaveta. 3. **O que é que vai ser medido, e comparado com quê?** Sem um antes, não há depois. São as mesmas três perguntas que fazemos a quem nos contacta. Não vendem nada, mas separam um projeto que vai acontecer de um projeto que vai ser discutido. --- **Fonte:** [Congresso Multidisciplinar da Dor 2026](https://im3m.pt/congresso-2026/), 16 a 18 de setembro, Porto. Q: Quando e onde é o congresso? A: A 16, 17 e 18 de setembro de 2026, no Porto, na Fundação António Cupertino de Miranda. Q: A realidade virtual reduz a dor? A: Não é isso que a RVer afirma. É usada durante procedimentos e tratamentos como foco alternativo de atenção. Não é analgesia, não substitui fármacos, não altera doses e não dispensa decisão clínica. Q: Por onde se começa num serviço? A: Pelos procedimentos em que o tempo de espera e a antecipação pesam mais, com uma pessoa responsável por conduzir e registar, e com uma medida definida antes de começar. ### O que as certidões de óbito não contam sobre a demência URL: https://rver.pt/blog/o-que-as-certidoes-de-obito-nao-contam/ Date: 9 September 2026 Menos de um terço tinha doença neurodegenerativa na certidão. A coorte é muito particular, mas o mecanismo não é. Um estudo publicado no *JAMA Network Open* olhou para 202 dadores de cérebro do UNITE Brain Bank (antigos jogadores de futebol americano, recrutados entre 2008 e 2021) e comparou duas coisas: o diagnóstico de demência estabelecido por clínicos e o que ficou escrito na certidão de óbito. Menos de um terço tinha uma doença neurodegenerativa registada como causa subjacente da morte. Os autores estimam que o campo da certidão falha cerca de **69% das mortes relacionadas com demência** naquela população. ## A ressalva, primeiro É uma população muito particular: homens, atletas profissionais, com exposição repetida a traumatismo craniano, e cérebros doados precisamente porque alguém suspeitava de patologia. Não se transporta este número para Portugal, nem para um lar em Viseu. O que se transporta é o mecanismo. **A certidão de óbito não é um instrumento de investigação.** É preenchida depressa, muitas vezes por quem não acompanhou a pessoa durante anos, e tende a registar o acontecimento final (pneumonia, sépsis, paragem cardíaca) e não a doença que levou a pessoa até ali. ## Porque é que isto importa a quem cuida Porque os registos administrativos são a matéria-prima das decisões que depois caem em cima das instituições. Quando se pergunta quanto custa a demência a um país, a resposta sai de bases de dados. Quando se decide quantas camas de cuidados continuados são precisas, sai de bases de dados. Quando se distribui financiamento por áreas de doença, sai de bases de dados. Se a demência aparece sistematicamente abaixo do que é, tudo o que vem a seguir fica calibrado abaixo do que devia. :::note Não é uma teoria sobre estatística. É a razão pela qual o orçamento de uma área pode ser menor do que a realidade dessa área, e ninguém consegue apontar onde é que a conta se perdeu. ::: Já tínhamos escrito sobre este fosso noutro plano, mais perto do chão: [o que o sistema de saúde mede e o que fica invisível](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/). A certidão de óbito é o mesmo problema, no fim da linha. ## O que uma instituição pode fazer, e o que não pode **Não pode** corrigir certidões de óbito. Isso é um ato médico, e quem o faz não está na sala de atividades. **Pode** cuidar do registo enquanto a pessoa está viva, que é a fonte de onde o resto bebe: 1. **Diagnóstico no processo, com data e origem.** «Demência» sem mais nada é o começo de um registo perdido. 2. **Observação em vez de impressão.** «Repetiu a mesma pergunta quatro vezes em vinte minutos» é registo. «Está mais confuso» não é. 3. **O que foi tentado, e o que aconteceu.** Uma atividade, uma sessão, uma alteração de rotina: o que se fez, quanto tempo, o que se observou. É isto que dá substância a uma carta de referenciação. Nenhum destes três tem custo. Todos dependem de alguém decidir que o registo é parte do cuidado e não papelada a seguir a ele: é o argumento que fizemos em [«A sessão e o processo clínico do doente»](/blog/a-sessao-e-o-processo-clinico-do-doente/). ## E a tecnologia? Um sistema de realidade virtual não resolve nada disto, e convém dizê-lo sem rodeios. O que uma ferramenta com registo faz é mais modesto: escreve sozinha o que aconteceu numa sessão (duração, cenário, o que a equipa observou) e poupa a parte do registo que se perde por cansaço no fim do turno. Isso não corrige uma certidão de óbito daqui a dez anos. Torna menos provável que aquela hora de quinta-feira desapareça sem deixar rasto. --- **Fonte:** estudo de coorte publicado no *JAMA Network Open* sobre 202 dadores do UNITE Brain Bank e o registo de doença neurodegenerativa nas certidões de óbito, [noticiado pelo AJMC](https://www.ajmc.com/view/nfl-dementia-deaths-often-miss-neurodegenerative-diagnosis). Q: O número de 69% aplica-se a Portugal? A: Não. A coorte é de antigos jogadores profissionais de futebol americano, com exposição repetida a traumatismo craniano e cérebros doados por suspeita de patologia. O que se transporta é o mecanismo, a certidão regista o acontecimento final e não a doença de fundo, não a percentagem. Q: Uma instituição pode corrigir isto? A: Não nas certidões, que são um ato médico. Pode cuidar do registo enquanto a pessoa está viva: diagnóstico com data e origem no processo, observação em vez de impressão, e registo do que foi tentado e do que aconteceu. Q: A realidade virtual ajuda no registo? A: Uma ferramenta com registo escreve o que aconteceu na sessão: duração, cenário, observações da equipa. Não corrige registos administrativos nem substitui o processo clínico; poupa a parte do registo que se perde no fim do turno. ### O plano das demências mudou de dono. E passou a contar outra coisa URL: https://rver.pt/blog/plano-demencias-o-que-passou-a-ser-contado/ Date: 8 September 2026 Mudou o organigrama, dizem. Mudaram os indicadores, e esses descem sempre até quem presta o cuidado. O Plano Nacional de Saúde para as Demências tem um modelo de governação novo desde abril de 2026. A notícia foi lida, na altura, como reorganização administrativa: a Direção Executiva do SNS passa a coordenar a execução, depois de extintas as Administrações Regionais de Saúde. Quem trabalha num lar ou numa unidade de convalescença encolheu os ombros, e com razão aparente: mudou o organigrama, não mudou a quinta-feira à tarde. Só que a parte que interessa não é quem coordena. É o que passou a ser contado. ## Os indicadores O despacho fixa indicadores de avaliação da implementação dos percursos de cuidados nas unidades locais de saúde. Entre eles: - o **número de percursos integrados** efetivamente implementados; - a **percentagem de profissionais de saúde com formação específica** na área das demências; - o **acompanhamento prestado aos cuidadores informais**; - planos individuais de cuidados, e indicadores assistenciais como internamentos, admissões em urgência e referenciação para cuidados continuados e paliativos. Vale a pena parar no segundo e no terceiro. Um plano nacional que mede **formação de profissionais** e **acompanhamento de cuidadores** está a dizer, em linguagem de indicador, que o cuidado à pessoa com demência não se resolve com um fármaco e uma consulta. Resolve-se com pessoas preparadas e com a família ao lado. ## O que isto muda para uma instituição Nada disto obriga uma instituição privada, um lar ou uma IPSS a coisa nenhuma. O despacho vincula o SNS. Mas os indicadores de um plano nacional têm o hábito de descer: aparecem depois nos cadernos de encargos, nas [candidaturas a financiamento](/aquisicao/), nas visitas de acompanhamento e nas conversas com a unidade local de saúde da área. Se a pergunta «quantos dos vossos profissionais têm formação específica em demências?» vai ser feita a alguém, mais vale ter o número. :::note Contar antes de ser perguntado é barato. Contar depois é uma reunião. ::: ## Onde entra uma ferramenta não farmacológica Com honestidade: não entra nos indicadores. Nenhum destes mede equipamento, e ainda bem: um plano que contasse aparelhos comprados mediria orçamento, não cuidado. Entra noutro sítio, que é o mais interessante. Dois dos indicadores, formação da equipa e acompanhamento do cuidador informal, descrevem **trabalho de pessoas**. Qualquer ferramenta, seja um [sistema de realidade virtual](/solucoes/lar-residencial/), uma sala Snoezelen ou um carrinho de atividades, só conta se a equipa souber usá-la e se o [registo do que aconteceu](/blog/a-sessao-e-o-processo-clinico-do-doente/) chegar ao processo do doente. O equipamento sozinho não produz nenhum destes números. É a mesma conclusão a que chegámos noutro contexto, quando escrevemos sobre [o que o sistema de saúde mede e o que fica invisível](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/): o que não é registado não existe para quem avalia, por muito bem que tenha corrido. ## Três coisas para fazer esta semana 1. **Contar quem tem formação.** Não «a equipa está sensibilizada»: quantas pessoas, que formação, que ano. 2. **Ver como se regista o contacto com o cuidador informal.** Se está num caderno, não conta. Se está no processo, conta. 3. **Perguntar à unidade local de saúde da área** se já tem percurso integrado de demência implementado, e quem é a pessoa de contacto. É uma chamada. Nenhuma destas três precisa de orçamento, e nenhuma precisa de tecnologia. São as que decidem se a quarta, comprar seja o que for, chega sequer a fazer sentido. --- **Fontes:** Despacho que aprova o novo modelo de governação do Plano Nacional de Saúde para as Demências, publicado a 13 de abril de 2026; [Plano Nacional para as Demências](https://alzheimerportugal.org/plano-nacional-para-as-demencias/), Associação Alzheimer Portugal. Q: O plano obriga lares e IPSS a alguma coisa? A: Não. O despacho vincula o SNS. Mas os indicadores de um plano nacional tendem a descer para cadernos de encargos, candidaturas a financiamento e visitas de acompanhamento: por isso convém ter os números antes de serem pedidos. Q: Há algum indicador sobre equipamento ou tecnologia? A: Não. Os indicadores medem percursos implementados, formação de profissionais, acompanhamento de cuidadores, planos individuais de cuidados e indicadores assistenciais. Um plano que contasse aparelhos comprados estaria a medir orçamento, não cuidado. Q: O que é a RVer e o que não é? A: A RVer é um sistema de realidade virtual para uso clínico, registado como dispositivo médico Classe I (produto base) no INFARMED e na EUDAMED, usado por equipas de saúde e de lares. Não diagnostica, não avalia e não substitui qualquer avaliação ou decisão clínica. ### A pessoa não estava desinteressada: não estava a ouvir URL: https://rver.pt/blog/perda-auditiva-o-que-muda-numa-sessao/ Date: 7 September 2026 «Não colaborou», «não gostou», «não percebeu»: três frases que aparecem no registo depois de uma sessão falhada, e que às vezes descrevem apenas um aparelho auditivo sem pilha. Vale a pena excluir isso antes de mudar o conteúdo. A perda auditiva é o fator de risco que junta duas coisas raras: **é dos que mais pesa na demência** e **é dos mais fáceis de corrigir**. Na atualização de 2024 da comissão do *Lancet*, responde por cerca de **7%** do risco atribuível: o valor mais alto da lista, a par do colesterol LDL na meia-idade. Foi 9% em 2017 e 8% em 2020, e a própria estimativa é criticada por não considerar a sobreposição entre fatores, o que convém dizer sempre que se cita uma percentagem destas. Escrevemos sobre a lista completa em [«Os 14 fatores de risco»](/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/). Mas este artigo não é sobre risco de demência a dez anos. É sobre a terça-feira: **a audição decide se a sessão de hoje resulta**, e é a explicação mais banal, e mais ignorada, de uma sessão que correu mal. ## O que a perda auditiva faz a uma sessão Quatro efeitos, e nenhum se parece com surdez à primeira vista: - **A instrução não chega.** «Olhe para a direita» dito de lado, com ruído de fundo, não é ouvido, e o que fica registado é que a pessoa não seguiu a instrução. - **O esforço de escuta cansa.** Quem ouve mal gasta atenção a decifrar em vez de a usar no que está a ver. Vinte minutos passam a ser muito. - **Confunde-se com declínio cognitivo.** Responder ao lado, pedir para repetir, desistir da conversa: é o retrato clássico de quem não ouve, e o retrato clássico de quem está a declinar. Sem excluir a audição, a segunda hipótese fica a ganhar sem julgamento, e é o mesmo problema que descrevemos em [declínio sem diagnóstico](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/). - **Isola.** Quem ouve mal participa menos em grupo, e é aí que começa a retirada que ninguém regista. ## Dois minutos antes da sessão A verificação não é clínica e faz-se sem material: 1. **O aparelho existe?** Muitos residentes têm um, na gaveta. 2. **Tem pilha, e está ligado?** É a causa isolada mais comum, e resolve-se em trinta segundos. 3. **Está bem colocado?** Um molde mal encaixado apita e a pessoa tira-o, e a partir daí não volta a usá-lo. 4. **De que lado ouve melhor?** Toda a gente da equipa devia saber isto de cor para os residentes com quem trabalha. 5. **Houve cera?** É frequente, banal, e reversível numa consulta. Se alguma destas cinco falhar, **resolvam isso antes de mudar o cenário**. Nenhum conteúdo compensa um aparelho na gaveta. ## Sete adaptações que mudam o resultado Nenhuma exige equipamento diferente do que já existe: - **Fale de frente e ao nível dos olhos**, antes de pôr o equipamento. O que se combina antes é o que vai valer durante. - **Combine sinais de mão** para «parar», «está bem» e «mais alto». Uma pessoa com o equipamento posto não vê a cara de ninguém, e isto vale para toda a gente, não só para quem ouve mal. - **Baixe o ruído da sala.** Televisão desligada, porta fechada. O ruído de fundo prejudica quem ouve mal muito mais do que prejudica os outros. - **Escolha conteúdo que não dependa de narração.** Um cenário que se explica sozinho vale mais do que um bom texto que não é ouvido: é um critério a acrescentar aos de [como se escolhe um cenário](/blog/atividade-significativa-como-se-escolhe-um-cenario/). - **Não grite: articule e abrande.** Gritar distorce e, com aparelho, chega a doer. - **Cuidado com o volume do equipamento.** Quem ouve mal pede mais volume, e um aparelho auditivo amplifica por cima. Comece baixo e suba com a pessoa a dizer. - **Encurte.** Se o esforço de escuta cansa, quinze minutos bons valem mais do que trinta arrastados: a lógica que está em [duração e frequência](/blog/duracao-frequencia-sessao-realidade-virtual/). ## O que registar Duas linhas, e mudam a próxima sessão: **se o aparelho estava colocado e a funcionar**, e **de que lado se falou**. Sem isso, a sessão seguinte recomeça do zero e a equipa volta a atribuir à pessoa aquilo que é do contexto. É o mesmo princípio dos outros artigos desta série: o que não fica escrito não chega a quem conduz da próxima vez. ## A parte que nos toca O nosso conteúdo tem áudio, e nada disto o dispensa. Quando um serviço nos pergunta se a RVer serve para uma pessoa com perda auditiva grave, a resposta honesta é: **serve, se a atividade for escolhida para ser vista e não ouvida**, e se a equipa combinar antes a forma de comunicar. Não é uma adaptação do produto: é uma adaptação da sessão, e é a equipa que a faz. Os limites gerais de quem pode e não pode usar estão em [acessibilidade](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação auditiva, diagnóstico ou acompanhamento clínico. Q: Qual é o peso da perda auditiva no risco de demência? A: Na atualização de 2024 da comissão do Lancet, a perda auditiva responde por cerca de 7% do risco atribuível: o valor mais alto da lista, a par do colesterol LDL na meia-idade. Era 9% em 2017 e 8% em 2020. A estimativa é criticada por não considerar a sobreposição entre fatores, o que convém referir sempre que se cita. Q: O que verificar antes de uma sessão com alguém que ouve mal? A: Cinco coisas, em dois minutos e sem material: se o aparelho auditivo existe, se tem pilha e está ligado, se está bem colocado, de que lado a pessoa ouve melhor, e se há cera. A pilha é a causa isolada mais comum e resolve-se em trinta segundos. Q: A perda auditiva pode ser confundida com declínio cognitivo? A: Sim, e é frequente. Responder ao lado, pedir para repetir e desistir da conversa são o retrato clássico de quem não ouve e também de quem está a declinar. Sem excluir a audição, a hipótese cognitiva fica a ganhar sem julgamento. Q: Como se adapta uma sessão a quem tem perda auditiva? A: Falar de frente antes de colocar o equipamento, combinar sinais de mão para parar e para ajustar, baixar o ruído da sala, escolher conteúdo que não dependa de narração, articular em vez de gritar, começar com volume baixo e subir com a pessoa a dizer, e encurtar a sessão: porque o esforço de escuta cansa. Q: A RVer serve para alguém com perda auditiva grave? A: Serve, se a atividade for escolhida para ser vista e não ouvida, e se a equipa combinar antes a forma de comunicar. Não é uma adaptação do produto, é uma adaptação da sessão, e quem a faz é a equipa da instituição. ### Realidade virtual no trabalho de parto: o que a evidência mostra e o que um bloco de partos tem de resolver antes URL: https://rver.pt/blog/realidade-virtual-trabalho-de-parto-dor-e-ansiedade/ Date: 6 September 2026 A literatura sobre realidade virtual no trabalho de parto é consistente numa direção: menos dor referida, menos ansiedade, sem sinal de dano. É também pequena e heterogénea. E entre o que os ensaios mostram e o que acontece numa sala de partos há cinco perguntas práticas que ninguém responde por vocês. É um dos pedidos que nos chegam com mais entusiasmo e menos preparação: *queremos pôr isto no bloco de partos*. O entusiasmo tem fundamento na literatura. A preparação é o que decide se aquilo passa da terceira semana. ## O que a evidência mostra Duas sínteses, e o que cada uma acrescenta. Uma **revisão sistemática com meta-análise** publicada na *JMIR Serious Games* reuniu **12 estudos com 1095 participantes**, procurados em sete bases de dados, sobre o uso de realidade virtual na gravidez e no parto. Avaliou dor, ansiedade, duração do trabalho de parto, satisfação e **eventos adversos**, e é este último desfecho que mais interessa a um serviço: a revisão foi desenhada para responder à segurança, não só à eficácia. Uma **revisão integrativa de 2025**, na *Pain Management Nursing*, rastreou 1227 estudos e incluiu **13** (10 dos quais ensaios aleatorizados), juntando aos resultados quantitativos a **experiência das próprias mulheres**, que é a parte normalmente ausente das meta-análises. A leitura conjunta, sem esticar: **os ensaios apontam de forma consistente para redução da dor referida e da ansiedade durante o trabalho de parto**, com boa aceitação e sem sinal de dano. E, como as próprias autoras assinalam, a heterogeneidade entre estudos é alta e o número de participantes é pequeno para a variabilidade que um parto tem. É evidência encorajadora, não é evidência fechada. :::note Uma coisa que a literatura não diz, e que nenhum fornecedor deve sugerir: isto **não é analgesia** e não substitui nenhuma decisão sobre analgesia. Não altera indicação de epidural, não trata dor, e não é ferramenta de decisão clínica. ::: ## Porque é que o parto é um caso favorável Três razões, e explicam por que motivo os resultados aparecem mesmo em ensaios pequenos: - **A dor tem uma componente atencional grande**, e o intervalo entre contrações é uma janela natural para trabalhar essa componente: o mecanismo que descrevemos em [gestão da dor](/blog/realidade-virtual-gestao-da-dor/). - **A ansiedade antecipatória amplifica a dor.** Quem chega a um bloco assustada sente mais, e é o mesmo padrão que aparece na [ansiedade pré-operatória](/blog/realidade-virtual-ansiedade-pre-operatoria/). - **A pessoa está acordada, colaborante e tem tempo.** Ao contrário de quase tudo o resto num hospital. ## As cinco perguntas que decidem, e que não são sobre conteúdo É aqui que os projetos falham, e nenhuma destas perguntas se resolve com um catálogo melhor. **1. Quem interrompe?** A mulher tem de poder tirar o equipamento **num segundo**, sem pedir, sem procurar um botão. Se a resposta não for imediata e óbvia, o resto não interessa. É a regra que já aplicamos em [quando o utente recusa](/blog/quando-o-utente-recusa-realidade-virtual/). **2. Quem conduz?** Uma sessão no parto acontece durante trabalho clínico ativo, e não pode acrescentar uma pessoa à sala. Ou a equipa que já lá está a consegue conduzir com formação de utilização, ver [quem pode conduzir](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/), ou o equipamento fica no armário. **3. Como se limpa, entre duas mulheres?** Um bloco de partos tem protocolo próprio, e um equipamento que não encaixe nele não entra. As nossas respostas estão em [higiene e segurança](/blog/higiene-seguranca-equipamento-realidade-virtual/), e a pergunta certa a fazer-nos é o tempo de reprocessamento, não o material. **4. E a monitorização?** Cardiotocografia, acessos, mobilidade da mulher, posição. O equipamento tem de ser compatível com tudo isso, e a resposta honesta é que depende da sala, não do produto. **5. Quando se propõe?** Uma proposta feita em plena fase ativa é uma má proposta. O consentimento pertence ao plano de parto, discutido antes, com a informação toda: incluindo a de que pode recusar sem justificar. É o mesmo princípio de [consentimento informado](/blog/consentimento-informado-realidade-virtual-saude/). ## Enjoo, que aqui é uma questão à parte O desconforto vestibular é raro e ligeiro com conteúdo bem escolhido, como escrevemos em [conforto e enjoo](/blog/conforto-e-enjoo-realidade-virtual/). No trabalho de parto há um agravante: **náusea é frequente por razões que nada têm a ver com o equipamento**: a própria fase de transição, a analgesia, o jejum. A consequência prática é de registo, não de conteúdo: se houver náusea, ninguém vai conseguir dizer depois de que foi. Vale a pena registar o que se usou e quando, para que a equipa não atribua ao equipamento um sintoma que ia acontecer de qualquer maneira, nem o contrário. ## Onde a RVer está nisto Com clareza: **não temos um produto obstétrico**. O produto base é uma biblioteca de conteúdo para conforto, distração e atividade, registada como [Dispositivo Médico Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/), sem alegação de tratamento e sem indicação específica para trabalho de parto. Um serviço que queira testar isto num bloco de partos consegue fazê-lo com o produto base, e deve fazê-lo como piloto, com as cinco perguntas de cima respondidas por escrito antes de a primeira mulher o experimentar. Se as respostas não existirem, a nossa recomendação é começar por um contexto mais simples e voltar ao bloco depois. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem analgesia, avaliação ou acompanhamento clínico. Q: A realidade virtual reduz a dor do parto? A: Os ensaios apontam de forma consistente para redução da dor referida e da ansiedade durante o trabalho de parto, com boa aceitação e sem sinal de dano. A revisão sistemática na JMIR Serious Games reuniu 12 estudos com 1095 participantes; uma revisão integrativa de 2025 na Pain Management Nursing incluiu 13 estudos, 10 deles aleatorizados. A heterogeneidade entre estudos é alta e as amostras são pequenas: é evidência encorajadora, não fechada. Q: Isto substitui a epidural ou outra analgesia? A: Não. Não é analgesia, não altera a indicação de qualquer método analgésico e não é ferramenta de decisão clínica. É uma medida de conforto e distração, complementar, e a decisão sobre analgesia continua inteiramente com a equipa e com a mulher. Q: A mulher pode tirar o equipamento a qualquer momento? A: Tem de poder, num segundo, sem pedir e sem procurar um botão. Se essa resposta não for imediata e óbvia, o equipamento não deve entrar numa sala de partos. Q: Quem conduz a sessão durante o trabalho de parto? A: A equipa que já está na sala, com formação de utilização: normalmente enfermagem especialista. Uma sessão que exija acrescentar uma pessoa à sala não é viável em trabalho clínico ativo, e é a razão mais comum para o equipamento acabar no armário. Q: E o enjoo, num contexto em que a náusea já é frequente? A: O desconforto vestibular é raro e ligeiro com conteúdo bem escolhido, mas no trabalho de parto a náusea é frequente por razões independentes: a fase de transição, a analgesia, o jejum. A consequência é de registo: anotar o que se usou e quando, para que a equipa não atribua ao equipamento um sintoma que ocorreria de qualquer forma, nem o contrário. Q: A RVer tem um produto para obstetrícia? A: Não. O produto base é uma biblioteca de conteúdo para conforto, distração e atividade, registada como dispositivo médico Classe I, sem alegação de tratamento e sem indicação específica para trabalho de parto. Um serviço pode testá-lo em piloto, com as questões de sala respondidas por escrito antes. ### «Quanto mais cedo souber, mais pode fazer»: o diagnóstico que falta nos lares URL: https://rver.pt/blog/mes-mundial-alzheimer-2026-o-diagnostico-que-falta/ Date: 5 September 2026 A campanha internacional deste setembro tem um tema que, em Portugal, bate num número concreto: «quanto mais cedo souber, mais pode fazer». Nos lares portugueses há uma parte substancial de residentes sobre quem ninguém sabe ao certo. *Escrito para o Mês Mundial do Alzheimer de 2026. As cinco coisas valem para qualquer mês.* Setembro é o **Mês Mundial do Alzheimer**, com o Dia Mundial a **21 de setembro** (está, com os outros, no [calendário de dias mundiais da saúde](/ferramentas/dias-mundiais/)). O tema da campanha da Alzheimer's Disease International para 2026 é **«The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters»**: quanto mais cedo souber, mais pode fazer. É um tema que se presta a cartazes. Também se presta a uma pergunta desconfortável, e é essa que vale a pena fazer numa instituição portuguesa. ## O número que corresponde ao tema Um estudo transversal em **423 estruturas residenciais para pessoas idosas** portuguesas, feito por investigadores das Universidades de Coimbra e de Aveiro no âmbito do projeto SINDIA e publicado na *Acta Médica Portuguesa*, encontrou, em média: cerca de **um terço** dos residentes com diagnóstico formal de demência, e cerca de **um quinto** com **suspeita de declínio cognitivo sem diagnóstico registado**. Escrevemos sobre o que isso muda na condução de uma sessão em [declínio cognitivo sem diagnóstico nos lares](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/). Aqui interessa outra coisa: esse quinto **é exatamente a população de que a campanha fala**. Não são pessoas por diagnosticar num consultório distante: estão numa instituição, com equipa a vê-las todos os dias. :::note Diagnosticar é um ato clínico. Nada neste artigo, e nada num equipamento de realidade virtual, substitui uma avaliação. O que uma instituição pode fazer é **encurtar o caminho até ela**. ::: ## Porque é que «mais cedo» muda alguma coisa A objeção honesta aparece cedo nestas conversas: *para quê diagnosticar, se não há cura?* Tem três respostas, e nenhuma delas é uma promessa terapêutica. **Muda o que é reversível.** Uma parte das suspeitas de demência não é demência: é depressão, hipotiroidismo, défice de B12, efeito de medicação, infeção urinária, perda auditiva ou visual mal corrigida. Sem avaliação, isso não se distingue, e essas coisas tratam-se. **Muda as decisões que a pessoa ainda pode tomar sozinha.** Onde quer viver, que cuidados quer receber, quem decide por si quando já não puder. Um diagnóstico tardio tira à pessoa a janela em que essas decisões ainda são dela, e o [Estatuto da Pessoa Idosa](/blog/estatuto-da-pessoa-idosa-atividades-e-autonomia/) diz que essa autonomia é um direito. **Muda a forma como a equipa lê o comportamento.** «Está a ser difícil» e «tem uma doença que lhe afeta a linguagem» produzem cuidados diferentes, com as mesmas pessoas e o mesmo orçamento. E o quadro concreto muda o que resulta numa atividade, como descrevemos em [tipos de demência](/blog/tipos-de-demencia-o-que-muda-numa-sessao/). ## Cinco coisas para fazer, sem depender de ninguém Nenhuma exige orçamento, e nenhuma exige tecnologia: 1. **Contar.** Quantos residentes têm diagnóstico registado no processo? Sobre quantos existe suspeita escrita, sem avaliação? A diferença entre os dois números é o trabalho de setembro. 2. **Escrever a observação, não a impressão.** «Repetiu a mesma pergunta quatro vezes em vinte minutos, a 3 de setembro» vale numa consulta. «Está mais confuso» não vale. 3. **Verificar audição e visão primeiro.** Um aparelho auditivo sem pilha e uma catarata por operar imitam declínio cognitivo, e são as duas coisas mais fáceis de excluir. A perda auditiva é, aliás, um dos fatores com maior peso na lista dos [14 fatores de risco](/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/). 4. **Levar a lista ao médico assistente**, com datas. Uma sequência datada de observações vale mais numa consulta de vinte minutos do que a memória de quem está de turno nesse dia. 5. **Falar com as famílias.** Setembro dá a desculpa perfeita para a conversa que se anda a adiar, e a campanha existe precisamente para isso. ## O que a tecnologia faz aqui, e o que não faz **Não diagnostica.** Nenhuma sessão de realidade virtual avalia, gradua ou deteta demência, e desconfiem de quem o sugerir. O que um registo consistente de sessões dá é **matéria-prima para quem avalia**: o que se usou, quanto tempo, como a pessoa reagiu, o que interrompeu, observações datadas de funcionamento **fora da consulta**, que é onde a maior parte da vida acontece. É a mesma coisa que um bom registo de atividades dá, com a diferença de ser mais fácil de manter. E o resto do que fazemos (reminiscência, estimulação, conforto) é [bem-estar e atividade](/blog/realidade-virtual-demencia-alzheimer/), medido em como correu a tarde, e é assim que entra no dia de um [lar](/solucoes/lar-residencial/). Não altera o curso da doença, e a campanha deste mês também não pede isso a ninguém. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, diagnóstico ou acompanhamento clínico. Q: Qual é o tema do Mês Mundial do Alzheimer de 2026? A: «The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters»: quanto mais cedo souber, mais pode fazer. É a campanha da Alzheimer's Disease International para setembro de 2026, com o Dia Mundial do Alzheimer a 21 de setembro, e centra-se no diagnóstico atempado. Q: Para que serve diagnosticar demência se não há cura? A: Por três razões que não são terapêuticas. Uma parte das suspeitas não é demência: é depressão, défice de B12, hipotiroidismo, efeito de medicação, perda auditiva ou visual mal corrigida, e essas causas tratam-se. Um diagnóstico atempado preserva a janela em que a própria pessoa ainda decide sobre a sua vida. E muda a forma como a equipa lê o comportamento, com o mesmo orçamento. Q: Quantos residentes em lares portugueses têm suspeita sem diagnóstico? A: Num estudo em 423 ERPI portuguesas (projeto SINDIA, Universidades de Coimbra e Aveiro, publicado na Acta Médica Portuguesa), cerca de um quinto dos residentes apresentava suspeita de declínio cognitivo sem diagnóstico registado, e cerca de um terço tinha diagnóstico formal. Os valores referem-se ao universo inquirido. Q: O que pode uma instituição fazer em setembro sem orçamento? A: Contar quantos residentes têm diagnóstico e sobre quantos há suspeita sem avaliação; registar observações datadas em vez de impressões; verificar audição e visão, que imitam declínio cognitivo e são fáceis de excluir; levar essa lista ao médico assistente; e usar a campanha como pretexto para a conversa com as famílias. Q: A realidade virtual ajuda a detetar demência? A: Não. Nenhuma sessão avalia, gradua ou deteta demência. O que um registo consistente de sessões dá é matéria-prima para quem avalia: observações datadas de como a pessoa funciona fora da consulta. ### Catorze fatores de risco de demência: onde entra a tecnologia, e onde não entra URL: https://rver.pt/blog/14-fatores-de-risco-de-demencia-onde-entra-a-tecnologia/ Date: 4 September 2026 A comissão do Lancet sobre demência atualizou a lista em 2024: são agora 14 fatores modificáveis, e até 45% dos casos poderiam, em teoria, ser evitados se todos fossem eliminados. Um deles é o isolamento social, e é o único em que uma sessão de tecnologia tem alguma coisa a dizer. Em julho de 2024, a comissão do *Lancet* sobre prevenção, intervenção e cuidados na demência publicou a atualização do seu relatório. Passaram a ser **14 fatores de risco modificáveis** ao longo da vida, e a estimativa que ficou a circular é esta: **até 45% dos casos futuros de demência poderiam ser evitados** se todos os 14 fossem eliminados. É um número que aparece em muitos slides, incluindo os de fornecedores de tecnologia. Vale a pena perceber o que ele diz. ## Os catorze Aos doze anteriores (baixa escolaridade, perda auditiva, hipertensão, tabagismo, obesidade, depressão, inatividade física, diabetes, consumo excessivo de álcool, traumatismo craniano, poluição do ar e **isolamento social**), a atualização de 2024 acrescentou dois: - **colesterol LDL elevado na meia-idade**, com cerca de 7% do risco atribuível; - **perda de visão não tratada na idade avançada**, com cerca de 2%. ## O que «45% evitável» quer dizer, e o que não quer Esta é a parte que se perde na citação, e é a parte que interessa. **É uma estimativa populacional, não uma promessa individual.** Diz o que aconteceria à incidência num país se aqueles fatores desaparecessem todos. Não diz que uma pessoa concreta que corrija um fator reduz o seu risco em nenhuma percentagem conhecida. **É um cenário-limite.** «Se todos os 14 fossem eliminados» não é um plano; nenhum sistema de saúde do mundo elimina a poluição do ar e a baixa escolaridade. **Risco atribuível não é causalidade demonstrada** para cada fator, e a própria comissão o assinala. É a melhor síntese disponível, e continua a ser uma síntese. **E a maior parte dos fatores é de meia-idade ou antes.** Escolaridade, hipertensão, colesterol, tabaco: quando alguém entra num lar, a janela de vários deles fechou há décadas. A prevenção séria acontece muito antes da porta de uma ERPI. ## O que um lar pode mesmo fazer da lista Seis, e nenhum é tecnológico: - **Perda auditiva**: verificar se o aparelho existe, se tem pilha e se é usado. É provavelmente a intervenção com melhor relação entre esforço e efeito de toda a lista. - **Perda de visão**: a novidade de 2024. Cataratas por operar e óculos errados são frequentes e tratáveis. - **Hipertensão e diabetes**: já estão a ser geridas; a questão é se estão controladas. - **Inatividade física**: o que existe, com que frequência, e para quem não vai às aulas de grupo. - **Depressão**: subdiagnosticada, e confundida com «está mais calado». - **Isolamento social**: o único onde entra a conversa que se segue. Se uma direção técnica quiser agir sobre risco de demência a partir desta lista, **é por aqui que começa**, e não por um catálogo de fornecedores. Dizê-lo é contra o nosso interesse comercial imediato e é a única leitura honesta do relatório. ## O isolamento social, e a fronteira O isolamento social está na lista desde antes de 2024, e é real: os dados portugueses que citámos em [declínio cognitivo sem diagnóstico nos lares](/blog/declinio-cognitivo-sem-diagnostico-nos-lares/) mostram uma população institucionalizada com contacto exterior muito reduzido: três em cada quatro pessoas com demência em lar não saem à rua e mais de um quarto nunca recebe visitas. Aqui é preciso ser exato, porque é o ponto onde toda a gente estica: **Reduzir isolamento com tecnologia não é o mesmo que reduzir risco de demência.** O fator de risco identificado pela comissão é o isolamento **ao longo de anos**, não a solidão de uma tarde. Nenhum estudo mostra que sessões de realidade virtual alteram a incidência de demência, e não conhecemos nenhum que o tenha sequer tentado medir. **O contacto humano não é substituível.** O que a evidência associa a menor risco é convívio real e continuado. Uma [videochamada com a família](/blog/videochamadas-familia-realidade-virtual/) é contacto humano com um meio pelo meio; um cenário imersivo, por muito bom que seja, não é. **O que fica é modesto e verdadeiro:** uma sessão pode dar assunto, pode dar prazer numa tarde, pode ser feita com outra pessoa ao lado e pode ser o motivo pelo qual alguém sai do quarto. Isso vale por si: não precisa de ser vendido como prevenção de demência, e não deve. É assim que o RVer entra no dia de um [lar](/solucoes/lar-residencial/). ## A frase que não devem deixar passar Se um fornecedor (nós ou outro) ligar um produto aos 45% da comissão do *Lancet*, a pergunta é simples: **em que ensaio é que este produto reduziu a incidência de demência?** A resposta honesta hoje, para qualquer produto de realidade virtual no mercado, é *nenhum*. O que existe é literatura de bem-estar, reminiscência e estimulação, que descrevemos em [demência e Alzheimer](/blog/realidade-virtual-demencia-alzheimer/) e em [estimulação cognitiva](/blog/estimulacao-cognitiva-idosos-realidade-virtual/), e que mede outra coisa (a biblioteca reúne-a no tema [qualidade de vida](/estudos/tema/qualidade-de-vida/)). A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não previnem, tratam nem retardam demência. Q: Quais são os 14 fatores de risco modificáveis de demência? A: Baixa escolaridade, perda auditiva, hipertensão, tabagismo, obesidade, depressão, inatividade física, diabetes, consumo excessivo de álcool, traumatismo craniano, poluição do ar e isolamento social (os doze anteriores), mais os dois acrescentados em 2024: colesterol LDL elevado na meia-idade (cerca de 7% do risco atribuível) e perda de visão não tratada na idade avançada (cerca de 2%). Q: O que significa dizer que 45% dos casos são evitáveis? A: É uma estimativa populacional num cenário-limite: o que aconteceria à incidência se todos os 14 fatores fossem eliminados. Não diz que uma pessoa concreta que corrija um fator reduz o seu risco numa percentagem conhecida, e não é o mesmo que causalidade demonstrada para cada fator. Q: A realidade virtual previne a demência? A: Não. Não conhecemos nenhum estudo que mostre que sessões de realidade virtual alteram a incidência de demência, e a literatura existente mede outras coisas: bem-estar, reminiscência, participação. Um produto que ligue os 45% da comissão do Lancet a si próprio deve ser confrontado com uma pergunta: em que ensaio reduziu a incidência? Q: O isolamento social conta como fator de risco. Isso não valida a tecnologia? A: Não da forma como costuma ser usado. O fator identificado é o isolamento ao longo de anos, não a solidão de uma tarde, e o que a evidência associa a menor risco é convívio real e continuado. Uma sessão pode dar assunto, prazer e um motivo para sair do quarto, o que vale por si, sem ser apresentado como prevenção. Q: O que pode um lar fazer a partir desta lista? A: Seis coisas, nenhuma tecnológica: verificar aparelhos auditivos (existência, pilha e uso), tratar perda de visão como cataratas por operar e óculos desatualizados, confirmar que hipertensão e diabetes estão controladas, olhar para a atividade física de quem não vai às aulas de grupo, e não confundir depressão com «está mais calado». ### O medo de cair tira a pessoa da sala antes de a queda acontecer URL: https://rver.pt/blog/medo-de-cair-idosos-o-que-a-realidade-virtual-faz/ Date: 4 September 2026 Muito antes de haver uma queda, há uma pessoa que deixou de ir à sala porque tem medo de cair no corredor. A literatura trata isso como um desfecho próprio, e é aí que os números da realidade virtual são mais consistentes. Numa equipa de lar, a conversa sobre quedas é quase sempre sobre as quedas: quantas houve, onde, o que se mudou a seguir. É a conversa certa, e fica-lhe a faltar metade. A outra metade é o **medo de cair**: que a literatura mede como desfecho próprio, separado das quedas, e que costuma chegar primeiro. A pessoa deixa de ir à sala, deixa de ir à casa de banho sem chamar, deixa de sair do quarto. Não há registo de incidente nenhum, e a vida encolheu na mesma. Muitas vezes, encolheu **por causa** do medo, e não da capacidade. ## O que a evidência mostra Uma **meta-análise publicada em 2025** no *Journal of Nursing Scholarship* reuniu **17 ensaios aleatorizados com 988 participantes**, publicados entre 2016 e 2025, sobre intervenções de realidade virtual em pessoas idosas. Os resultados agrupados: | Desfecho | Efeito (SMD) | Intervalo de confiança 95% | | --- | --- | --- | | Medo de cair | −0,40 | −0,72 a −0,08 | | Equilíbrio | 0,45 | 0,07 a 0,83 | | Controlo postural | 0,50 | 0,13 a 0,86 | Três leituras honestas destes números, que valem mais do que os números: - **São efeitos pequenos a moderados, não transformações.** Um SMD de 0,40 a 0,50 é um resultado sério em reabilitação, e é muito menos do que a palavra «eficaz» costuma sugerir numa apresentação. - **Os intervalos de confiança quase tocam o zero** nos três casos. Significa que o efeito é real no conjunto, e que num ensaio individual pode não aparecer. - **A heterogeneidade é alta no equilíbrio** (I² ≈ 74%): os ensaios não estão a medir a mesma coisa da mesma maneira. É o valor em que se deve confiar menos dos três. E a limitação que fecha a leitura: **estes desfechos não são «menos quedas»**. Medo de cair, equilíbrio e controlo postural são medidos com escalas e testes. Demonstrar redução de quedas exige ensaios maiores, mais longos e com outro desenho, e é uma afirmação que ninguém deve fazer com base nesta meta-análise, nós inclusive. ## Porque é que o medo de cair é o alvo mais útil num lar Por três razões práticas. **Aparece antes.** Dá para atuar meses antes de haver uma queda para registar. **Alimenta-se a si próprio.** Quem tem medo mexe-se menos; quem se mexe menos perde força e equilíbrio; quem perde equilíbrio tem mais motivos para ter medo. É o ciclo que faz um residente autónomo ficar acamado sem doença nova nenhuma, e é o mesmo custo de estar parado que descrevemos em [imobilidade no internamento](/blog/imobilidade-no-internamento-o-custo-de-estar-parado/). **Mede-se sem equipamento.** Existem escalas validadas de medo de cair, e a equipa pode aplicá-las antes e depois de qualquer intervenção: de uma aula de ginástica, de uma barra nova no corredor, de tecnologia. Se for para medir alguma coisa num piloto, esta é das poucas que responde em semanas. ## Onde a RVer entra, e onde não entra Aqui é preciso ser exato, porque a tentação de esticar é grande. **O produto base da RVer não é treino de equilíbrio.** É uma biblioteca de conteúdo para conforto, distração e atividade significativa, e é isso que está coberto pelo registo de [dispositivo médico Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/). Não faz avaliação de risco de queda, não prescreve exercício e não substitui fisioterapia. **O movimento guiado é o [RVer Motion](/blog/rver-motion-reabilitacao-com-realidade-virtual/)**, que é um **módulo em desenvolvimento e não está coberto por aquele registo**. Quando estiver, a fronteira mantém-se: quem decide o que uma pessoa deve fazer é o fisioterapeuta. O que o produto base faz, e que não é pouco: dá um motivo para a pessoa estar sentada, atenta e ocupada durante vinte minutos, e dá à equipa uma observação datada de como ela reagiu. Se isso ajuda a manter alguém em atividade num período em que estava a recolher-se, é útil, e não é a mesma coisa que reduzir o medo de cair, que é o que a meta-análise mede em programas de exercício. ## O que fazer com isto na segunda-feira Quatro passos, e nenhum precisa de comprar nada: 1. **Perguntar.** Dos residentes que se deslocam sozinhos, quantos dizem ter medo de cair? Não é uma pergunta que apareça sozinha no processo. 2. **Separar do registo de quedas.** São duas listas diferentes, e a mais longa costuma ser a do medo. 3. **Aplicar uma escala** antes de mudar seja o que for, para que a mudança tenha contra o que ser lida. 4. **Ver o que já existe**: a adesão à fisioterapia é o fator que mais decide o resultado, e é sobre isso que escrevemos em [adesão à fisioterapia](/blog/realidade-virtual-fisioterapia-idosos-adesao/). Se depois destes quatro passos a tecnologia ajudar, ajuda em cima de um problema medido. Se ninguém der os quatro passos, nenhum equipamento resolve, e o nosso também não. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, fisioterapia ou acompanhamento clínico. Q: A realidade virtual reduz as quedas? A: Não é isso que a evidência disponível mostra. A meta-análise de 2025 aqui citada mede medo de cair, equilíbrio e controlo postural, e não a ocorrência de quedas. Demonstrar redução de quedas exige ensaios maiores, mais longos e com outro desenho, e não é uma afirmação que se possa fazer a partir destes dados. Q: O que diz a meta-análise de 2025 sobre medo de cair? A: Publicada no Journal of Nursing Scholarship, reuniu 17 ensaios aleatorizados com 988 participantes (2016–2025) e encontrou efeitos significativos na redução do medo de cair (SMD −0,40; IC 95% −0,72 a −0,08), no equilíbrio (0,45; 0,07 a 0,83) e no controlo postural (0,50; 0,13 a 0,86). São efeitos pequenos a moderados, com intervalos de confiança próximos de zero e heterogeneidade alta no equilíbrio. Q: Porque é que o medo de cair se mede separadamente das quedas? A: Porque chega antes e tem consequências próprias: a pessoa reduz a atividade, perde força e equilíbrio, e fica com mais motivos para ter medo. Esse ciclo pode levar alguém autónomo à imobilidade sem que exista uma única queda registada. Q: A RVer faz treino de equilíbrio? A: O produto base não. É uma biblioteca de conteúdo para conforto, distração e atividade significativa, e não faz avaliação de risco de queda nem prescreve exercício. O movimento guiado é o RVer Motion, um módulo em desenvolvimento que não está coberto pelo registo de Classe I. Q: Como se mede o medo de cair num lar? A: Com escalas validadas, aplicadas pela própria equipa antes e depois de qualquer alteração: uma aula, uma barra de apoio nova, um equipamento. É dos poucos desfechos que responde em semanas e não precisa de tecnologia nenhuma para ser medido. ### Nos EUA a realidade virtual já tem código de reembolso. Aqui não, e o que isso muda URL: https://rver.pt/blog/codigo-de-reembolso-realidade-virtual-eua-e-portugal/ Date: 4 September 2026 Desde abril de 2023 o Medicare tem um código para um dispositivo de realidade virtual terapêutica. É um facto verdadeiro e citado em quase todas as apresentações comerciais do setor, incluindo, ocasionalmente, contra nós. Vale a pena perceber exatamente o que ele cobre. Aparece cedo em muitas conversas de aquisição, e aparece bem: *«nos Estados Unidos já há reembolso para realidade virtual»*. É verdade. E é uma verdade muito mais estreita do que a frase sugere. Este artigo diz o que existe ao certo, e o que isso significa, ou não significa, para quem está a montar um orçamento em Portugal. ## O que existe A 1 de abril de 2023, os **CMS** (o organismo que gere o Medicare) criaram o código **E1905**, descrito como *dispositivo de realidade virtual para terapia cognitivo-comportamental, incluindo software de terapia pré-programado*. Foi o **primeiro** código atribuído a um dispositivo de RV terapêutica, na sequência de um pedido de um fabricante norte-americano, e veio acompanhado de uma decisão que coloca o produto na categoria **DMEPOS**: equipamento médico duradouro. O dispositivo em causa, o RelieVRx, tinha autorização da FDA para **dor lombar crónica, em utilização domiciliária**, e passara pelo programa de dispositivos inovadores. Essas quatro coisas (o código, a categoria, a autorização e a indicação) andam juntas e não se separam. :::note O que se segue é a leitura de um fornecedor sobre enquadramentos de financiamento, não aconselhamento jurídico nem de codificação clínica. Confirme sempre junto do pagador, incluindo contra o que aqui está escrito. ::: ## O que o código não é **Não é um código para «realidade virtual».** É um código para *aquele* dispositivo, com *aquela* indicação, naquele contexto de uso. Um segundo equipamento não passa a ser reembolsável por o primeiro ter conseguido um código. **Não é uma garantia de pagamento, nem sequer nos EUA.** Ter código significa que existe uma forma de o pedir; a cobertura efetiva varia entre pagadores, exige justificação de necessidade médica e, nalguns casos, autorização prévia. **E não atravessa o Atlântico.** O Medicare é um sistema de um país. Nada do que ali se decide cria elegibilidade em Portugal: nem no SNS, nem nos subsistemas, nem nos seguros. ## Porque é que isto interessa a quem compra cá Por duas razões opostas, e as duas úteis. **A primeira é um sinal real.** Um pagador público grande aceitou, para um caso concreto, que a realidade virtual é equipamento clínico e não um acessório de bem-estar. Isso não financia nada em Lisboa, mas muda o tom de uma conversa interna: o tema deixou de ser exótico. **A segunda é uma defesa.** Quando um fornecedor cita o E1905 numa proposta, valem duas perguntas, e respondem-se em trinta segundos: 1. **O código é do vosso produto, ou de outro?** Na esmagadora maioria dos casos é de outro, e a resposta honesta é essa. 2. **Que consequência prática tem no nosso orçamento?** Se a resposta for «nenhuma direta», está certa. Se for outra coisa, peçam-na por escrito. A nossa resposta às duas está aqui: **o E1905 não é da RVer**, não temos código de reembolso em Portugal e nenhuma parte do vosso investimento é recuperável por essa via. ## O que existe mesmo, cá O enquadramento português está descrito em [financiamento e comparticipação](/blog/financiamento-comparticipacao-realidade-virtual-saude/), e a frase que importa repetir é esta: **o registo de dispositivo médico não confere elegibilidade a apoios públicos.** São coisas separadas, e confundi-las já custou tempo a mais do que um projeto. O que sobra é a conta que a instituição faz com os seus próprios números, [o pilar de custo e retorno](/blog/custo-roi-realidade-virtual-instituicao-saude/), e a honestidade sobre o que essa conta consegue provar, que discutimos em [«O que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## O que estaria por trás de um código português Vale a pena perceber a distância, porque explica por que motivo isto não está para breve. Um código de reembolso não se pede: constrói-se sobre uma **indicação clínica específica**, com **evidência que a sustente para essa indicação** e um **dispositivo com a classe de risco correspondente**. A RVer é [Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/) e a sua finalidade prevista é de conforto e atividade, não de tratamento. Um produto que quisesse um código teria primeiro de mudar de alegação, e, com ela, de classe, de exigência regulatória e de custo. É uma estrada legítima e há empresas a percorrê-la. Não é a estrada em que estamos, e dizê-lo à partida poupa uma reunião a toda a gente. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem acompanhamento clínico. Q: Existe reembolso para realidade virtual em Portugal? A: Não existe um código de comparticipação para realidade virtual terapêutica em Portugal. O registo de dispositivo médico não confere elegibilidade a apoios públicos: são coisas separadas. O investimento é avaliado como qualquer outra aquisição de equipamento pela instituição. Q: O que é o código E1905 do Medicare? A: É um código HCPCS criado pelos CMS a 1 de abril de 2023 para um dispositivo de realidade virtual de terapia cognitivo-comportamental, com software pré-programado, na sequência de um pedido de um fabricante norte-americano. Foi o primeiro código atribuído a um dispositivo de RV terapêutica e colocou-o na categoria de equipamento médico duradouro (DMEPOS). Q: Esse código cobre qualquer equipamento de realidade virtual? A: Não. Cobre aquele dispositivo, com aquela indicação (dor lombar crónica em utilização domiciliária, com autorização da FDA) e naquele contexto de uso. Outro equipamento não se torna reembolsável por este ter obtido um código. Q: A RVer tem código de reembolso? A: Não. O E1905 não é da RVer, não existe equivalente português, e nenhuma parte do investimento é recuperável por essa via. Dizemo-lo à partida porque a alternativa é descobri-lo a meio de um processo de aquisição. Q: O que seria preciso para existir um código destes em Portugal? A: Uma indicação clínica específica, evidência que a sustente para essa indicação, e um dispositivo com a classe de risco correspondente. A RVer é Classe I e a sua finalidade prevista é de conforto e atividade, não de tratamento: mudar isso significaria mudar de alegação, de classe e de exigência regulatória. ### Duas coisas diferentes chamam-se «realidade virtual em saúde mental» URL: https://rver.pt/blog/realidade-virtual-saude-mental-duas-coisas-diferentes/ Date: 3 September 2026 A saúde mental é hoje o segmento que mais cresce na realidade virtual aplicada à saúde. O problema é que sob o mesmo rótulo se vendem dois produtos com finalidades, exigências e riscos diferentes, e a confusão custa dinheiro e credibilidade a quem compra o errado. Todas as análises de mercado apontam para o mesmo: dentro da realidade virtual aplicada à saúde, **a saúde mental é o segmento que mais cresce**: à frente da cirurgia, da formação e da reabilitação. O interesse é real e a evidência, nalgumas áreas, também. O efeito colateral é menos simpático: sob a expressão «realidade virtual em saúde mental» estão hoje **dois produtos diferentes**, que exigem coisas diferentes de quem os compra. Um serviço que adquire um a pensar que está a adquirir o outro descobre-o tarde: normalmente já com equipamento no armário. Este artigo é um mapa para separar os dois, e diz sem rodeios em qual deles está a RVer. ## O primeiro: terapia de exposição em realidade virtual É **psicoterapia**. Recria de forma controlada a situação temida (a altura, o avião, a aranha, a plateia) para que a pessoa a enfrente por passos, com a intensidade a subir ao ritmo dela, até a resposta de medo diminuir. Duas características definem-na, e ambas são exigentes: - **É conduzida por um profissional de saúde mental**, dentro de um plano terapêutico. A tecnologia é o cenário; o tratamento é o trabalho do clínico. - **Provoca ansiedade de propósito.** É esse o mecanismo. Não é um efeito secundário a evitar. A evidência para fobias específicas é das mais fortes de toda a investigação em RV na saúde, e reunimo-la em [realidade virtual no tratamento de fobias](/blog/realidade-virtual-tratamento-fobias/). Nas perturbações de ansiedade em geral o quadro é mais variado: ver [realidade virtual e perturbações de ansiedade](/blog/realidade-virtual-perturbacoes-ansiedade/). O que uma instituição precisa para usar isto: psicólogos ou psiquiatras com formação na técnica, tempo de consulta, enquadramento clínico e, conforme a alegação do fabricante, um dispositivo com classe de risco superior à nossa. Sem essas pessoas, o equipamento não faz nada: não é software que se instale e funcione sozinho. ## O segundo: ambientes de conforto e bem-estar Não é psicoterapia e não deve ser apresentado como tal. É uma experiência de conforto, distração e atividade significativa, conduzida por profissionais da instituição, que **complementa** os cuidados existentes. O mecanismo é o oposto do primeiro: em vez de aproximar a pessoa do que a assusta, afasta a atenção do que a incomoda: a espera, o procedimento, a tarde longa, o quarto sempre igual. E o critério de sucesso também é outro: não é a extinção de uma resposta de medo ao longo de semanas, é como correu **esta** sessão, hoje. **É aqui que a RVer está.** O produto base é um Dispositivo Médico Classe I, e a fronteira que isso implica está descrita em [dispositivo médico Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/): não fazemos alegações de tratamento, não substituímos acompanhamento clínico e não fornecemos terapia de exposição. ## Porque é que a distinção não é cosmética Três consequências práticas de trocar um pelo outro: **Quem conduz.** No primeiro caso, um profissional de saúde mental com formação na técnica. No segundo, a equipa da instituição com formação de utilização (enfermagem, terapia ocupacional, animação sociocultural) como descrevemos em [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Comprar o primeiro sem ter as pessoas do primeiro é comprar um armário de equipamento parado. **O que se promete.** Um serviço que apresenta ambientes de conforto como tratamento de ansiedade cria uma expectativa que o produto não cumpre, e é a instituição, não o fornecedor, que fica à frente do doente quando isso se nota. **O que se mede.** Métricas de psicoterapia (redução sintomática ao longo de um plano) aplicadas a sessões de bem-estar produzem um relatório que diz que o projeto falhou, quando o projeto nunca prometeu aquilo. Escolher a métrica errada é a forma mais silenciosa de matar um piloto que estava a correr bem. ## Seis perguntas para fazer a qualquer fornecedor Funcionam ao telefone, antes de avançar: 1. **Qual é a finalidade prevista declarada** do produto, e qual é a classe de risco do dispositivo? 2. O produto **trata** alguma condição, ou complementa cuidados? Peçam a frase exata, por escrito. 3. **Quem tem de estar na sala** para uma sessão: um psicoterapeuta, ou um profissional da equipa com formação de utilização? 4. A experiência **provoca ansiedade de propósito** em algum momento? 5. Que **evidência** existe para a finalidade declarada, e não para «realidade virtual em saúde» em geral? 6. Que **formação** vem incluída, e para que perfil profissional? As respostas às perguntas 3 e 4 separam os dois produtos em menos de um minuto, e não há resposta má: há a resposta que corresponde ao que o serviço precisa e a que não corresponde. Os critérios completos de aquisição estão em [como escolher realidade virtual terapêutica](/blog/como-escolher-realidade-virtual-terapeutica/). ## O que isto não significa Não significa que o segundo produto seja o primo pobre do primeiro. Significa que respondem a perguntas diferentes. A maior parte dos serviços que nos contacta não tem lista de espera de fobias específicas para tratar: tem doentes ansiosos à espera de um exame, residentes com tardes vazias, pessoas acamadas sem nada para fazer entre as visitas. Para essas situações, um plano de psicoterapia por RV seria a ferramenta errada: cara, sobredimensionada e dependente de pessoas que o serviço não tem. E se o que o serviço precisa mesmo é do primeiro produto, o mais útil que podemos fazer é dizê-lo à primeira reunião, que é o que fazemos. O lugar do não farmacológico no sistema, e as suas fronteiras, ficaram escritos em [saúde mental em Portugal](/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/). A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, psicoterapia ou acompanhamento clínico. Q: A RVer faz terapia de exposição em realidade virtual? A: Não. A terapia de exposição é psicoterapia conduzida por um profissional de saúde mental, dentro de um plano terapêutico, e provoca ansiedade de forma deliberada e controlada. A RVer fornece ambientes de conforto, distração e atividade significativa, conduzidos por profissionais da instituição, que complementam os cuidados existentes e não constituem tratamento. Q: Qual é a diferença prática entre os dois tipos de produto? A: Quem conduz e qual é o mecanismo. Na terapia de exposição tem de estar na sala um profissional de saúde mental com formação na técnica, e a experiência aproxima deliberadamente a pessoa daquilo que a assusta. Num ambiente de conforto conduz um profissional da equipa com formação de utilização, e a experiência afasta a atenção do que incomoda. Também mudam as métricas: redução sintomática ao longo de um plano, num caso; como correu a sessão de hoje, no outro. Q: Que perguntas devo fazer a um fornecedor antes de comprar? A: Seis: qual é a finalidade prevista declarada e a classe de risco do dispositivo; se o produto trata alguma condição ou complementa cuidados, com a frase exata por escrito; quem tem de estar na sala durante a sessão; se a experiência provoca ansiedade de propósito; que evidência existe para a finalidade declarada em concreto; e que formação vem incluída e para que perfil profissional. Q: Um ambiente de conforto em RV trata a ansiedade? A: Não, e apresentá-lo assim cria uma expectativa que o produto não cumpre, com a agravante de ser a instituição, e não o fornecedor, a estar à frente do doente quando isso se nota. O que estes ambientes fazem é oferecer conforto e distração num momento concreto, sob supervisão de um profissional. Q: Porque é que a saúde mental é o segmento que mais cresce na RV em saúde? A: Pela combinação de necessidade não satisfeita com evidência madura nalgumas áreas específicas, sobretudo o tratamento de fobias. O crescimento do interesse traz, porém, o efeito colateral de agrupar sob o mesmo rótulo produtos com finalidades e exigências muito diferentes. ### O Estatuto da Pessoa Idosa e as atividades: o que muda num lar URL: https://rver.pt/blog/estatuto-da-pessoa-idosa-atividades-e-autonomia/ Date: 3 September 2026 A Lei n.º 7/2026 entrou em vigor em fevereiro e escreveu preto no branco uma coisa que muda o plano de atividades de qualquer lar: a pessoa idosa decide sobre o seu envolvimento em atividades. Aqui fica a leitura operacional, artigo a artigo. A Lei n.º 7/2026, de 25 de fevereiro, aprovou o **Estatuto da Pessoa Idosa**. Não criou uma resposta social nova nem um financiamento novo: juntou num diploma só direitos que andavam dispersos, e aplicou-os expressamente às IPSS e a todos os estabelecimentos, públicos ou privados, que acolhem e cuidam de pessoas idosas (artigo 2.º, n.º 3). Para uma direção técnica, a pergunta útil não é «o que é o Estatuto». É **o que muda na segunda-feira de manhã**. Este artigo responde a isso na parte que nos toca, a das atividades, e diz também onde a tecnologia não tem nada a fazer. :::note Este artigo é uma leitura do diploma feita por um fornecedor de tecnologia, não um parecer jurídico. O texto integral está publicado no Diário da República, 1.ª série, n.º 39, de 25 de fevereiro de 2026. ::: ## Os quatro artigos que mexem com o plano de atividades **Artigo 6.º, alínea b): autonomia.** A pessoa idosa tem direito «à autonomia, devendo ser livre de tomar decisões relativas à sua vida, incluindo sobre o local onde deseja residir, os cuidados que quer receber e o envolvimento em atividades sociais, políticas e culturais». Leia-se a última parte devagar: **o envolvimento em atividades é uma decisão da pessoa**. Não é uma sugestão de boas práticas nem uma recomendação de um manual de qualidade. É um direito num diploma da Assembleia da República. **Artigo 18.º: participação em atividades culturais e de lazer.** Uma frase só: a pessoa idosa tem direito a participar em atividades culturais, desportivas e de lazer. O direito é de participar, e o artigo 6.º diz que a decisão de participar é dela. **Artigo 3.º, n.º 3, alínea c)**: entre os pressupostos da garantia dos direitos está «o primado de formas alternativas de participação, ocupação e convívio da pessoa idosa com as demais gerações». *Alternativas* e *intergeracionais*: a bingo-e-televisão não é o que o legislador tinha em mente. **Artigo 8.º, n.º 2**: nas políticas públicas de saúde e proteção social, a alínea b) menciona explicitamente serviços que articulem cuidados com «estimulação cognitiva, sensorial e motora», e a alínea f) manda reforçar as respostas «com os mecanismos e as ferramentas tecnológicas que promovam a sua eficiência». É, tanto quanto conseguimos ler, a primeira vez que a estimulação cognitiva e sensorial aparece nomeada num diploma desta natureza: ao lado da medicina, da enfermagem, da psicologia e da fisioterapia, e não como enfeite. ## O que isto muda, na prática ### 1. O plano de atividades deixa de poder ser só coletivo Se a decisão de participar é individual, um plano feito só de atividades de grupo com hora marcada responde mal ao artigo 6.º para quem não quer, não pode ou não consegue estar no grupo. E numa ERPI essa gente é muita: o residente acamado, o que tem afasia, o que se agita ao fim do dia, o que nunca gostou de cantar em conjunto. A leitura honesta é esta: **o Estatuto não obriga a comprar nada**. Obriga a ter resposta para quem fica de fora do que já existe. Escrevemos sobre como se constrói esse plano em [plano de atividades para um lar de idosos](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). ### 2. O «não» do residente passa a ter estatuto Recusar uma atividade sempre foi um direito moral. Agora é um direito escrito. O que isso obriga a mudar é sobretudo o **registo**: uma recusa que não fica escrita transforma-se, dois meses depois, num «ele nunca quis participar» que ninguém consegue datar nem justificar. No nosso caso a regra é anterior à lei e está no [o que fazer quando o utente recusa](/blog/quando-o-utente-recusa-realidade-virtual/): a sessão termina quando a pessoa quiser, sem argumentação, e a recusa fica registada como qualquer outra ocorrência. ### 3. O consentimento sobe de nível O artigo 10.º trata da informação e da decisão sobre cuidados de saúde, com revogabilidade a qualquer momento. Para uma atividade não clínica de bem-estar isso não é um processo pesado, mas é a razão pela qual o consentimento de quem usa equipamento nas nossas instalações está descrito em [consentimento informado](/blog/consentimento-informado-realidade-virtual-saude/), incluindo o caso em que a pessoa não consegue consentir sozinha. ### 4. Sair do lar continua a ser insubstituível É aqui que temos de ser claros contra o nosso próprio interesse comercial. O artigo 3.º fala em convívio **com as demais gerações**, e o artigo 22.º em mobilidade e remoção de barreiras. Nenhuma tecnologia dentro de um edifício cumpre isso. Um passeio, uma visita, uma criança na sala: **não há equivalente digital**. Quando um lar usa um equipamento para deixar de fazer as saídas que fazia, o resultado é pior do que antes de o comprar, e é contrário ao espírito do diploma. O nosso lugar é no que sobra: os dias em que a saída não é possível, e as pessoas que já não podem sair. ## O que a lei não diz O Estatuto **não menciona realidade virtual**, nem devia. Não cria obrigação de adquirir equipamento, não define rácios de atividades, não fixa prazos e não traz financiamento associado. Quem vos disser que «a nova lei obriga a ter X» está a vender X. O que a lei faz é deslocar o ónus: passa a ser preciso justificar por que motivo um residente **não** tem resposta de participação, em vez de bastar mostrar que existe um plano de atividades afixado na parede. ## Uma lista curta para a próxima reunião de equipa Quatro perguntas que se respondem sem comprar nada: 1. Dos residentes atuais, quantos participaram em pelo menos uma atividade na última semana? E quantos **não** participaram em nenhuma? 2. Para esses, está escrito porquê: recusa, condição clínica, ou simplesmente não havia nada que servisse? 3. As recusas ficam registadas, com data e com quem estava presente? 4. O que existe hoje para quem não sai do quarto? Se a resposta à quarta for «pouco», há aí um problema que é anterior a qualquer catálogo de fornecedores, o nosso incluído. E se depois disso a tecnologia ajudar, ajuda por ser útil a pessoas concretas, não por ser nova. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem acompanhamento clínico. Q: O Estatuto da Pessoa Idosa obriga os lares a ter tecnologia nas atividades? A: Não. A Lei n.º 7/2026 não menciona realidade virtual nem qualquer equipamento, não cria obrigação de aquisição e não traz financiamento associado. O que estabelece é o direito da pessoa idosa a participar em atividades culturais, desportivas e de lazer (artigo 18.º) e a decidir livremente sobre o seu envolvimento nelas (artigo 6.º, alínea b). Q: Quando entrou em vigor e a quem se aplica? A: Foi publicada a 25 de fevereiro de 2026 (Lei n.º 7/2026, Diário da República, 1.ª série, n.º 39). Aplica-se a pessoas com idade igual ou superior à idade normal de acesso à pensão de velhice e, nos termos do artigo 2.º, n.º 3, às IPSS e a todos os estabelecimentos públicos ou privados que apoiam, acolhem e cuidam de pessoas idosas. Q: O que muda no plano de atividades de uma ERPI? A: Muda o ónus. Um plano feito só de atividades coletivas com hora marcada continua legal, mas deixa sem resposta quem não pode ou não quer participar no grupo, e é sobre esses residentes que o artigo 6.º passa a exigir uma justificação. Na prática, obriga a registar recusas e a ter alguma resposta individual para quem não sai do quarto. Q: Um residente pode recusar uma sessão de realidade virtual? A: Sim, a qualquer momento e sem ter de justificar. É o que decorre do artigo 6.º, alínea b), e é também a regra de utilização da RVer: a sessão termina quando a pessoa quiser e a recusa fica registada. Q: A realidade virtual substitui as saídas e o convívio intergeracional? A: Não, e não deve ser usada para isso. O artigo 3.º valoriza formas de participação e convívio com as demais gerações, e o artigo 22.º a mobilidade: um passeio, uma visita ou uma atividade com crianças não têm equivalente digital. A tecnologia serve os dias em que a saída não é possível e as pessoas que já não podem sair. Q: O Estatuto menciona estimulação cognitiva? A: Sim. O artigo 8.º, n.º 2, alínea b), refere serviços de apoio ao domicílio que articulem cuidados médicos e de enfermagem, psicologia, fisioterapia e estimulação cognitiva, sensorial e motora. A alínea f) do mesmo número manda reforçar as respostas com ferramentas tecnológicas que promovam a sua eficiência. ### Declínio cognitivo sem diagnóstico nos lares: o que isso muda numa sessão URL: https://rver.pt/blog/declinio-cognitivo-sem-diagnostico-nos-lares/ Date: 3 September 2026 Num inquérito a 423 estruturas residenciais portuguesas, a suspeita de declínio cognitivo sem diagnóstico registado aparece em cerca de um quinto dos residentes. Para quem conduz uma atividade, isto não é um problema de estatística: é o motivo pelo qual o processo do residente não chega para preparar a sessão. Um estudo transversal em **423 estruturas residenciais para pessoas idosas (ERPI)** portuguesas, feito por investigadores das Universidades de Coimbra e de Aveiro no âmbito do projeto SINDIA através de inquérito às direções técnicas, publicado na *Acta Médica Portuguesa*, deixa dois números que vale a pena ler juntos: - em média, cerca de **um terço** dos residentes tem **diagnóstico formal de demência**; - cerca de **um quinto** tem **suspeita de declínio cognitivo sem diagnóstico registado**. O mesmo trabalho aponta iniquidade territorial no acesso ao diagnóstico e nas respostas institucionais, e divulga dois números sobre a vida dentro das instituições que são difíceis de esquecer: **75% das pessoas com demência em lar não saem à rua e 28% nunca recebem visitas**. :::note Os valores são os do estudo e referem-se ao universo inquirido, não a uma amostra representativa de todos os lares do país. A leitura que interessa aqui não é epidemiológica: é operacional. ::: ## O que o segundo número significa mesmo Um quinto dos residentes está numa zona cinzenta: a equipa nota que alguma coisa mudou, mas não há avaliação, não há código, não há nada escrito no processo. E o que não está escrito no processo **não chega a quem prepara a atividade**. Na prática isso significa três coisas: 1. Quem conduz a sessão trabalha com informação incompleta sobre uma parte substancial das pessoas com quem trabalha. 2. A adaptação que faria por saber o diagnóstico (ritmo, apoio verbal, duração, escolha do conteúdo) não é feita, ou é improvisada no momento. 3. Quando a sessão corre mal, a explicação registada tende a ser sobre a pessoa («não colaborou», «não gostou») em vez de ser sobre a preparação. Este artigo não é sobre diagnosticar. Diagnosticar é um ato clínico e não é o que fazemos, nem o que a tecnologia deve tentar fazer. É sobre **conduzir atividades num contexto em que o diagnóstico frequentemente não existe**. ## Três consequências práticas ### 1. Preparar pelo funcionamento observado, não pelo rótulo O rótulo diz pouco mesmo quando existe: as diferenças entre quadros mudam bastante o que resulta numa sessão, como escrevemos em [tipos de demência: o que muda numa sessão](/blog/tipos-de-demencia-o-que-muda-numa-sessao/). Quando não existe, a alternativa não é adivinhar: é **descrever o que se observa**. Quatro perguntas que se respondem sem avaliação formal e que mudam mais a sessão do que qualquer código de diagnóstico: - A pessoa segue uma instrução de um passo? E de dois? - Mantém atenção durante quanto tempo, aproximadamente, antes de se desligar? - Reconhece pessoas e sítios? Quais? - O que a agita: barulho, escuro, ser tocada, pressa? É isto que devia ficar escrito antes da primeira sessão, e é isto que se lê antes da segunda. ### 2. Começar mais curto do que parece necessário Com incerteza sobre o estado cognitivo, o erro caro é começar longo. Uma primeira sessão curta que corre bem dá informação suficiente para alongar a seguinte; uma sessão longa que corre mal fecha a porta a esta pessoa durante semanas, e às vezes para sempre, porque fica registada como «não tolera». A duração e a frequência não são um número universal, e discutimos as variáveis em [duração e frequência de uma sessão](/blog/duracao-frequencia-sessao-realidade-virtual/). ### 3. Registar o que aconteceu, não a impressão do dia É aqui que a zona cinzenta se resolve sozinha, com o tempo. Um registo consistente de sessões (o que se usou, quanto tempo, como reagiu, o que interrompeu) é um dos poucos materiais que uma equipa acumula sobre o funcionamento de alguém **fora** da consulta. Não é um diagnóstico e não substitui nenhum. Mas quando o médico assistente pergunta «desde quando é que isto está assim», uma sequência datada de observações vale muito mais do que a memória de quem está de turno nesse dia. É a razão pela qual o [registo de sessão](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/) existe e é o que ele serve: nada mais do que isso. ## Sobre os 75% que não saem à rua Este é o número que não se resolve com tecnologia, e convém dizê-lo aqui em vez de deixar que outra pessoa o diga por nós. Uma sessão num equipamento pode dar a alguém quinze minutos numa praia ou na rua onde viveu (e sabemos, pelo que as equipas nos contam, que para uma pessoa acamada isso não é nada) mas **não é sair à rua**. A resposta certa para 75% de pessoas que não saem é organizar saídas, transporte adaptado, e abrir a instituição à comunidade. Se um equipamento for usado como substituto disso, torna o problema mais confortável de ignorar, e isso é pior do que não o ter. O lugar honesto da tecnologia é o resto: os dias em que a saída não é possível, o inverno, a pessoa que já não tem mobilidade para sair, e as 28% que nunca recebem visitas: para essas, o que temos visto funcionar melhor não é sequer um cenário, é a [ligação por videochamada com a família](/blog/videochamadas-familia-realidade-virtual/). ## Três perguntas para a próxima reunião 1. Quantos dos vossos residentes têm diagnóstico registado, e sobre quantos existe suspeita sem avaliação? 2. Para esses, existe alguma descrição funcional escrita: instruções, atenção, reconhecimento, gatilhos de agitação? 3. Quando alguém deixa de participar numa atividade que fazia, isso é registado como acontecimento com data, ou desaparece em silêncio? Nenhuma das três exige orçamento. Todas mudam mais o dia a dia do que a próxima aquisição. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. As sessões são conduzidas por profissionais da instituição, complementam os cuidados existentes e não substituem avaliação, diagnóstico ou acompanhamento clínico. Q: Quantos residentes em lares portugueses têm demência? A: Num estudo transversal em 423 ERPI portuguesas (projeto SINDIA, Universidades de Coimbra e Aveiro, publicado na Acta Médica Portuguesa), em média cerca de um terço dos residentes tinha diagnóstico formal de demência e cerca de um quinto apresentava suspeita de declínio cognitivo sem diagnóstico registado. Os valores referem-se ao universo inquirido. Q: A realidade virtual ajuda a diagnosticar demência? A: Não. Diagnosticar é um ato clínico e nenhuma sessão de realidade virtual o substitui ou antecipa. O que um registo de sessões consistente dá é uma sequência datada de observações de funcionamento fora da consulta, útil para a equipa clínica que faz a avaliação: nada mais do que isso. Q: Como se prepara uma sessão quando não há diagnóstico? A: Pelo funcionamento observado, não pelo rótulo: se segue instruções de um ou dois passos, quanto tempo mantém atenção antes de se desligar, o que e quem reconhece, e o que a agita. Estas quatro respostas mudam mais a condução da sessão do que o código de diagnóstico, e obtêm-se sem avaliação formal. Q: Quanto deve durar a primeira sessão com alguém sem diagnóstico? A: Menos do que parece necessário. Uma primeira sessão curta que corre bem permite alongar a seguinte; uma sessão longa que corre mal costuma ficar registada como intolerância e fecha a porta àquela pessoa durante semanas. Q: A realidade virtual compensa o facto de os residentes não saírem à rua? A: Não. Segundo o mesmo estudo, 75% das pessoas com demência em lar não saem à rua e 28% nunca recebem visitas: problemas que se resolvem com saídas, transporte adaptado e abertura à comunidade. Usar equipamento como substituto disso torna o problema mais fácil de ignorar. O lugar da tecnologia é nos dias em que a saída não é possível e nas pessoas que já não podem sair. ### Quando o lugar da pessoa não está na biblioteca: como se escolhe um cenário de reminiscência URL: https://rver.pt/blog/quando-o-lugar-da-pessoa-nao-esta-na-biblioteca/ Date: 2 September 2026 O lugar daquela pessoa não está na biblioteca, e não vai estar. Isso não termina a sessão de reminiscência: muda a unidade de escolha, que quase nunca é o nome do sítio. A reminiscência não funciona por causa da imagem. Funciona por causa do **reconhecimento**. A pessoa vê um sítio, o sítio devolve-lhe qualquer coisa, e é isso que abre a conversa. Sem reconhecimento, um cenário bonito é só um cenário bonito. O que se segue daí é o problema prático que aparece em quase todos os lares na segunda semana de utilização: **o lugar daquela pessoa não está na biblioteca**. Não está a rua dela, não está a aldeia dela, não está a casa onde criou os filhos. E não vai estar: nenhum catálogo cobre biografias. ## O erro que se comete primeiro O erro é tratar a biblioteca como se fosse o álbum de fotografias da pessoa, e desistir quando não é. A equipa procura «Trás-os-Montes», não encontra a aldeia certa, e conclui que a reminiscência não serve para aquele utente. Serve. Só que a unidade de reconhecimento raramente é o topónimo. ## Três substituições que funcionam **1. O tipo de lugar, não o lugar.** Quem cresceu à beira-mar reconhece um porto de pesca que nunca viu. Quem passou a vida no campo reconhece um caminho de terra batida com muros de pedra. O cérebro não está a validar coordenadas: está a reconhecer uma categoria de sítio onde já esteve muitas vezes. **2. A época e a estação.** Uma vindima, uma feira, uma procissão, neve, uma matança, o Verão de uma praia cheia. O calendário é uma das últimas coisas a apagar-se e traz consigo o resto. **3. A atividade, não a paisagem.** Alguém que foi sapateiro, costureira, pescador ou motorista reconhece o gesto antes de reconhecer o sítio. Escolher pelo que a pessoa fez, e não pelo sítio onde viveu, muda o resultado de muitas sessões. ## O que não fazer **Não insistir num lugar «parecido» quando a pessoa já disse que não é.** Se ela corrige, «isso não é a minha terra», a correção é informação, não resistência. Anota-se e muda-se de cenário. **Não corrigir a pessoa.** Se ela diz que aquela praia é a da Nazaré e não é, a sessão não é sobre geografia. Corrigir custa a conversa toda e não devolve nada. **Não usar a biblioteca às cegas.** As perguntas fazem-se **antes** da sessão, à família ou no processo, e não durante. «Onde é que nasceu, onde é que trabalhou, onde é que passava férias, o que é que fazia ao domingo»: quatro perguntas que resolvem a escolha de cenário durante meses. É o mesmo princípio que está em [como se escolhe um cenário](/blog/atividade-significativa-como-se-escolhe-um-cenario/). ## E quando não resulta mesmo Resulta em muita gente e não resulta em toda a gente. Há utentes para quem o reconhecimento não acontece: por fase da doença, por biografia que ninguém conhece, ou simplesmente porque não. Nesses casos a sessão continua a valer pelo **conforto e pela atividade**, que é uma proposta diferente e menor, e que deve ser dita como tal em vez de ser vendida como reminiscência. ## O registo é que fecha o ciclo Escolher bem é metade. A outra metade é **saber o que resultou**. O que correu bem com aquele utente fica no registo da sessão (conteúdo escolhido, duração real, como terminou) e a leitura é sempre da equipa. Passadas três ou quatro sessões, o padrão está lá: esta pessoa responde ao mar, esta ao campo, esta a nada disto. Ver [o que a equipa clínica vê no registo de sessão](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/). ## Onde a RVer perde, e convém dizê-lo Não filmamos a rua de cada utente. Não há forma de o fazer à escala e quem prometer isso está a prometer uma equipa de filmagem por residente. E há um limite maior: **a maior parte da nossa biblioteca foi filmada em Portugal e na Europa**. Para um utente português é uma vantagem. Para um utente que nunca cá esteve, a reminiscência propriamente dita deixa de estar em cima da mesa e o que fica é a primeira coluna da tabela seguinte: atividade, conforto, novidade. São coisas boas, mas não são a mesma coisa, e um catálogo europeu não se vende como biografia universal. | O que o cenário faz | Precisa de reconhecimento? | |---|---| | Atividade e conforto | Não | | Novidade e conversa | Não | | Orientação para a conversa sobre a vida | Ajuda muito | | Reminiscência propriamente dita | Sim | A biblioteca é validada e organizada pela equipa clínica, ver [biblioteca validada](/blog/biblioteca-validada-equipa-clinica-realidade-virtual/), e o critério de escolha, esse, continua do lado de quem conhece a pessoa. ## O papel do RVer O **produto base** da RVer é uma biblioteca de vídeo imersivo, registada como Dispositivo Médico Classe I no INFARMED e na EUDAMED. A plataforma **regista** a sessão: não avalia, não classifica, não diagnostica e não substitui a avaliação clínica nem a decisão da equipa. A escolha do cenário é de quem acompanha a pessoa. Q: A reminiscência só funciona se o cenário for do sítio exato da pessoa? A: Não. O que abre a conversa é o reconhecimento, e ele raramente depende do topónimo. Quem cresceu à beira-mar reconhece um porto de pesca que nunca viu; quem viveu no campo reconhece um caminho de terra com muros de pedra. A unidade útil é o tipo de lugar, a época do ano ou a atividade, não o nome da terra. Q: O que perguntar à família antes de escolher um cenário? A: Quatro perguntas resolvem meses de escolhas: onde nasceu, onde trabalhou, onde passava férias e o que fazia ao domingo. As perguntas fazem-se antes da sessão, à família ou a partir do processo, não durante a sessão, que é para a pessoa e não para o inquérito. Q: E se o utente disser que aquele sítio não é o dele? A: Anota-se e muda-se de cenário. A correção é informação útil, não resistência. E não se corrige a pessoa: se ela nomear mal a praia, a sessão não é sobre geografia, e corrigir custa a conversa toda. Q: A RVer filma o lugar de cada utente? A: Não. Não há forma de o fazer à escala: seria uma equipa de filmagem por residente. A biblioteca cobre tipos de lugar, épocas e atividades, e a escolha faz-se a partir daí. Q: A biblioteca serve utentes que nunca viveram na Europa? A: Para atividade, conforto e conversa, sim. Para reminiscência propriamente dita, não: a maior parte da biblioteca foi filmada em Portugal e na Europa, e sem reconhecimento a proposta é outra: menor e diferente. Vale a pena dizê-lo em vez de vender uma coisa pela outra. Q: O que fica registado destas escolhas? A: O conteúdo escolhido e efetivamente reproduzido, a duração real e como a sessão terminou. É um registo da atividade: a RVer não pontua, não classifica e não interpreta. Passadas três ou quatro sessões, o padrão de preferências de cada utente é legível pela equipa. ### O projeto sobrevive a quem o trouxe? O teste que quase nenhum passa URL: https://rver.pt/blog/o-projeto-sobrevive-a-quem-o-trouxe/ Date: 1 September 2026 Há um padrão que se repete tantas vezes que já não é anedota: o equipamento entra pela mão de alguém que acreditou nele, e sai da vida do serviço no mês em que essa pessoa muda de turno, de serviço ou de emprego. Todos os projetos de tecnologia clínica que vimos correr bem começaram da mesma maneira: **uma pessoa quis.** Uma enfermeira, uma diretora técnica, um fisioterapeuta. Sem essa pessoa não há projeto nenhum, e já escrevemos que [o primeiro dos seis sins é o do serviço](/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/). O problema é o passo seguinte, e quase ninguém o dá: **o projeto continua a ser dessa pessoa para sempre.** Ela é quem sabe ligar, quem tem o PIN, quem conhece os cenários, quem se lembra de carregar. E quando muda de serviço, o que em saúde acontece com frequência, o projeto não é entregue a ninguém. Simplesmente para. ## O teste É de uma frase e não precisa de consultoria nenhuma: > **Isto funciona na semana em que a pessoa que o trouxe está de férias?** Se a resposta for não, ainda não há projeto. Há um entusiasta, e um entusiasta é uma coisa boa e frágil. Uma variante mais dura, para serviços que já passaram o primeiro ano: **funciona no turno da noite, num fim de semana prolongado, com metade da equipa a ser de substituição?** [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## As cinco defesas Nenhuma é cara. Todas são aborrecidas, que é a razão por que não se fazem. **1. Duas pessoas formadas por turno, nunca uma.** É a defesa mais eficaz e a mais ignorada. Uma pessoa por turno é o mesmo que zero quando essa pessoa falta. E convém que a segunda não seja a mesma segunda pessoa em todos os turnos. **2. O procedimento escrito onde o equipamento está.** Não num email de agosto, não numa pasta partilhada que ninguém encontra. Cinco linhas coladas na porta do armário valem mais do que um manual de trinta páginas, [já defendemos isso a propósito da logística](/blog/onde-vive-o-equipamento-realidade-virtual-hospital/). **3. A tarefa numa função, não num nome.** «A Ana põe a carregar» é frágil. «Quem fecha o turno põe a carregar» sobrevive à saída da Ana. Vale para o carregamento, para a higiene e para a chave do armário. **4. Formação de quem chega, não só de quem estava.** A formação inicial é dada uma vez, à equipa que existia nesse dia. Dois anos depois, metade das pessoas não esteve lá. Se a integração de um profissional novo não inclui isto, o projeto dilui-se sem que ninguém decida nada. **5. Um dono formal, com substituto nomeado.** Alguém responde pelo projeto, e está escrito quem responde quando essa pessoa não está. É a diferença entre um projeto do serviço e um projeto de uma pessoa. ## O que nós resolvemos, e é pouco Sejamos exatos, porque é fácil vender continuidade como funcionalidade. **Resolvemos uma coisa:** o registo. Quando cada sessão fica [registada](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/), o conhecimento sobre o que se fez deixa de viver na cabeça de uma pessoa. Quem chega vê o que foi feito, com quem, e o que foi interrompido. Isso é transferência de conhecimento sem reunião nenhuma, e é real. **Não resolvemos:** a formação, a substituição, o dono, os turnos. Nada disso é uma funcionalidade de software, e um fornecedor que lhe diga que a plataforma «garante continuidade» está a vender-lhe uma coisa que só a instituição pode fazer. Também não resolvemos o mais difícil: **a vontade não se transfere.** Uma pessoa que herda um projeto raramente o quer com a mesma intensidade de quem o trouxe. O que se pode fazer é baixar o custo de o manter, de forma a que não seja preciso entusiasmo para continuar, só rotina. ## Um sinal de alarme fácil de ler Se, ao fim de seis meses, **as sessões estão todas registadas com o mesmo nome**, o projeto tem uma pessoa e não tem equipa. É visível no registo em dez segundos, e é a altura de agir, não daqui a um ano, quando essa pessoa sair. ## Em resumo - **Todos os projetos começam com uma pessoa**, e quase nenhum deixa de depender dela. - **O teste é o das férias**, e a versão dura é o turno da noite num fim de semana prolongado. - **Duas pessoas por turno, procedimento afixado, tarefas por função, formação de quem chega, dono com substituto.** - **Software não garante continuidade.** O registo transfere conhecimento; o resto é da instituição. - **Se as sessões têm todas o mesmo nome, o projeto tem prazo de validade.** Q: Como se evita que um projeto de tecnologia morra quando quem o trouxe sai? A: Com cinco medidas simples: formar duas pessoas por turno em vez de uma, afixar o procedimento onde o equipamento está, atribuir tarefas a funções e não a nomes, incluir a formação na integração de quem chega, e nomear um dono formal com substituto. Nenhuma é cara; todas são aborrecidas, que é a razão por que raramente se fazem. Q: Qual é o teste para saber se um projeto é sustentável? A: Se funciona na semana em que a pessoa que o trouxe está de férias. Uma variante mais exigente, para serviços com mais de um ano de utilização, é se funciona no turno da noite, num fim de semana prolongado, com metade da equipa a ser de substituição. Q: A plataforma ajuda na continuidade? A: Só numa coisa: o registo de cada sessão faz com que o conhecimento sobre o que foi feito deixe de viver na cabeça de uma pessoa. A formação, a substituição, os turnos e a atribuição de responsabilidade não são funcionalidades de software, e um fornecedor que diga que a plataforma garante continuidade está a prometer o que só a instituição pode fazer. ### Atividade significativa: o conceito da terapia ocupacional que muda como se escolhe um cenário URL: https://rver.pt/blog/atividade-significativa-como-se-escolhe-um-cenario/ Date: 1 September 2026 Há uma distinção que os terapeutas ocupacionais fazem há décadas e que quase todo o material sobre tecnologia para idosos ignora: manter alguém ocupado e dar-lhe uma ocupação são coisas diferentes. Numa sala com dez pessoas, é possível ter toda a gente ocupada e ninguém a fazer nada que lhe diga respeito. A televisão faz isso muito bem. A terapia ocupacional trabalha há décadas com a distinção que interessa aqui: **ocupação não é passatempo.** É atividade ligada a quem a pessoa é: ao que fazia, ao papel que tinha, ao que a define para si própria. Uma atividade significativa é a que a pessoa reconheceria como sua. Vale a pena importar esse enquadramento para a escolha de conteúdo, porque explica um padrão que quem trabalha nestas salas conhece e raramente consegue nomear. ## O padrão Uma paisagem tecnicamente impecável (praia tropical, aurora boreal, mergulho com tartarugas) rende frequentemente **menos** do que uma imagem banal de um sítio que a pessoa conhece. Não é uma questão de qualidade de imagem. É que a segunda tem a pessoa lá dentro e a primeira não. Já escrevemos sobre isto do lado da [reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/). O que a terapia ocupacional acrescenta é a explicação e um método. ## Ocupação, papéis, e o que se perde primeiro Quando alguém entra numa instituição, o que desaparece primeiro não é a capacidade. São os **papéis**: deixou de ser quem cozinhava, quem tratava do quintal, quem conduzia até à feira, quem decidia. Passou a ser quem é cuidado. A pergunta útil, portanto, não é «de que é que ela gosta?», é: > **O que é que esta pessoa fazia quando ainda decidia sobre a própria vida?** A resposta a essa pergunta é o que torna uma proposta significativa em vez de apenas agradável. ## As cinco perguntas da história de vida Nenhuma exige formação especializada e todas se fazem à família em dez minutos: 1. **Onde é que esta pessoa passou mais tempo da vida?** Não onde nasceu, mas onde viveu. 2. **Do que é que ela tratava?** Terra, animais, oficina, casa, contas, netos. 3. **Onde é que ia quando podia escolher?** Domingos, férias, romarias. 4. **Que trabalho fez, e teve orgulho em qual?** 5. **Há alguma coisa que seja melhor evitar?** Um mar onde alguém se afogou, um sítio de uma perda. Esta é a pergunta que quase nunca se faz e a que mais evita sessões que correm mal. Com estas cinco respostas escreve-se uma linha por pessoa, e essa linha vale mais do que qualquer catálogo. ## O erro que o catálogo induz Uma biblioteca grande convida a escolher pelo que é bonito, porque é o que se vê na miniatura. É a lógica errada: **o critério não é a qualidade do cenário, é a proximidade à biografia.** E há um segundo erro relacionado: escolher pelo diagnóstico. Como já escrevemos a propósito dos [tipos de demência](/blog/tipos-de-demencia-o-que-muda-numa-sessao/), o diagnóstico ajuda a antecipar como a sessão vai correr; **é a biografia que escolhe o conteúdo**. ## Onde isto falha, e é honesto dizê-lo - **Nem sempre há biografia.** Pessoas sem família presente, sem história recolhida, com o passado inacessível. Aí trabalha-se com o que há e sem pretensões. - **Nem toda a gente quer o passado.** Há quem prefira coisas novas, e projetar nostalgia sobre uma pessoa é outra forma de não a ver. - **O significado não se produz com equipamento.** Um cenário do sítio certo pode não gerar nada. A conversa que vem a seguir é frequentemente a parte que vale, e essa não é do sistema. - **A biblioteca é limitada.** Se a pessoa é de uma aldeia específica, é provável que não esteja lá. O que existe são categorias (praias, montanhas, campos) e o mais próximo possível, não o exato. ## O que o sistema faz nisto A funcionalidade assistida por IA ajuda a encontrar cenários a partir do **tipo de momento** que a equipa descreve: relaxamento, memória, orientação. Não conhece a pessoa, não lê história de vida e **não decide**: ordena e explica porque sugeriu, e a escolha é da equipa. A informação que importa, as cinco respostas acima, vive na cabeça de quem cuida e na família. Nenhum sistema a substitui, e o nosso não tenta. ## Em resumo - **Ocupar não é dar ocupação.** A diferença é se a pessoa se reconhece naquilo. - **A pergunta é o que fazia quando decidia**, não do que gosta. - **Cinco perguntas à família** valem mais do que a biblioteca inteira, e a quinta, o que evitar, é a que mais problemas poupa. - **O critério é a proximidade à biografia**, não a qualidade da imagem. - **O significado não vem do equipamento.** Vem de quem conhece a pessoa. Q: O que é uma atividade significativa? A: É atividade ligada a quem a pessoa é (ao que fazia, ao papel que tinha, ao que a define para si própria) e não simplesmente algo que ocupa o tempo. É a distinção que a terapia ocupacional faz há décadas entre ocupação e passatempo, e a que explica porque é que um sítio conhecido rende frequentemente mais do que uma paisagem tecnicamente impecável. Q: Como se escolhe o conteúdo para uma pessoa concreta? A: Pela biografia, não pelo catálogo nem pelo diagnóstico. Cinco perguntas à família resolvem a maior parte: onde passou mais tempo da vida, do que tratava, onde ia quando podia escolher, que trabalho fez com orgulho, e se há alguma coisa a evitar. A última é a que menos se faz e a que mais evita sessões que correm mal. Q: A funcionalidade de IA escolhe o cenário certo para cada pessoa? A: Não. Ajuda a encontrar cenários a partir do tipo de momento descrito pela equipa (relaxamento, memória, orientação), ordena o conteúdo e explica porque sugeriu. Não conhece a pessoa, não lê história de vida e não decide. A escolha é sempre da equipa clínica, e a informação que mais importa vive com quem cuida e com a família. ### O sistema não integra com o hospital. Então como é que a sessão entra no processo? URL: https://rver.pt/blog/a-sessao-e-o-processo-clinico-do-doente/ Date: 1 September 2026 «Não precisa de integração» é a frase que faz a informática do hospital respirar de alívio. É verdadeira, é uma vantagem real, e tem uma consequência que só aparece três meses depois. Quando a informática de um hospital pergunta o que é preciso integrar, a resposta «nada» resolve a conversa em dois minutos. É uma das [oito perguntas](/blog/informatica-hospital-perguntas-realidade-virtual/) e é a que costuma desbloquear tudo: sem integração não há projeto de TI, não há calendário de desenvolvimento, não há dependência de terceiros. Mas há um preço, e é justo dizê-lo: **o registo da sessão fica onde o sistema está, e não no processo clínico do doente.** ## Porque é que isso importa O processo clínico é onde o cuidado é contado. Se uma coisa não está lá, para efeitos práticos não aconteceu: - o médico que vê o doente na semana seguinte não sabe que houve sessões; - a passagem de turno não a inclui; - uma auditoria não a encontra; - e se alguém quiser mais tarde estudar o que se fez, os dados estão noutro sítio. Do outro lado, há uma vantagem que também é real e que já explicámos a propósito do [Espaço Europeu de Dados de Saúde](/blog/espaco-europeu-de-dados-de-saude-o-que-muda/): não recolhendo dados clínicos nem sendo um sistema de registo de saúde eletrónico, a superfície regulatória é pequena. [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## As três vias **1. Nota manual no processo.** Quem conduziu a sessão escreve uma linha no sistema do hospital, como escreve qualquer outra intervenção não farmacológica. - *Custo:* trinta segundos por sessão, e depende de alguém se lembrar. - *Ganho:* está no processo, com autoria e data, no sistema que a instituição já audita. - **É a via que recomendamos para começar**, e na maioria dos serviços é a única que chega a existir. **2. Exportação periódica.** O registo do sistema é exportado e anexado ou resumido, tipicamente por período ou por doente. - *Custo:* alguém tem de o fazer, e o que fica no processo é um resumo e não o detalhe. - *Ganho:* não depende da memória de cada turno. - Útil quando há muitas sessões e o registo manual se degrada. **3. Integração à medida.** Fazer o sistema escrever no sistema hospitalar. - *Custo:* é um projeto de TI, com tudo o que isso implica: âmbito, calendário, segurança, manutenção, e uma dependência que passa a existir para sempre. - *Ganho:* automático e completo. - **Não é o que este sistema faz hoje**, e desconfie de quem lho prometa como coisa simples. Integrar com sistemas hospitalares raramente é. ## O que a nota manual deve conter Se seguir a via 1, e provavelmente vai, vale a pena combinar o conteúdo antes, porque a diferença entre uma nota útil e uma nota inútil é pequena e decide tudo. **Uma nota útil:** o que foi feito, quanto tempo, e **o que se observou nas palavras do que se viu**. «Sessão de 12 minutos, cenário de praia; manteve-se calmo, falou do Algarve, pediu para repetir amanhã.» **Uma nota inútil:** «realizada sessão de RV.» Não diz nada a quem lê a seguir. E uma que **não** se deve escrever: conclusões que o sistema não sustenta. «Sessão reduziu a ansiedade» é uma inferência clínica; se quem escreve é clínico e a assume, é dele. Não é do equipamento, que [não avalia nem mede estados emocionais](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/). ## O que existe do nosso lado O [registo de cada sessão](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/): o que foi reproduzido, quando, por quanto tempo, se foi interrompido e em que ponto. É informação operacional sobre a utilização do equipamento, guardada na instituição, e é o que alimenta as vias 1 e 2. O que **não** existe: escrita automática no processo, e qualquer campo que pareça um resultado clínico. ## Em resumo - **Não integrar é uma vantagem na instalação e um custo no fim.** - **Se não está no processo, para efeitos práticos não aconteceu.** - **Três vias:** nota manual, exportação periódica, integração à medida, por ordem crescente de custo e de fragilidade. - **Comece pela nota manual**, e combine o que ela deve conter antes da primeira sessão. - **Nunca escreva no processo uma conclusão que o equipamento não sustenta.** Q: A RVer integra com o sistema informático do hospital? A: Não. O sistema funciona de forma independente e corre na rede local da instituição, o que dispensa um projeto de TI e costuma ser a resposta que desbloqueia a conversa com a informática. A contrapartida é que o registo da sessão fica no sistema e não no processo clínico do doente. Q: Como é que a sessão chega ao processo clínico? A: Por três vias, em ordem crescente de custo. Uma nota manual escrita por quem conduziu a sessão, que é a mais recomendada para começar; uma exportação periódica do registo, anexada ou resumida no processo; ou uma integração à medida com o sistema hospitalar, que é um projeto de TI e não é o que este sistema faz hoje. Q: O que deve constar de uma nota de sessão no processo? A: O que foi feito, quanto tempo durou e o que se observou, nas palavras do que se viu: por exemplo, sessão de doze minutos com cenário de praia, manteve-se calmo, falou do Algarve, pediu para repetir. Não deve conter conclusões que o equipamento não sustenta: o sistema não avalia nem mede estados emocionais, e qualquer inferência clínica pertence a quem a escreve e assume. ### Espaço Europeu de Dados de Saúde: o calendário e o que muda para quem compra software URL: https://rver.pt/blog/espaco-europeu-de-dados-de-saude-o-que-muda/ Date: 31 August 2026 É o maior enquadramento europeu de dados de saúde de sempre, entra em aplicação a 26 de março de 2027, e a maior parte das instituições ainda não sabe se algum dos seus fornecedores é abrangido. O **Regulamento (UE) 2025/327**, que estabelece o Espaço Europeu de Dados de Saúde, entrou em vigor a **26 de março de 2025** e começa a aplicar-se a **26 de março de 2027**. Não é uma proposta nem uma consulta pública: é direito em vigor com um calendário faseado. Como quase tudo neste terreno, o problema não é a existência da regra: é ninguém saber a quem se aplica. ## As quatro datas | Quando | O quê | |---|---| | 26 mar. 2025 | Entrada em vigor | | **26 mar. 2027** | **Aplicação geral**, incluindo regras sobre ambientes de processamento seguro e pedidos de acesso a dados | | **26 mar. 2029** | **Uso secundário** (Capítulo III) e troca do primeiro grupo de categorias prioritárias: resumos de doente, receitas e dispensas | | 26 mar. 2031 | Partilha obrigatória de imagem médica e respetivos relatórios, resultados de exames e cartas de alta | Repare que a data que toda a gente cita, 2027, é a **menos** exigente das três. As obrigações que mais mexem com sistemas (uso secundário e partilha de imagem) são de 2029 e 2031. ## Duas metades que se confundem sempre **Uso primário** é sobre a pessoa e o seu cuidado: aceder ao próprio registo, levá-lo consigo entre países e prestadores, e os sistemas conseguirem falar uns com os outros. **Uso secundário** é sobre investigação, inovação, políticas públicas e regulação: acesso a dados de saúde despersonalizados através de organismos próprios, com pedidos, permissões e ambientes de processamento seguro. Confundir os dois leva a conversas erradas com fornecedores. Um sistema pode ser irrelevante para uma metade e central na outra. ## O que muda para sistemas de registo de saúde eletrónico Esta é a parte que apanha software: o regulamento estabelece **requisitos para sistemas de registo de saúde eletrónico**, com componentes obrigatórias de interoperabilidade e de registo de acessos, mais um regime de conformidade e declarações. Portanto a pergunta útil não é «cumprem o EHDS?», é: > **O vosso sistema é um sistema de registo de saúde eletrónico na aceção do > regulamento? E se não é, que dados de saúde processa, e para quem?** Um fornecedor que responda «sim, estamos totalmente conformes com o EHDS» a um regulamento cuja aplicação geral é em 2027 está a dizer-lhe muito pouco. ## Onde a RVer fica nisto Sendo específicos, porque é a única forma de isto ser útil: - **A RVer não é um sistema de registo de saúde eletrónico.** Não é um processo clínico, não substitui um, e não pretende sê-lo. - **Não recolhe dados clínicos do doente.** O que existe é o [registo da sessão](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/): o que foi reproduzido, quando, por quanto tempo, se foi interrompido, que é informação operacional sobre a utilização do equipamento. - **Não avalia, não classifica e não diagnostica**, portanto não gera dados clínicos novos. - **Não integra com o [sistema informático hospitalar](/blog/informatica-hospital-perguntas-realidade-virtual/)**, e a reprodução corre [no próprio equipamento, sem nuvem](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/). Isto tem uma consequência prática agradável e uma desagradável. A agradável é que a superfície de exposição ao EHDS é pequena. A desagradável é que **isso também significa que as sessões não entram no processo clínico do doente**: quem quiser essa integração tem de a construir, e não é o que este sistema faz. Do lado do RGPD, que continua a aplicar-se em paralelo e não foi substituído por nada, já escrevemos [o que há a saber](/blog/privacidade-rgpd-realidade-virtual-saude/), e a minuta de AIPD pré-preenchida está em [Como financiar e contratar](/aquisicao/). ## O que perguntar a qualquer fornecedor, agora Vale a pena fazê-lo já, porque as respostas demoram a chegar: 1. **É um sistema de registo de saúde eletrónico na aceção do regulamento?** 2. **Que dados processa, e onde ficam?** Dentro da instituição, num servidor vosso, num de terceiros? 3. **Quem é o responsável pelo tratamento, e quem é subcontratante?** 4. **Se for abrangido, qual é o plano até março de 2027?** Uma data e um nome, não uma declaração de intenções. 5. **O que acontece aos dados se a relação terminar?** As duas últimas são as que mais informação dão sobre a maturidade de quem responde. ## O que não sabemos Com todas as letras: **isto não é aconselhamento jurídico.** Somos fabricante, não escritório de advogados. Há zonas do regulamento cuja aplicação prática a sistemas de nicho ainda está a assentar, os atos de execução continuam a sair, e a fronteira entre software de bem-estar, dispositivo médico e sistema de registo está a ser desenhada em tempo real. Se a sua instituição precisa de uma posição formal, ela tem de vir de quem a possa assinar. ## Em resumo - **Em vigor desde março de 2025**, aplicação geral em **março de 2027**, uso secundário em **2029**, imagem médica em **2031**. - **Uso primário e uso secundário são conversas diferentes.** - **A pergunta certa é se o sistema é um registo de saúde eletrónico**, não se «cumpre o EHDS». - **A RVer não é um, e não recolhe dados clínicos**, com o custo de as sessões não entrarem no processo do doente. Q: Quando é que o EHDS começa a aplicar-se? A: O Regulamento (UE) 2025/327 entrou em vigor a 26 de março de 2025 e a aplicação geral começa a 26 de março de 2027. As obrigações de uso secundário aplicam-se a partir de 26 de março de 2029, e a partilha obrigatória de imagem médica, resultados de exames e cartas de alta a partir de 26 de março de 2031. Q: A RVer é abrangida pelo EHDS? A: A RVer não é um sistema de registo de saúde eletrónico na aceção do regulamento: não é um processo clínico nem o substitui, não recolhe dados clínicos do doente, não avalia nem diagnostica, e não integra com o sistema informático hospitalar. O que regista é informação operacional sobre a utilização do equipamento. Isto não é aconselhamento jurídico, e a classificação de cada caso cabe à instituição. Q: O EHDS substitui o RGPD? A: Não. O RGPD continua a aplicar-se em paralelo e não foi substituído. O EHDS acrescenta um enquadramento próprio para uso primário e secundário de dados de saúde e requisitos para sistemas de registo de saúde eletrónico, mas as obrigações de proteção de dados mantêm-se. ### Comprar tecnologia de saúde a uma empresa pequena: o que perguntar antes URL: https://rver.pt/blog/comprar-tecnologia-de-saude-a-uma-empresa-pequena/ Date: 31 August 2026 É a pergunta que ninguém faz na reunião e toda a gente pensa: e se vocês fecharem? Merece uma resposta a sério, e é mais fácil dá-la sendo nós a levantá-la. O mercado de saúde digital europeu cresce e, ao mesmo tempo, **concentra-se**: o capital vai para menos empresas e maiores, e o que existe por baixo é uma cauda comprida de fornecedores pequenos. Nós somos um deles. Isso cria um risco que raramente aparece num caderno de encargos e que é inteiramente da instituição: **o equipamento fica, o fornecedor pode não ficar.** Vale mais discutir isto de frente do que esperar que ninguém pergunte. ## Porque é que isto é diferente noutros setores Se um fornecedor de cadeiras fechar, as cadeiras continuam a ser cadeiras. Em software e equipamento ligado, o produto pode deixar de funcionar sem ninguém lhe tocar: uma licença que expira, um servidor que desliga, uma loja de aplicações que deixa de servir a aplicação. A pergunta certa não é «são sólidos?», todos dizem que sim. É: > **O que é que continua a funcionar no dia em que vocês desaparecerem?** [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## As sete perguntas Valem para qualquer fornecedor pequeno de tecnologia de saúde: 1. **O produto funciona sem os vossos servidores?** Se a resposta for não, está a comprar uma assinatura de um serviço, não um equipamento. 2. **Precisa de internet para a utilização normal?** 3. **Se a empresa desaparecer, o que para de funcionar exatamente, e quando?** 4. **Os dados são exportáveis num formato aberto, sem vos pedir nada?** 5. **Quem consegue reparar ou substituir o hardware sem ser vocês?** 6. **O contrato prevê o quê em caso de cessação, insolvência ou aquisição?** 7. **Quantas pessoas conseguem manter isto a funcionar?** Se for uma, é uma pessoa e não uma empresa. ## As nossas respostas, incluindo as que não nos favorecem **O que continua a funcionar sem nós:** - **A reprodução do conteúdo já instalado.** Os cenários estão no equipamento e correm [sem internet](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/). Um headset com a biblioteca instalada continua a fazer sessões. - **O comando a partir do browser**, porque corre na [rede local da instituição](/blog/app-companion-controlo-remoto-realidade-virtual/), não na nossa nuvem. - **O hardware.** O equipamento é comercial e não foi modificado por nós; não fica inutilizado. **O que deixa de funcionar:** - **Conteúdo novo.** O catálogo é gerado a partir do nosso backoffice. Sem nós, a biblioteca congela no que estiver instalado. - **Atualizações** da aplicação, correções e novas funcionalidades. - **Suporte, formação e substituição** de equipamento avariado ao abrigo do contrato. - **Os módulos em desenvolvimento**, que já hoje não estão abrangidos pelo registo de dispositivo médico e não devem contar na decisão de compra. Resumindo sem adornos: **as sessões continuam, a evolução para.** É uma resposta melhor do que a de muitos produtos que dependem de nuvem para funcionar, e é pior do que «não muda nada», que não seria verdade. ## O que uma instituição pode exigir por contrato Nada disto é exótico e a maior parte dos fornecedores aceita, se lhe pedirem: - **Exportação de dados** em formato aberto, a pedido e sem custo. - **Prazo de aviso prévio** em caso de cessação do serviço. - **Cláusula de continuidade** que garanta a utilização do que está instalado. - **Documentação de operação** suficiente para outra pessoa perceber o sistema. Se um fornecedor recusar a primeira, é um sinal por si só. ## O outro lado, que também é honesto Empresas grandes descontinuam produtos com a mesma facilidade: só que sem aviso e sem ninguém para falar. «Comprar ao maior» reduz o risco de insolvência e aumenta o risco de irrelevância: um produto pequeno dentro de uma empresa grande é o primeiro a ser cortado numa reorganização. O que reduz risco a sério não é o tamanho do fornecedor. É **a arquitetura** (funciona sem eles?) e **o contrato**. ## Em resumo - **O equipamento fica, o fornecedor pode não ficar**, e o risco é da instituição. - **A pergunta é o que continua a funcionar**, não se o fornecedor é sólido. - **Connosco: as sessões continuam** (conteúdo instalado, rede local, hardware comercial) **e a evolução para** (conteúdo novo, atualizações, suporte). - **Exija exportação de dados e cláusula de continuidade.** Quem recusa está a responder-lhe. - **Comprar ao maior troca um risco por outro**, não o elimina. Q: O que acontece ao equipamento se o fornecedor fechar? A: Depende inteiramente da arquitetura. No caso da RVer, a reprodução do conteúdo já instalado continua a funcionar porque os cenários estão no equipamento e correm sem internet, o comando a partir do browser continua porque corre na rede local da instituição, e o hardware é comercial e não modificado. O que para é o conteúdo novo, que é gerado a partir do nosso backoffice, mais atualizações, suporte e substituição de equipamento. Q: Que perguntas fazer a um fornecedor pequeno antes de comprar? A: Se o produto funciona sem os servidores do fornecedor, se precisa de internet para uso normal, o que exatamente para de funcionar se a empresa desaparecer, se os dados são exportáveis em formato aberto sem pedir autorização, quem consegue reparar o hardware sem ser o fornecedor, o que o contrato prevê em caso de cessação ou insolvência, e quantas pessoas conseguem manter o sistema a funcionar. Q: É mais seguro comprar a uma empresa grande? A: Troca um risco por outro. Reduz o risco de insolvência e aumenta o de descontinuação: um produto pequeno dentro de uma empresa grande costuma ser o primeiro a ser cortado numa reorganização, muitas vezes sem aviso e sem interlocutor. O que reduz risco a sério é a arquitetura do produto e o que está escrito no contrato, não o tamanho de quem o vende. ### A Alemanha comparticipa apps de saúde. Portugal não tem nada disso: porquê URL: https://rver.pt/blog/diga-pecan-e-o-que-portugal-nao-tem/ Date: 31 August 2026 Um médico alemão pode prescrever uma aplicação e o seguro paga. Um médico português não pode prescrever nada disso, porque não há nada para prescrever, e a diferença explica boa parte de como se compra tecnologia de saúde por cá. Desde 2019, um médico na Alemanha pode passar uma receita de uma **aplicação digital** e o seguro de saúde obrigatório paga. Chama-se **DiGA**: *digitale Gesundheitsanwendungen*, e passa por uma avaliação do BfArM com uma via rápida que permite entrada provisória enquanto se produz evidência. A França criou depois o **PECAN**, uma via de comparticipação antecipada com lógica parecida: entra cedo, prova depois. Em **Portugal não existe nada equivalente.** Não há registo nacional de terapêuticas digitais, não há via de comparticipação, e não há sequer a figura da «aplicação prescritível». ## O que isto muda na prática Numa instituição alemã, parte da conversa é sobre **elegibilidade**: está na lista, é prescritível, o seguro paga. Numa instituição portuguesa, a conversa é inteiramente outra: **de que orçamento sai isto?** É por isso que quase toda a compra de tecnologia de saúde em Portugal cai no mesmo problema que já descrevemos em [quem paga não é quem poupa](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/): um serviço a suportar sozinho uma despesa cujos benefícios se espalham. Sem via de comparticipação, não há terceiro a partilhar o custo, e as vias possíveis estão todas do lado da instituição, como listámos em [como financiar](/blog/financiamento-comparticipacao-realidade-virtual-saude/). ## O que a via alemã exige em troca, e que raramente se conta Quem cita o DiGA como modelo costuma esquecer-se do preço de entrada. Para entrar é preciso, entre outras coisas: - ser **dispositivo médico** com marcação CE, de classe baixa; - demonstrar requisitos de segurança da informação, proteção de dados e interoperabilidade; - e, sobretudo, apresentar **evidência de efeito positivo em saúde** dentro de um prazo: a entrada provisória não é permanente, e há produtos que saíram da lista por não terem conseguido demonstrá-lo. Ou seja: não é um subsídio, é um contrato. Entra-se com uma promessa de prova, e quem não prova, sai. ## E a RVer caberia? Não, e não é por modéstia Esta é a parte que interessa dizer com clareza, porque a tentação de fingir o contrário é grande. O modelo DiGA foi desenhado para **aplicações que o doente usa sozinho**, em casa, depois de prescritas. É uma via de autoadministração. A RVer é o oposto disso por desenho: a finalidade prevista exige [utilização acompanhada](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/), o utilizador previsto são profissionais e cuidadores com formação, e o sistema vive dentro de uma instituição com uma equipa a conduzir. **Não é uma aplicação prescritível a um doente para uso próprio, e não vamos torcer o produto para caber numa via de financiamento.** Portanto, se Portugal criasse um DiGA amanhã, isso seria excelente para o setor, e provavelmente não mudaria nada para nós. ## O que faria diferença em Portugal, e não é copiar o modelo Se a pergunta for o que destravaria adoção por cá, a resposta não é uma lista nacional de apps. É mais aborrecida e mais eficaz: 1. **Reconhecimento em contratos-programa.** Enquanto atividade não farmacológica não contar para nada do que uma instituição reporta, compete com o que conta: é a mesma lógica de [«O que o sistema mede»](/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/). 2. **Elegibilidade clara em financiamento existente.** RNCCI, apoios sociais, fundos de recuperação: a maior parte das dúvidas é sobre se uma rubrica cobre isto, não sobre se vale a pena. 3. **Um caminho para instituições pequenas.** Um lar de trinta camas não tem estrutura para concorrer a fundos, e é onde a diferença por utente seria maior. ## O que perguntar a quem lhe cite o DiGA Se um fornecedor lhe disser que o produto «está alinhado com o modelo DiGA» ou que «seria elegível na Alemanha», três perguntas resolvem: - **Está na lista do BfArM?** Se sim, o número. Se não, é uma afirmação sobre o futuro. - **É de autoadministração ou exige profissional?** Decide se a comparação sequer faz sentido. - **Que evidência de efeito positivo em saúde existe, e publicada onde?** É o requisito central da via que estão a citar. Nós não estamos na lista, não somos elegíveis, e dizemo-lo antes de nos perguntarem. ## Em resumo - **Alemanha (DiGA, desde 2019) e França (PECAN)** têm vias de comparticipação; **Portugal não tem nenhuma.** - **A via alemã não é um subsídio**: exige marcação CE, requisitos técnicos e prova de efeito, com saída para quem não prova. - **A RVer não caberia lá**, porque o DiGA é para uso autoadministrado e a nossa finalidade prevista exige supervisão. - **O que destravaria Portugal** é reconhecimento nos indicadores e elegibilidade clara no financiamento que já existe. Q: O que é o DiGA alemão? A: É a via alemã pela qual aplicações digitais de saúde podem ser prescritas por um médico e comparticipadas pelo seguro obrigatório, existente desde 2019. Passa por avaliação do BfArM e inclui uma via rápida com entrada provisória enquanto se produz evidência de efeito positivo em saúde. Não é um subsídio: exige marcação CE, requisitos de segurança e proteção de dados, e produtos que não demonstram efeito acabam por sair da lista. Q: Portugal tem alguma via de comparticipação para saúde digital? A: Não existe equivalente. Não há registo nacional de terapêuticas digitais, não há via de comparticipação e não existe a figura da aplicação prescritível. Na prática, a conversa numa instituição portuguesa não é sobre elegibilidade mas sobre de que orçamento sai a despesa. Q: A RVer seria elegível para uma via tipo DiGA? A: Não, e não é por modéstia. O modelo foi desenhado para aplicações que o doente usa sozinho em casa após prescrição, e a finalidade prevista da RVer exige utilização acompanhada por profissionais de saúde ou cuidadores com formação, dentro de uma instituição. Não é uma aplicação prescritível para uso próprio, e não distorcemos o produto para caber numa via de financiamento. ### Cuidador informal: o que a tecnologia faz em casa, e o que não faz URL: https://rver.pt/blog/cuidador-informal-o-que-a-tecnologia-faz-em-casa/ Date: 21 August 2026 É a resposta social mais usada do país e a menos equipada. Alguém, quase sempre uma mulher, quase sempre sozinha, a cuidar de um familiar em casa, e a receber ofertas de tecnologia que foram pensadas para instituições. Portugal reconheceu o **Estatuto do Cuidador Informal** em 2019, com a Lei 100/2019, e criou uma figura legal para uma coisa que já existia há décadas: alguém que cuida de um familiar em casa, sem ser profissional de saúde e sem horário. O estatuto distingue o cuidador **principal**, que cuida em permanência e não tem atividade profissional, do **não principal**, que concilia. Só o principal pode aceder ao subsídio de apoio, e sob condição de recursos do agregado, o que na prática exclui muita gente que cuida a tempo inteiro. Há também descanso do cuidador previsto, com disponibilidade que varia muito consoante o concelho. Escrevemos isto porque é o contexto onde mais tecnologia é oferecida e onde menos dela serve. ## O que realmente pesa em casa Falando com quem cuida, os problemas repetem-se e quase nenhum é o que a tecnologia costuma prometer resolver: - **não haver substituição.** A pessoa não sai de casa há meses; - **o isolamento**, que é do cuidador e não só de quem é cuidado, e vale a pena separá-lo da [solidão](/blog/solidao-isolamento-social-idosos-tecnologia/), que é outra coisa; - **as noites**, quando há agitação ou perturbação do sono; - **as horas mortas**: o dia é longo e há períodos em que não há nada a fazer e ninguém consegue sair; - **a informação**, que chega em pedaços e nunca no momento certo; - **a culpa**, quando se pensa em institucionalizar. ## O que a tecnologia resolve, com honestidade **Resolve razoavelmente:** comunicação com quem está longe, lembretes de medicação, sensores de queda e de porta aberta, e telemonitorização em situações específicas. São coisas concretas e baratas, e a maioria já existe em produtos de consumo. **Só parece resolver:** quase tudo o que promete «ocupar» a pessoa cuidada por períodos longos sem ninguém por perto. Se o produto exige que o cuidador esteja presente e atento, não devolveu tempo nenhum, apenas mudou o que se faz com ele. **Não resolve de todo:** a ausência de substituição. Nenhum equipamento vai a casa às terças para que alguém possa ir ao médico. É o problema central e é um problema de serviços, não de dispositivos. ## Onde a RVer está nisto, e a resposta é desconfortável Vamos ser diretos, porque a pergunta chega-nos com frequência. **A RVer não é um produto de consumo e não se vende a famílias para uso doméstico.** É um dispositivo médico de Classe I registado no INFARMED e na EUDAMED, e a finalidade prevista diz que a utilização é **sempre acompanhada**, o manual é explícito: não deixar a pessoa sozinha com o headset. O utilizador previsto são profissionais de saúde e cuidadores **com formação**. Isso tem uma consequência prática que convém dizer sem rodeios: **num contexto doméstico sem apoio profissional, uma sessão exige que o cuidador esteja ali, atento, durante o tempo todo.** Ou seja, não devolve tempo, e tempo é exatamente o que falta. Vendê-la como «uma hora de descanso» seria vender ao contrário do que o produto é. **Onde faz sentido:** quando existe uma equipa por trás. Apoio domiciliário, [cuidados continuados](/blog/realidade-virtual-cuidados-continuados-rncci/), uma unidade de paliativos que acompanha em casa, um centro de dia. Aí há um profissional que conduz e o cuidador não fica com mais uma tarefa. **E há uma coisa que faz sentido em qualquer caso**, mesmo com a pessoa numa instituição: a [videochamada durante a sessão](/blog/videochamadas-familia-realidade-virtual/), que serve precisamente o cuidador que não pode estar lá. ## Se cuida em casa, o que perguntar a quem lhe vende 1. **Exige que eu esteja presente?** Se sim, não me devolve tempo. Pode ser bom à mesma, mas por outra razão. 2. **É dispositivo médico?** E se for, qual é a finalidade prevista e quem é o utilizador previsto? 3. **Funciona sem internet?** 4. **O que é que acontece se eu não conseguir usá-lo?** Há formação, há alguém ao telefone? 5. **Quanto custa por mês, tudo incluído?** ## Em resumo - **O Estatuto existe desde 2019**, mas o subsídio tem condição de recursos e não chega a toda a gente que cuida. - **O problema central é a falta de substituição**, e isso é serviços, não tecnologia. - **Um produto que exige presença não devolve tempo.** - **A RVer não se vende para uso doméstico sem apoio profissional**: a finalidade prevista exige acompanhamento. - **Onde há equipa, faz sentido.** Onde não há, dizemos que não. Q: A RVer pode ser usada em casa por um familiar? A: Não como produto de consumo. É um dispositivo médico de Classe I cuja finalidade prevista exige utilização acompanhada, com o utilizador previsto a ser profissionais de saúde e cuidadores com formação, e o manual é explícito em não deixar a pessoa sozinha com o headset. Faz sentido em casa quando existe uma equipa por trás: apoio domiciliário, cuidados continuados ou uma equipa de paliativos. Q: O que é o Estatuto do Cuidador Informal? A: É a figura legal criada em Portugal pela Lei 100/2019, que distingue o cuidador informal principal, que cuida em permanência e não tem atividade profissional, do não principal, que concilia. Só o principal pode aceder ao subsídio de apoio, sujeito a condição de recursos do agregado, e existe também descanso do cuidador com disponibilidade variável entre concelhos. Q: Que tecnologia ajuda mesmo quem cuida em casa? A: As coisas concretas e baratas: comunicação com quem está longe, lembretes de medicação, sensores de queda e de porta aberta, e telemonitorização em situações específicas. O que não se resolve com equipamento é a ausência de substituição, que é o problema central e é uma questão de serviços. ### Saúde mental em Portugal: o lugar das respostas não farmacológicas URL: https://rver.pt/blog/saude-mental-em-portugal-o-lugar-do-nao-farmacologico/ Date: 21 August 2026 Há dois factos sobre a saúde mental em Portugal que não costumam aparecer na mesma frase, e é na distância entre eles que vive todo o mercado das respostas complementares. Dois factos, e a tensão entre eles. **Primeiro:** Portugal está sistematicamente entre os países europeus com maior consumo de benzodiazepinas e de antidepressivos, e é um padrão antigo, não uma oscilação recente. **Segundo:** o acesso a psicoterapia no Serviço Nacional de Saúde é limitado. O número de psicólogos por habitante ficou historicamente abaixo do que a Organização Mundial da Saúde recomenda, e os tempos de espera para consulta de psicologia são longos em boa parte do país. A leitura mais simples é a mais desconfortável: quando a resposta psicológica não está disponível em tempo útil, **a resposta farmacológica é a que resta**, e frequentemente é dada por quem não queria ser a única resposta disponível, no tempo curto de uma consulta de medicina geral e familiar. ## O espaço que isto abre, e o risco que traz Entre «não fazer nada» e «medicar» há um espaço grande. É onde vivem os grupos de suporte, o exercício, a atividade estruturada, a psicoeducação, o contacto com a natureza, e também as tecnologias. É um espaço legítimo. E é, por isso mesmo, **o espaço onde é mais fácil vender ilusões**: quem está em sofrimento e sem acesso a resposta compra esperança, e há muita gente a vender. Vale a pena dizer que uma resposta complementar não é uma alternativa. Um ansiolítico prescrito e uma sessão de relaxamento não estão em concorrência, e apresentar a segunda como forma de evitar o primeiro é uma decisão clínica que não pertence a um fornecedor. ## O que a RVer é, e o que não é, nesta conversa Sendo explícitos, porque nesta área a imprecisão faz mal: - **Não é tratamento de saúde mental.** O produto base é um dispositivo médico de Classe I registado no INFARMED e na EUDAMED, usado como **complemento não farmacológico** para conforto, distração e relaxamento, sob supervisão da equipa de saúde. - **Não substitui psicoterapia, consulta ou medicação.** - **Não avalia, não classifica e não diagnostica** estados emocionais. Não há pontuação de bem-estar. - **Não é para autoadministração.** A finalidade prevista exige acompanhamento: o que a torna, por desenho, inadequada como resposta individual a quem está em lista de espera. **O que existe:** literatura sobre ambientes imersivos em ansiedade e stress, sobretudo em situações concretas: o momento antes de um procedimento, o internamento, o contexto institucional. Reunimo-la na [biblioteca de estudos](/estudos/), onde o tema do relaxamento, stress e ansiedade é dos mais representados. E já escrevemos sobre [ansiedade pré-operatória](/blog/realidade-virtual-ansiedade-pre-operatoria/), que é o caso com melhor sustentação. Há uma exceção que convém nomear com rigor: a **exposição gradual** em contexto de fobias e perturbação de stress pós-traumático tem um corpo de investigação próprio e mais antigo, conduzido por profissionais. No nosso caso, isso é o [RVer Exposure](/blog/realidade-virtual-tratamento-fobias/): um módulo **em desenvolvimento e não abrangido pelo registo**, em que o clínico escolhe o nível e define o ritmo, sem progressão automática, sem pontuação e sem classificação. ## Onde faz sentido, e onde não **Faz sentido** dentro de um serviço que já acompanha a pessoa: um internamento, um hospital de dia, uma unidade, um lar. Há profissional, há continuidade e há registo. **Não faz sentido** como resposta a quem está numa lista de espera e não tem acompanhamento. Não porque o equipamento não funcione: porque **não é isso que ele é**, e porque a ausência de acompanhamento é precisamente o problema que nenhum equipamento resolve. Se lhe apresentarem realidade virtual como forma de reduzir listas de espera em saúde mental, é o momento de perguntar que estudos sustentam isso. Nós não temos nenhum para lhe dar. ## Em resumo - **Consumo elevado de psicofármacos e acesso limitado a psicoterapia** são o mesmo problema visto de dois lados. - **O espaço para respostas complementares é real**, e é onde mais se vende esperança. - **Complementar não é alternativa**, e a decisão sobre medicação não é de um fornecedor. - **A RVer não trata, não avalia e não substitui** consulta nem psicoterapia. - **Onde há equipa a acompanhar, faz sentido. Numa lista de espera, não.** Q: A realidade virtual pode substituir consulta de psicologia ou medicação? A: Não, e não o afirmamos. O produto base é um dispositivo médico de Classe I usado como complemento não farmacológico para conforto, distração e relaxamento, sob supervisão da equipa de saúde. Não trata, não avalia, não diagnostica e não substitui consulta, psicoterapia ou prescrição. Uma resposta complementar não é uma alternativa. Q: Serve para quem está em lista de espera para psicologia? A: Não, e a razão é de desenho e não de eficácia: a finalidade prevista exige utilização acompanhada, o que a torna inadequada como resposta individual a quem não tem acompanhamento. Faz sentido dentro de um serviço que já segue a pessoa (internamento, hospital de dia, unidade ou lar) onde há profissional, continuidade e registo. Q: E a exposição gradual em fobias e stress pós-traumático? A: Tem um corpo de investigação próprio e mais antigo, sempre conduzido por profissionais. No nosso caso corresponde ao módulo RVer Exposure, que está em desenvolvimento e não é abrangido pelo registo de dispositivo médico, e em que o clínico escolhe o nível e define o ritmo, sem progressão automática, sem pontuação e sem classificação. ### Consulta da dor: onde entra a realidade virtual, e onde não entra URL: https://rver.pt/blog/consulta-da-dor-onde-entra-a-realidade-virtual/ Date: 21 August 2026 Uma unidade de dor recebe pessoas que já passaram por vários médicos e várias tentativas. É o contexto onde uma promessa nova é mais bem-vinda e onde é mais irresponsável fazê-la sem cuidado. As consultas e unidades de dor recebem doentes numa fase específica do percurso: já viram vários médicos, já tentaram várias coisas, e muitos já ouviram que «não há mais nada a fazer». É um contexto onde qualquer proposta nova é recebida com esperança, e é por isso que merece o cuidado maior. Há uma distinção que decide quase tudo o que se segue. ## Dor aguda e dor crónica não são a mesma conversa **Dor aguda** (a de um procedimento, de um penso, de uma punção) é um evento com princípio e fim. A atenção é um recurso limitado, e ocupá-la durante esses minutos tem efeito documentado. **É aqui que está a evidência mais consistente da realidade virtual em saúde**, e já a desenvolvemos em [gestão da dor](/blog/realidade-virtual-gestao-da-dor/). **Dor crónica** é outra coisa. Não é dor aguda que se prolongou: envolve alterações no processamento da dor, medo do movimento, evitamento, sono perturbado, humor, e uma vida que se foi organizando à volta da dor. Distrair alguém durante vinte minutos não muda nada disso. Confundir as duas é o erro comercial mais comum deste setor. **A evidência da primeira é usada para vender na segunda.** ## O que uma unidade de dor faz, e onde isto pode encaixar Uma abordagem moderna à dor crónica é multimodal: medicação quando indicada, exercício e reativação do movimento, componente psicológica, educação sobre dor, higiene do sono, e trabalho sobre função em vez de trabalho sobre a intensidade. Se a realidade virtual tiver um lugar, é **dentro de uma dessas componentes**, não ao lado delas: - **Durante procedimentos feitos na unidade**: infiltrações, bloqueios, colocação de dispositivos. Aqui é dor aguda, e aplica-se a evidência boa. - **No apoio ao movimento**, para quem evita mexer-se por medo. O obstáculo é frequentemente o medo, não a capacidade. Nota necessária: isso corresponde ao módulo **RVer Motion**, que está **em desenvolvimento e não é abrangido pelo registo** de dispositivo médico Classe I. - **Como componente de relaxamento**, dentro de um plano que já existe e conduzido por quem o conduz. ## Onde a evidência é fraca, e convém dizê-lo Em dor crónica, os estudos existentes são na maioria **pequenos, curtos e heterogéneos**: populações diferentes, protocolos diferentes, desfechos diferentes. Vários mostram melhorias durante a sessão que não se mantêm depois. É um sinal interessante, e não é a mesma coisa que efeito clínico duradouro. Reunimos o que existe na [biblioteca de estudos](/estudos/), onde a dor é um dos temas com mais trabalhos, e ver a lista é mais útil do que qualquer afirmação nossa. Onde a evidência não sustenta, dizemo-lo lá também, como fizemos em [«O que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). **O que não afirmamos, e não vamos afirmar:** que a RVer reduz dor crónica, que reduz consumo de analgésicos, ou que substitui qualquer componente de um plano de dor. O produto base é um dispositivo médico de Classe I usado como **complemento não farmacológico**, sob supervisão. Não avalia dor, não a mede e não a classifica. ## O risco específico desta população Vale a pena nomeá-lo, porque é diferente de outros contextos: **estas pessoas já foram desiludidas várias vezes.** Uma proposta apresentada com entusiasmo a mais, que depois não corresponde, não é neutra: reforça a ideia de que nada resulta e custa credibilidade a quem a apresentou, que é a equipa e não o fornecedor. Por isso, se for para testar, vale a pena dizer ao doente exatamente o que se espera: **«isto pode tornar este procedimento mais fácil»** é uma coisa; **«isto pode ajudar com a sua dor»** é outra, e a segunda não se sustenta. ## O que uma unidade pode testar sem prometer nada 1. **Um procedimento concreto** que já se faça na unidade, comparando com o habitual. 2. **Recusas e interrupções**, que é onde os problemas aparecem primeiro. 3. **Função, não intensidade.** O que a pessoa consegue fazer é mais informativo do que um número numa escala, e é o que a própria unidade já tende a medir. 4. **Três meses**, não três semanas. ## Em resumo - **A evidência boa é de dor aguda**, e é frequentemente usada para vender em dor crónica. - **Dor crónica é multimodal**: se isto entra, entra dentro de uma componente. - **Em dor crónica os estudos são pequenos e curtos**, com efeitos que muitas vezes não persistem. - **Não afirmamos redução de dor nem de analgésicos.** - **Prometer de mais a esta população custa credibilidade à equipa**, não ao fornecedor. Q: A realidade virtual reduz a dor crónica? A: Não afirmamos isso. A evidência mais consistente é em dor aguda, sobretudo durante procedimentos, onde ocupar a atenção tem efeito documentado. Em dor crónica os estudos existentes são na maioria pequenos, curtos e heterogéneos, e vários mostram melhorias durante a sessão que não se mantêm depois. Q: Qual é a diferença entre dor aguda e crónica nesta conversa? A: Dor aguda é um evento com princípio e fim, e ocupar a atenção durante esses minutos tem efeito documentado. Dor crónica envolve alterações no processamento da dor, medo do movimento, evitamento, sono e humor, e uma vida organizada à volta da dor. Distrair durante vinte minutos não muda isso, e usar a evidência da primeira para vender na segunda é o erro comercial mais comum do setor. Q: Onde pode encaixar numa unidade de dor? A: Dentro de uma componente do plano e não ao lado dele: durante procedimentos feitos na unidade, como infiltrações ou bloqueios, onde se aplica a evidência de dor aguda; no apoio ao movimento para quem evita mexer-se por medo, notando que isso corresponde ao módulo RVer Motion, em desenvolvimento e não abrangido pelo registo; e como componente de relaxamento dentro de um plano existente. ### Tipos de demência: quais são, como se distinguem e o que muda numa sessão URL: https://rver.pt/blog/tipos-de-demencia-o-que-muda-numa-sessao/ Date: 21 August 2026 «Demência» não é uma doença: é um conjunto de sinais que várias doenças podem causar. Os principais tipos são Alzheimer, vascular, corpos de Lewy, frontotemporal e mista. Como começa cada um, o que os distingue, e o que cada um muda numa sessão de realidade virtual. «Demência» não é uma doença. É o nome de um conjunto de sinais (perda de memória, de linguagem, de orientação, de autonomia) que várias doenças diferentes podem causar. Os principais tipos de demência são a **doença de Alzheimer**, a **demência vascular**, a **demência por corpos de Lewy**, a **demência frontotemporal** e a **demência mista**, quando há mais do que uma causa ao mesmo tempo. Há outras menos frequentes, como a demência na doença de Parkinson ou a associada ao álcool. E o défice cognitivo ligeiro, que se confunde muitas vezes com elas, não é uma demência. Saber qual delas está por trás muda o que se espera, o que se faz e o que se evita. Este guia junta os tipos mais frequentes, os primeiros sinais de cada um e o que os distingue, e depois o que cada um muda numa sessão de realidade virtual. Não substitui uma avaliação médica: o diagnóstico é sempre de um médico, normalmente de neurologia ou psiquiatria, e depende de exames que nenhum texto faz. ## Quantas pessoas vivem com demência Segundo a [Organização Mundial da Saúde](https://www.who.int/news-room/fact-sheets/detail/dementia), em 2021 havia 57 milhões de pessoas com demência no mundo, com quase 10 milhões de casos novos por ano. É hoje a sétima causa de morte a nível mundial e uma das principais causas de dependência nas pessoas mais velhas. Não é exclusiva da velhice: a demência de início precoce, antes dos 65 anos, representa até 9% dos casos. Em Portugal, a [Alzheimer Portugal](https://alzheimerportugal.org/wp-content/uploads/2026/07/CI_Evento-Alzheimer-AR_20.07.2026.pdf) estima que em 2025 viviam com demência 238 401 pessoas, 2,29% da população, acima da média europeia (1,77%). A projeção para 2050 é de quase 368 mil. ## Os tipos de demência mais comuns, lado a lado | Tipo | Frequência | Primeiros sinais típicos | Como costuma evoluir | |---|---|---|---| | **Doença de Alzheimer** | A mais comum: 60 a 70% dos casos (OMS) | Esquecer acontecimentos recentes, repetir perguntas, perder objetos | Gradual e contínua, ao longo de anos | | **Demência vascular** | A segunda mais frequente | Lentidão a pensar, dificuldade em planear e decidir, alterações da marcha | Muitas vezes em degraus: períodos estáveis e agravamentos súbitos | | **Demência por corpos de Lewy** | Menos frequente; pode ser confundida com Alzheimer ou Parkinson | Alucinações visuais, flutuações do estado de alerta, rigidez e tremor | Flutuante: dias, ou horas, muito diferentes | | **Demência frontotemporal** | Menos comum, mas uma causa importante antes dos 65 anos | Mudanças de comportamento e de personalidade, ou dificuldade na linguagem | Começa mais cedo; a memória pode manter-se no início | | **Demência mista** | Comum em idades avançadas | Combinação dos sinais acima, sobretudo Alzheimer com vascular | Depende das doenças combinadas | ## Doença de Alzheimer É a causa mais frequente de demência. Resulta da acumulação de proteínas anormais no cérebro (placas de beta-amiloide e tranças de proteína tau), que danificam e destroem progressivamente as células nervosas, começando muitas vezes pelo hipocampo, a zona ligada à formação de memórias novas. **Primeiros sinais.** A memória de acontecimentos recentes falha antes da memória antiga: a pessoa repete a mesma pergunta, esquece uma conversa da véspera, mas lembra-se com detalhe da aldeia onde cresceu. Seguem-se dificuldades em encontrar palavras, em orientar-se em sítios conhecidos e em gerir tarefas como o dinheiro ou a medicação. **Evolução.** Lenta e contínua, normalmente ao longo de vários anos, com fases ligeira, moderada e avançada. ## Demência vascular É causada pela redução do fluxo de sangue no cérebro: um AVC, vários pequenos enfartes, ou doença dos pequenos vasos ao longo do tempo. Nem toda a pessoa que tem um AVC desenvolve demência. Os fatores de risco são, em grande parte, os do coração: tensão arterial alta, diabetes, colesterol, tabaco. **Primeiros sinais.** Mais do que a memória, falha a velocidade e a organização do pensamento: dificuldade em planear, em seguir uma sequência de passos, em concentrar-se e em tomar decisões, por vezes com períodos curtos de confusão súbita. São frequentes alterações da marcha, quedas e alterações de humor. **Evolução.** Muitas vezes em degraus: períodos de estabilidade interrompidos por agravamentos súbitos, que podem coincidir com novas lesões. A variação dentro do mesmo dia também pode ser grande. ## Demência por corpos de Lewy Deve o nome a depósitos anormais de uma proteína (alfa-sinucleína) dentro das células nervosas, os corpos de Lewy. É próxima da doença de Parkinson e partilha com ela vários sinais, incluindo a dificuldade de movimento e um risco maior de quedas. **Primeiros sinais.** Alucinações visuais muito nítidas (pessoas, animais), frequentemente desde cedo; flutuações marcadas da atenção e do estado de alerta; sinais motores parecidos com os de Parkinson; e perturbações do sono em que a pessoa «vive» os sonhos, falando ou mexendo-se. **Evolução.** Flutuante: a mesma pessoa pode estar lúcida de manhã e muito confusa à tarde. É também uma demência com sensibilidade particular a alguns medicamentos antipsicóticos, o que torna o diagnóstico correto especialmente importante. ## Demência frontotemporal Afeta sobretudo os lobos frontais e temporais, as zonas ligadas ao comportamento, à personalidade e à linguagem. Costuma começar mais cedo do que as outras, sendo diagnosticada com mais frequência entre os 45 e os 65 anos, e é por isso uma causa importante de demência em pessoas mais novas. É também a que mais vezes tem uma componente familiar. **Primeiros sinais.** Depende da forma: - na **variante comportamental**, mudanças de personalidade, desinibição, perda de empatia, apatia, comportamentos repetitivos ou alterações alimentares; - nas **variantes de linguagem** (afasias progressivas primárias), dificuldade em encontrar palavras, em compreender o significado das palavras ou em construir frases. A memória pode manter-se relativamente preservada no início, o que atrasa muitas vezes o diagnóstico: os sinais são confundidos com depressão, stress ou «feitio». ## Demência mista Em idades avançadas é comum haver mais do que uma causa ao mesmo tempo. A combinação mais frequente é a doença de Alzheimer com demência vascular, mas há outras, como Alzheimer com corpos de Lewy. Os sinais misturam-se, e pode ser difícil saber quanto pesa cada causa. ## Outros tipos menos frequentes - **Demência na doença de Parkinson:** quando os sintomas motores aparecem primeiro e a demência surge anos depois. Segundo a [Alzheimer's Society](https://www.alzheimers.org.uk/about-dementia/types-dementia), cerca de um terço das pessoas com Parkinson acaba por desenvolver demência. - **Demência associada ao álcool** (lesão cerebral relacionada com o álcool, incluindo a síndrome de Korsakoff, por défice de vitamina B1). Ao contrário da maioria das demências, nem sempre se agrava com o tempo. - **Doença de Huntington:** hereditária, com movimentos involuntários e alterações do comportamento. - **Doença de Creutzfeldt-Jakob:** muito rara e de evolução muito rápida. - **Traumatismos cranianos repetidos** e algumas **infeções**, como o VIH. ## Quando parece demência e não é Há situações que provocam sinais semelhantes e que podem ser tratadas. É uma das razões pelas quais uma avaliação médica é essencial: - **Delirium:** confusão súbita, muitas vezes por infeção (urinária, respiratória), desidratação ou medicação. Aparece em horas ou dias, não em meses. - **Depressão** nas pessoas mais velhas, que pode imitar perda de memória. - **Défice de vitamina B12** e **alterações da tiroide**. - **Efeitos de medicamentos**, sobretudo quando se juntam vários. - **Hidrocefalia de pressão normal:** alterações da marcha, incontinência e lentidão de pensamento. E há o **défice cognitivo ligeiro**, que [não é uma demência](https://www.nhs.uk/conditions/dementia/about-dementia/causes/): dificuldades de memória ou de pensamento maiores do que o esperado para a idade, mas que ainda não comprometem a autonomia no dia a dia. Nem sempre evolui para demência, e por vezes tem uma causa tratável. Escrevemos sobre isso em [Défice cognitivo ligeiro: primeiro usável, depois útil](/blog/defice-cognitivo-ligeiro-primeiro-usavel-depois-util/). Se há esquecimentos que se repetem, pioram e começam a interferir com a vida diária, o passo certo é falar com o médico de família. ## O que muda numa sessão de realidade virtual Nos materiais comerciais deste setor, «demência» aparece quase sempre no singular. Quem trabalha numa sala sabe que não é assim: o que resulta com uma pessoa pode ser indiferente para outra e desconfortável para uma terceira, e o diagnóstico explica parte disso. Não somos nós a decidir nada disto: a decisão é sempre da equipa clínica, que conhece a pessoa. O que se segue é o que costuma mudar na prática, para que a conversa com quem propõe tecnologia seja mais informada. ## Numa sessão: doença de Alzheimer É a mais comum e é aquela sobre a qual existe mais literatura em atividades não farmacológicas. A memória de acontecimentos recentes deteriora-se antes da memória antiga, o que torna a [reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/) o território mais natural: lugares da infância, a terra, o mar de sempre. Na prática: **conteúdo antigo e familiar antes de conteúdo novo.** Uma paisagem genérica bonita costuma render menos do que um sítio com história pessoal, e a biografia vale mais do que qualquer catálogo. Já escrevemos em detalhe sobre [Alzheimer](/blog/realidade-virtual-demencia-alzheimer/). ## Numa sessão: demência vascular Tem duas características que mudam o planeamento. A evolução é frequentemente em degraus, e não em declive contínuo: há períodos estáveis e quedas abruptas. E a variabilidade dentro do mesmo dia pode ser grande. Na prática: o que correu bem na semana passada pode não correr esta semana, e isso não é falha de ninguém. Vale a pena registar a sessão em vez de confiar na memória do turno, para que a equipa veja o padrão em vez de o adivinhar. Há frequentemente compromisso motor associado, o que torna a posição (sentado estável, ou o [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/)) mais importante do que noutros casos. ## Numa sessão: demência frontotemporal É a que menos se parece com o estereótipo. Costuma começar mais cedo, por vezes antes dos 65 anos, e o que se altera primeiro é o comportamento, a linguagem ou o julgamento social, e não necessariamente a memória. Na prática: a pessoa pode compreender perfeitamente e ainda assim recusar de forma abrupta, ou perder o interesse a meio sem aviso. Não se negoceia. É também a população onde é mais fácil enganarmo-nos a interpretar sinais: uma reação plana não quer dizer que não esteja a acontecer nada, e uma reação intensa não quer dizer desconforto. E como muitas destas pessoas são mais novas, o conteúdo de reminiscência «para idosos» é desadequado: a biografia é de outra geração. ## Numa sessão: corpos de Lewy, e aqui a prudência é maior Esta merece um parágrafo próprio, porque tem características que interagem diretamente com o que uma experiência imersiva faz. As **alucinações visuais** são frequentes e fazem parte do quadro, muitas vezes desde cedo. Há também perturbações da perceção visual e do processamento visuoespacial, flutuações marcadas do estado de alerta ao longo do dia, e frequentemente sinais motores de tipo parkinsónico. Pôr um ecrã imersivo diante de alguém cuja perceção visual está alterada não é uma decisão neutra. Não temos evidência de dano, e também não temos evidência de segurança nesta população: o que existe é razão para prudência acrescida e para a decisão ser tomada por quem conhece o caso, com observação atenta e sessões curtas, se é que se faz. A sensibilidade a fármacos neurolépticos que caracteriza esta demência não tem relação com isto, mas é um lembrete de que é um quadro onde as reações fogem ao esperado. Se há uma frase para levar deste artigo, é esta: um fornecedor que lhe apresente realidade virtual como boa para «demência» sem distinguir corpos de Lewy não estudou o assunto. ## O que é comum a todas - **A pessoa, não o diagnóstico**, decide o conteúdo. O diagnóstico ajuda a antecipar; a biografia é que escolhe (a [ficha de história de vida](/ferramentas/historia-de-vida/) ajuda a recolhê-la). - **Sessões curtas**, mais curtas do que noutros contextos. - **Alguém conhecido ao lado**, a falar. A voz faz parte da sessão. - **Parar ao primeiro sinal**, e a [recusa não se negoceia](/blog/quando-o-utente-recusa-realidade-virtual/). - **Registar o que se observou** com as palavras do que se viu, não com conclusões. ## O que o RVer não faz Convém ser explícito: **não avalia, não classifica e não diagnostica.** Não distingue tipos de demência, não sugere conteúdo com base em diagnóstico, e não mede resposta. A funcionalidade assistida por IA ajuda a encontrar um cenário a partir do tipo de momento que a equipa descreve, e a escolha é sempre da equipa. O RVer é um dispositivo médico de Classe I (registado no INFARMED, CDM 94571546, e na EUDAMED, Basic UDI-DI 56006195127RVERTZ), usado como complemento não farmacológico e sempre sob supervisão da equipa. Não trata nem substitui os cuidados médicos de nenhum tipo de demência. O que aqui se descreve diz respeito ao produto base; os módulos em desenvolvimento não estão abrangidos. E a literatura, que reunimos na [biblioteca](/estudos/tema/qualidade-de-vida/), é sobretudo de **bem-estar e reminiscência em demência ligeira a moderada**. Para estádios avançados, e para corpos de Lewy em particular, é escassa. ## Em resumo - **«Demência» é um conjunto de sinais com várias causas**, e a causa muda o que se espera. No singular, é uma simplificação comercial. - **Alzheimer:** a mais comum (60 a 70% dos casos); começa pela memória recente. Numa sessão: reminiscência, conteúdo antigo e familiar. - **Vascular:** pensamento lento e planeamento difícil; evolução em degraus. Numa sessão: registar em vez de confiar na memória. - **Frontotemporal:** comportamento ou linguagem primeiro; começa mais cedo. Numa sessão: recusa abrupta, biografia de outra geração. - **Corpos de Lewy:** alucinações visuais e flutuações. Numa sessão: prudência maior, e sem evidência de segurança nesta população. - **Mista:** frequente em idades avançadas, sobretudo Alzheimer com vascular. - **O défice cognitivo ligeiro não é demência**, e há situações tratáveis que a imitam. O diagnóstico é sempre médico. ## Fontes - Organização Mundial da Saúde, [*Dementia*](https://www.who.int/news-room/fact-sheets/detail/dementia), ficha informativa. - Alzheimer Portugal, [comunicado de 20/07/2026](https://alzheimerportugal.org/wp-content/uploads/2026/07/CI_Evento-Alzheimer-AR_20.07.2026.pdf) (prevalência em Portugal, 2025 e 2050). - NHS, [*Causes of dementia*](https://www.nhs.uk/conditions/dementia/about-dementia/causes/). - Alzheimer's Society, [*Types of dementia*](https://www.alzheimers.org.uk/about-dementia/types-dementia). Q: Quais são os principais tipos de demência? A: Os mais frequentes são a doença de Alzheimer (60 a 70% dos casos, segundo a OMS), a demência vascular, a demência por corpos de Lewy e a demência frontotemporal. É comum, em idades avançadas, haver mais do que uma causa ao mesmo tempo (demência mista). Há outras menos frequentes, como a demência na doença de Parkinson ou a associada ao álcool. Q: Qual é a diferença entre demência e Alzheimer? A: Demência é o nome do conjunto de sinais (perda de memória, de linguagem, de orientação, de autonomia); a doença de Alzheimer é a causa mais frequente desses sinais. A doença de Alzheimer é um tipo de demência, mas nem toda a demência é Alzheimer. Q: O défice cognitivo ligeiro é uma demência? A: Não. São dificuldades de memória ou de pensamento maiores do que o esperado para a idade, mas que ainda não comprometem a autonomia no dia a dia. Nem sempre evolui para demência e por vezes tem uma causa tratável. Quem nota esquecimentos que se repetem e pioram deve falar com o médico de família. Q: A demência é hereditária? A: Na maioria dos casos, não de forma direta. Há formas raras com uma causa genética clara, sobretudo de Alzheimer de início precoce, de demência frontotemporal (a que mais vezes tem componente familiar) e a doença de Huntington. Ter um familiar com demência não a torna inevitável. Q: A realidade virtual pode ser usada em qualquer tipo de demência? A: A decisão é sempre clínica e caso a caso. O que muda entre tipos é relevante: no Alzheimer a reminiscência é o território mais natural; na demência vascular há grande variabilidade entre dias; na frontotemporal a recusa pode ser abrupta e a pessoa é frequentemente mais nova. Na demência por corpos de Lewy, em que as alucinações visuais e as alterações da perceção visual são frequentes, justifica-se prudência acrescida. ### Botão de pânico, sensores, visores: que tecnologia serve para que problema URL: https://rver.pt/blog/que-tecnologia-para-que-problema-idosos/ Date: 21 August 2026 Cinco categorias de produto, vendidas nas mesmas feiras, aos mesmos compradores, com os mesmos folhetos. Resolvem problemas completamente diferentes, e comprar pela ordem errada é o desperdício mais comum do setor. Uma direção técnica de um lar, ou uma família a organizar o apoio a alguém em casa, recebe propostas de coisas muito diferentes com uma embalagem parecida: botão de pânico, sensores, câmaras, tablets, aplicações, visores. Todas dizem melhorar a vida de pessoas mais velhas. O problema é que **resolvem problemas diferentes**, e a pergunta útil não é «qual é o melhor»: é **qual é o meu problema**. ## Os cinco problemas **1. Segurança.** Alguém cai, sai de casa à noite, deixa o fogão ligado. **2. Autonomia.** Alguém precisa de ajuda para se lembrar, orientar-se, gerir o dia. **3. Comunicação.** Alguém está longe da família. **4. Ocupação.** As catorze horas acordado de cada dia. **5. Momento clínico.** Um procedimento, uma sessão, um momento difícil concreto. Quase todos os erros de compra que vemos são um produto de uma linha a ser comprado para o problema de outra. ## O mapa | Problema | O que resolve | O que não resolve | |---|---|---| | Segurança | Teleassistência com botão, sensores de queda, sensores de porta e de fogão | Não ocupa o dia nem melhora a experiência de nada | | Autonomia | Dispensadores de medicação, lembretes, relógios com localização | Não substitui presença nem vigilância | | Comunicação | Videochamada simplificada, tablets com interface reduzida, moldura digital | Não é companhia; ver [solidão e isolamento](/blog/solidao-isolamento-social-idosos-tecnologia/) | | Ocupação | Atividades, tablets com jogos, música, e sim, realidade virtual | Nenhum ocupa sem ninguém por perto, se for supervisionado | | Momento clínico | Realidade virtual para uso clínico, sob supervisão | Não substitui equipa, nem serve para vigiar | Repare numa coisa: **o botão de pânico e o visor não competem.** Estão em linhas diferentes da tabela. Comprar um em vez do outro é como escolher entre um extintor e uma cadeira. ## A ordem que faz sentido Se o orçamento é limitado, e é sempre, há uma ordem defensável: **Primeiro, segurança.** É a única categoria onde a falha tem consequência irreversível. Uma queda sem ninguém a saber durante horas é de outra ordem de gravidade do que uma tarde aborrecida. É também a categoria mais barata. **Depois, comunicação.** Custa pouco, resolve um problema real e imediato, e é o que as famílias mais agradecem. **Depois, ocupação.** É onde vive a maior parte da qualidade de vida do dia a dia, e é a categoria mais negligenciada: precisamente porque a sua falha não dá incidente nenhum para reportar. **Por fim, o momento clínico.** Faz sentido quando há equipa, quando há um caso concreto, e depois de as três anteriores estarem resolvidas. **Nós estamos na quarta linha**, e às vezes na terceira. Se alguém tem um problema de segurança por resolver, comprar um sistema clínico primeiro é a escolha errada, e dizemo-lo. ## Cinco perguntas para separar o trigo do joio Valem para qualquer fornecedor destas cinco categorias, incluindo nós: 1. **Qual das cinco linhas é a vossa?** Se a resposta for «todas», não é nenhuma. 2. **Funciona sem alguém presente?** Muda tudo. Um sensor funciona; uma sessão supervisionada não. 3. **Precisa de internet? E se ela falhar?** 4. **Quem instala, quem forma, e quem atende o telefone quando avaria?** 5. **O que acontece aos dados, e quem é o responsável pelo tratamento?** É uma pergunta de [RGPD](/blog/privacidade-rgpd-realidade-virtual-saude/), e as câmaras e sensores levantam-na de forma mais aguda do que um visor que não recolhe dados clínicos. ## O caso especial das câmaras Fica de fora da tabela de propósito, porque merece uma nota: a videovigilância em quartos resolve um problema de segurança à custa de um problema de dignidade e de proteção de dados. É uma decisão que exige enquadramento próprio e consentimento, e não é comparável com as outras linhas. Se lhe venderem uma câmara como «monitorização de bem-estar», está a comprar vigilância com outro nome. ## Em resumo - **Cinco problemas, não um.** A pergunta é qual é o seu, não qual é o melhor produto. - **Segurança primeiro**, porque é a única cuja falha é irreversível, e é a mais barata. - **Ocupação é a mais negligenciada**, porque a sua falha não gera incidente. - **O botão de pânico e o visor não competem.** - **Se a segurança não está resolvida, não compre o nosso primeiro.** Q: O que comprar primeiro para apoiar uma pessoa idosa? A: Segurança, porque é a única categoria cuja falha tem consequência irreversível e é também a mais barata: teleassistência com botão, sensores de queda, de porta e de fogão. Depois comunicação, depois ocupação do dia, e por fim soluções para momentos clínicos concretos, que fazem sentido quando já existe equipa e um caso definido. Q: Um botão de pânico e um sistema de realidade virtual são alternativas? A: Não, resolvem problemas diferentes. O botão de pânico responde a segurança: alguém cai ou precisa de ajuda imediata. Um sistema de realidade virtual para uso clínico responde a ocupação do dia e a momentos clínicos concretos, sob supervisão. Escolher entre os dois é como escolher entre um extintor e uma cadeira. Q: E as câmaras nos quartos? A: Resolvem um problema de segurança à custa de um problema de dignidade e de proteção de dados, e exigem enquadramento próprio e consentimento. Não são comparáveis com as outras categorias. Se forem apresentadas como monitorização de bem-estar, trata-se de vigilância com outro nome. ### Meditação guiada ou realidade virtual: quando é que uma app chega URL: https://rver.pt/blog/meditacao-guiada-ou-realidade-virtual-qual-usar/ Date: 21 August 2026 É a pergunta que uma direção sensata faz, e que quase nenhum fornecedor responde com honestidade: se o objetivo é acalmar alguém, porque não uma app de cinco euros por mês? Se o objetivo é ajudar alguém a acalmar, há uma opção que custa poucos euros por mês, cabe num telemóvel que já existe e não precisa de autorização de ninguém: uma **app de meditação guiada**. É uma pergunta legítima, e responder-lhe com «mas o nosso é imersivo» não é resposta. Vale a pena separar o que as duas coisas realmente fazem. ## Não fazem o mesmo **Meditação guiada** é uma prática **ativa**. Pede atenção dirigida, seguir uma instrução, voltar à respiração quando a cabeça foge. O trabalho é da pessoa; a voz é um andaime. Tem um corpo de evidência considerável, sobretudo em adultos com capacidade de seguir instrução verbal. **Um ambiente imersivo** é sobretudo **passivo**. Não pede tarefa nenhuma: a pessoa está noutro sítio, e o mecanismo proposto é a ocupação da atenção pelo ambiente, não o treino dela. É por isso que a literatura mais consistente em saúde é de **distração** durante procedimentos, não de treino de atenção. Esta diferença é a que decide quase todos os casos. ## Onde a meditação guiada ganha, e ganha claramente - **Custo.** Poucos euros por mês contra um sistema. Não há discussão. - **Autonomia.** A pessoa faz sozinha, em casa, quando quiser. Um dispositivo médico com [supervisão obrigatória](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/) não compete nisto e não deve fingir que compete. - **Evidência em adultos.** É uma base mais antiga e mais sólida. - **Nada para instalar, limpar ou carregar.** Sem [rotina de higiene](/blog/higiene-seguranca-equipamento-realidade-virtual/), sem bateria, sem armário. - **Zero risco de enjoo.** ## Onde não chega - **Quando a pessoa não consegue seguir instrução verbal.** É o caso central. Em demência moderada a avançada, em confusão aguda, em delírio, «repare na sua respiração» não é uma instrução acessível. A app assume uma competência que ali já não está. - **Quando o problema é o momento, não o estado.** Durante uma punção, um penso ou uma sessão de diálise, o objetivo não é treinar atenção: é ocupá-la, já e sem esforço da pessoa. - **Quando não há sítio.** Numa enfermaria com seis camas, televisão e carrinhos, a app compete com o ambiente. O ambiente ganha. - **Quando a memória é que interessa.** Uma app não leva ninguém à terra onde nasceu; a [reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/) precisa de imagem concreta e pessoal. ## As quatro situações em que a resposta é a app Dizemos isto enquanto fabricante do outro produto, e é a sério: 1. **Adultos autónomos com ansiedade ligeira**, que conseguem praticar sozinhos. 2. **Profissionais de saúde**, para si próprios. Se o problema é o [desgaste da equipa](/blog/realidade-virtual-burnout-profissionais-saude/), uma app que cada um usa quando quer é mais praticável do que agendar equipamento partilhado. 3. **Quando não há orçamento e há que começar por algum lado.** Começar pequeno é melhor do que não começar. 4. **Quando não há ninguém para conduzir sessões.** Sem pessoa que conduza, um sistema supervisionado não funciona, e nós dizemos isso antes de vender. ## E há uma resposta que não é nenhuma das duas Vale a pena dizer, porque se esquece: para muita gente, o que resulta é uma pessoa sentada ao lado a conversar, música conhecida, ou sair para o jardim. Não tem fornecedor, não tem licença e não aparece em apresentação nenhuma. Se resulta, é a resposta certa. ## Como decidir, em três perguntas 1. **A pessoa consegue seguir uma instrução verbal e mantê-la alguns minutos?** Se sim, comece pela app. 2. **O objetivo é um momento concreto e difícil, ou um estado geral?** Momento aponta para o imersivo; estado aponta para prática regular. 3. **Existe alguém para conduzir e um sítio para o equipamento?** Se não, a pergunta anterior é académica. ## Em resumo - **Não fazem o mesmo:** uma treina atenção, a outra ocupa-a. - **A app ganha em custo, autonomia e simplicidade**, e não vale a pena fingir o contrário. - **Não chega quando falta a capacidade de seguir instrução**, que é o caso mais frequente nos contextos onde trabalhamos. - **Em quatro situações concretas, a app é a escolha certa.** - **Às vezes a resposta não é tecnologia nenhuma.** Q: Uma app de meditação guiada substitui a realidade virtual? A: Em vários casos sim, e é a escolha certa: adultos autónomos com ansiedade ligeira, profissionais de saúde para uso próprio, situações sem orçamento e situações onde não há quem conduza sessões. As duas coisas não fazem o mesmo: a meditação guiada é uma prática ativa que pede atenção dirigida, enquanto um ambiente imersivo é sobretudo passivo e ocupa a atenção sem pedir tarefa. Q: Quando é que a meditação guiada não chega? A: Sobretudo quando a pessoa não consegue seguir instrução verbal, o que acontece em demência moderada a avançada, em confusão aguda ou em delírio. Também quando o objetivo é um momento concreto e difícil, como uma punção ou um penso, em que se pretende ocupar a atenção sem esforço da pessoa, e quando o conteúdo pessoal e concreto da reminiscência é o que interessa. Q: Qual das duas tem mais evidência? A: A meditação guiada tem um corpo de evidência mais antigo e mais sólido em adultos com capacidade de seguir instrução verbal. A literatura mais consistente em realidade virtual em saúde é de distração durante procedimentos, e não de treino de atenção. São bases diferentes para objetivos diferentes. ### Escolher um lar: as perguntas sobre atividades que quase ninguém faz URL: https://rver.pt/blog/escolher-um-lar-perguntas-sobre-atividades/ Date: 21 August 2026 Uma visita a um lar dura uma hora e decide anos. Quase toda essa hora é gasta a ver instalações, que são a parte mais fácil de melhorar e a que menos diz sobre como se vive lá dentro. Este artigo é sobre uma hora difícil: a visita a um lar, com um familiar em casa à espera de uma decisão. Escrevemo-lo para famílias, mas serve também a quem dirige uma instituição: porque estas são as perguntas que vão começar a ouvir, e vale a pena ter resposta. Uma nota de honestidade à partida: somos fabricantes de um sistema usado em lares. Nenhuma das perguntas abaixo é sobre o nosso produto, e a maior parte das boas instituições responde-lhes bem sem terem tecnologia nenhuma. ## O que quase toda a gente pergunta Quarto individual ou duplo, ementa, preço, distância, se há médico. São perguntas necessárias e insuficientes: são todas sobre **instalações e contrato**, que é a parte visível e a mais fácil de arranjar para uma visita. O que decide a vida de alguém lá dentro é outra coisa: **o que acontece entre as refeições.** Um dia tem catorze horas acordado. ## As doze perguntas **Sobre o dia** 1. **O que é que a maioria das pessoas está a fazer agora?** Faça a pergunta a olhar para a sala. A resposta melhor é a que corresponde ao que está a ver. 2. **Quantas horas por dia a televisão está ligada na sala comum?** Não é para condenar a televisão. É para perceber se é o programa ou o ambiente. 3. **O que acontece entre as 15h e as 18h?** É a janela onde a agitação aparece com mais frequência em pessoas com demência, e onde a diferença entre instituições é maior. Já escrevemos sobre a [agitação ao entardecer](/blog/agitacao-fim-da-tarde-demencia-sundowning/). 4. **Quem não sai do quarto, e porquê?** Toda a instituição tem essas pessoas. A resposta boa nomeia-as e explica; a resposta má é que não há. **Sobre as atividades** 5. **Quem planeia as atividades, e com que formação?** 6. **O que é que fazem com quem não participa?** É a pergunta mais reveladora da lista. Um plano só para quem já participa é meio plano. 7. **Há atividades individuais, ou só de grupo?** Quem tem demência avançada, défice auditivo ou simplesmente não gosta de grupos fica de fora dos programas que só têm grupo. 8. **Fica registado o que cada pessoa fez?** Ou o registo é só de medicação e incidentes? Sem registo, ninguém consegue dizer daqui a três meses se algo mudou. **Sobre a família e a pessoa** 9. **Como é que sabem o que esta pessoa gostava?** Há uma conversa de história de vida, ou preenche-se uma ficha de admissão? A biografia é a única coisa que torna uma atividade pessoal. 10. **Quais são os horários de visita, e o que acontece fora deles?** 11. **Como é que a família em Inglaterra fala com ela?** Metade das famílias portuguesas tem alguém emigrado. Se a resposta for «temos o telefone da sala», é uma resposta. 12. **Quem me liga se algo mudar, e ao fim de quanto tempo?** ## Sinais que devem preocupar - **«Temos atividades todos os dias» sem conseguir descrever a de ontem.** - **Um plano de atividades afixado e desatualizado.** Diz mais do que um plano inexistente. - **Toda a gente sentada em fila voltada para o mesmo sítio**, a qualquer hora. - **Nenhuma resposta sobre quem não participa.** - **Tecnologia exibida na visita e sem uso combinado.** Vale para o nosso equipamento tanto como para qualquer outro: se estiver numa prateleira a impressionar visitas, não está a ser usado. ## Sobre a tecnologia, com franqueza Se lhe mostrarem equipamento, de realidade virtual ou outro, faça três perguntas simples: **quantas sessões fizeram no último mês, quem as conduz, e onde é que isso fica registado.** Se não houver resposta a estas três, o equipamento é decoração. E o contrário também é verdade: **um lar sem tecnologia nenhuma pode ser excelente.** O que distingue não é o equipamento, é haver alguém que sabe o nome da pessoa, o que ela gostava, e o que fez ontem. ## Em resumo - **A hora da visita gasta-se quase toda no que menos importa.** - **A pergunta que mais revela é o que fazem com quem não participa.** - **Sem registo do que cada pessoa faz, ninguém consegue provar nada**, nem para bem nem para mal. - **Equipamento sem sessões contadas é decoração.** - **Um bom lar sem tecnologia é melhor do que um mau lar com ela.** Q: Que perguntas fazer quando se visita um lar de idosos? A: Além do quarto, da ementa e do preço, vale a pena perguntar o que a maioria das pessoas está a fazer naquele momento, o que acontece entre as 15h e as 18h, quem não sai do quarto e porquê, o que fazem com quem não participa nas atividades, se há atividades individuais além das de grupo, e se fica registado o que cada pessoa fez. Q: Qual é o sinal de alerta mais claro numa visita? A: Não haver resposta sobre quem não participa. Um plano de atividades que só serve quem já participa é meio plano, e as pessoas que ficam no quarto são exatamente aquelas cujo dia depende mais da instituição. Um plano afixado e desatualizado também diz mais do que a ausência de plano. Q: Um lar com tecnologia é melhor do que um sem? A: Não necessariamente, e dizemo-lo enquanto fabricantes. Se lhe mostrarem equipamento, pergunte quantas sessões foram feitas no último mês, quem as conduz e onde fica registado. Sem resposta às três, o equipamento é decoração. Um bom lar sem tecnologia nenhuma é melhor do que um mau lar com ela. ### Realidade virtual nas urgências: a pergunta que fazem e a resposta que damos URL: https://rver.pt/blog/realidade-virtual-nas-urgencias-o-que-respondemos/ Date: 21 August 2026 É a sugestão que aparece em todas as conversas sobre espera hospitalar, e é sedutora: se as pessoas estão ali há seis horas, porque não dar-lhes um sítio melhor para estar? A resposta curta é que a sala de espera é o pior sítio possível. Os tempos de espera nas urgências são das coisas mais procuradas em saúde em Portugal, e a sugestão aparece sempre: se há gente à espera durante horas, porque não ocupar esse tempo com alguma coisa melhor? Recebemos a pergunta com frequência. A resposta honesta tem duas partes, e a primeira é desagradável. ## A sala de espera é o pior sítio Não é uma questão de vontade. Falham cinco coisas ao mesmo tempo: **1. Não há quem supervisione.** É o obstáculo que vem antes de todos. A finalidade prevista do sistema exige [utilização acompanhada](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/), e numa sala de espera não há ninguém disponível para acompanhar. Sem isso, não é uma sessão: é um aparelho emprestado. **2. O doente tem de ver e ouvir o que se passa.** Está à espera de ser chamado. Um equipamento que tapa a visão e o som é exatamente o oposto do que aquele momento exige, e a primeira chamada perdida acaba com a experiência para toda a gente. **3. O estado clínico não está definido.** Numa sala de espera há pessoas com náusea, tonturas, traumatismo craniano por avaliar, intoxicação. É a população onde menos se sabe quem pode usar, e a triagem não foi feita para responder a essa pergunta. **4. Higiene e rotatividade.** Um equipamento partilhado entre desconhecidos, com [rotina de limpeza](/blog/higiene-seguranca-equipamento-realidade-virtual/) entre cada um, numa sala com dezenas de pessoas por hora. A conta não fecha. **5. Não resolve o problema.** E é o mais importante: **o tempo de espera continua igual.** A espera nas urgências é um problema de capacidade, fluxo e recursos humanos. Nenhum equipamento lhe toca. Quem lhe vender realidade virtual como resposta a tempos de espera está a vender-lhe outra coisa com o nome errado. ## Onde a resposta é sim Dentro do mesmo serviço, há momentos com todas as condições que faltam à sala de espera: há profissional presente, o doente já foi visto, e o objetivo é concreto. **1. Procedimentos dolorosos ou assustadores.** Sutura, colocação de cateter, punção, remoção de corpo estranho, penso de queimadura. É aqui que está a literatura mais consistente em saúde: **distração durante o procedimento**, sobretudo em crianças. Já escrevemos sobre [medo de agulhas](/blog/realidade-virtual-medo-de-agulhas-procedimentos/) e sobre [pediatria](/blog/realidade-virtual-pediatria-criancas/). **2. Espera em maca já dentro do serviço**, com o doente atribuído a uma equipa. Aqui há supervisão e há continuidade. É diferente da sala de espera geral, ainda que a palavra «espera» seja a mesma. **3. Doente em observação prolongada.** Quando alguém fica algumas horas em observação, com equipa atribuída, aplica-se o mesmo raciocínio do internamento. ## O que perguntar antes de avançar Se dirige uma urgência e quer testar, três perguntas resolvem a maior parte da conversa: 1. **Quem conduz a sessão, em cada turno?** Se a resposta for «quem puder», não há projeto. É o [primeiro dos seis sins](/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/). 2. **Em que momento exato, e para que doentes?** «Nas urgências» não é um caso de uso. «Durante a sutura, em crianças dos 4 aos 12» é. 3. **Onde fica o equipamento, e quem o limpa entre doentes?** Numa urgência isto pesa mais do que em qualquer outro serviço. ## Uma nota sobre o que se mede Se fizer um piloto, **não meça tempo de espera.** Vai variar por razões que não têm nada a ver consigo, e a atribuição é impossível. Meça o que está perto do procedimento: quantas vezes foi preciso repetir, se houve necessidade de contenção ou sedação, e o que a equipa observou. Desenvolvemos isso em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## Em resumo - **Na sala de espera, não.** Faltam supervisão, atenção ao ambiente, triagem adequada e higiene, e nada disso é contornável. - **O tempo de espera não muda.** É capacidade e fluxo, não tecnologia. - **Durante procedimentos, sim**, e é onde a evidência é mais consistente, sobretudo em crianças. - **«Nas urgências» não é um caso de uso.** O momento exato é que é. Q: A realidade virtual reduz o tempo de espera nas urgências? A: Não. O tempo de espera é um problema de capacidade, fluxo e recursos humanos, e nenhum equipamento lhe toca. Quem apresentar realidade virtual como resposta a tempos de espera está a descrever outra coisa com o nome errado. Q: Porque é que a sala de espera não é boa para uma sessão? A: Falham cinco condições ao mesmo tempo: não há quem supervisione e a finalidade prevista exige acompanhamento; o doente precisa de ver e ouvir para ser chamado; o estado clínico ainda não está definido, com náusea, tonturas ou traumatismo por avaliar; a rotina de higiene entre desconhecidos é incomportável ao ritmo de uma urgência; e o tempo de espera continua igual. Q: Onde é que faz sentido dentro de um serviço de urgência? A: Em três momentos com profissional presente e objetivo concreto: durante procedimentos dolorosos ou assustadores como sutura, punção ou penso de queimadura, sobretudo em crianças, que é onde a literatura é mais consistente; na espera em maca já dentro do serviço com equipa atribuída; e em doentes em observação prolongada. ### Quando o utente recusa, ou a primeira sessão corre mal URL: https://rver.pt/blog/quando-o-utente-recusa-realidade-virtual/ Date: 20 August 2026 Quase todo o material sobre esta tecnologia descreve sessões que correm bem. Vale mais falar das outras: porque são elas que decidem se a equipa continua a propor ou desiste em silêncio. Há um número que ninguém publica: a proporção de vezes em que se propõe uma sessão e a pessoa diz que não. Na prática das equipas com quem trabalhamos, não é raro. E o que acontece a seguir importa mais do que a recusa em si. O reflexo mais comum é tratá-la como um obstáculo: insistir, convencer, «mostrar só um bocadinho». É o pior caminho disponível, por uma razão prática antes de ser ética: **uma pessoa convencida a fazer uma sessão que não queria recusa todas as próximas**, e leva o resto da enfermaria com ela. ## Sete razões, e o que muda em cada uma Vale a pena separar, porque só três se resolvem mudando alguma coisa. **1. Não percebeu o que é.** A mais frequente, e a mais fácil. «Headset de realidade virtual» não quer dizer nada a quem nunca viu um. Mostrar o equipamento, deixar tocar-lhe, explicar que se tira a qualquer momento. Muitas vezes o não vira sim aqui, e não por insistência, mas por informação. **2. Tem medo de ficar às escuras ou preso.** Legítimo e comum, sobretudo em pessoas mais velhas. Responde-se com factos: a pessoa mantém-se onde está, alguém fica ao lado, tira-se com uma mão. **3. Não é boa altura.** Dor, náusea, uma visita à espera, acabou de ser mudado de posição. Isto não é recusa da tecnologia: é uma recusa **de agora**, e propor noutro momento é o correto. **4. Não gosta do que lhe propuseram.** Um cenário de praia a quem tem má memória do mar. Aqui muda-se o cenário, não a conversa. **5. Não gosta da coisa.** Algumas pessoas simplesmente não querem um aparelho na cara, e isso não precisa de justificação. É uma preferência, e é para respeitar como qualquer outra. **6. Está a exercer controlo.** Numa vida em que quase tudo é decidido por outros, dizer não a uma coisa opcional pode ser a única escolha disponível naquele dia. Insistir retira exatamente aquilo que ali estava a ser exercido. **7. Há uma razão clínica.** Deve ter sido detetada antes, e há [situações em que não é a proposta certa](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). ## As três que se resolvem Só as razões 1, 2 e 4 se resolvem mudando alguma coisa: informação, segurança, conteúdo. As outras quatro resolvem-se **aceitando**. Saber em qual está é a competência que interessa aqui, e não há truque nenhum que a substitua. ## Quando a sessão começa e corre mal Diferente da recusa, e mais delicado. A pessoa aceitou, colocou, e a meio há desconforto, confusão ou agitação. A sequência é sempre a mesma, e vale a pena estar escrita antes de ser precisa: 1. **Parar.** Não perguntar se quer parar: parar. Perguntar depois. 2. **Tirar o equipamento** e devolver a orientação: dizer onde está, quem está ali, que horas são. 3. **Ficar.** Os minutos a seguir importam mais do que a sessão. 4. **Registar o que aconteceu**, incluindo em que ponto. É o que evita que a próxima pessoa repita a mesma proposta às cegas. 5. **Não voltar a propor no mesmo dia.** Vale distinguir [enjoo de desconforto emocional](/blog/conforto-e-enjoo-realidade-virtual/): o primeiro tem sinais físicos e resolve-se sentando e esperando; o segundo pede presença e conversa, e às vezes pede que não se repita. ## O que isto obriga do lado de quem conduz Uma coisa só, e não é técnica: **quem propõe tem de estar genuinamente disposto a ouvir não.** Se a sessão está a ser proposta porque há um equipamento comprado que tem de mostrar utilização, a pessoa à frente percebe. Percebem sempre. É também por isto que o [consentimento](/blog/consentimento-informado-realidade-virtual-saude/) aqui não é um papel: é a possibilidade real de dizer não sem que isso custe nada a quem diz. ## Onde nós não ajudamos Não temos nada que aumente a aceitação, e desconfie de quem disser que tem. Nenhuma funcionalidade convence ninguém. O que existe do nosso lado é modesto e concreto: a sessão para de imediato à distância pelo Companion, sem quem conduz ter de ir buscar o equipamento; e a recusa e a interrupção ficam registadas como qualquer outra coisa, o que permite ver padrões que a memória do turno perde. Um sistema que registasse só as sessões que correram bem seria mais bonito e menos útil. ## Em resumo - **A recusa é informação.** Sete razões, e só três se resolvem mudando algo. - **Convencer alguém uma vez custa todas as vezes seguintes.** - **Se corre mal: parar primeiro, perguntar depois**, e ficar. - **Registar recusas e interrupções**, não só o que correu bem. - **Quem propõe tem de poder ouvir não**: senão isto passa a ser sobre o equipamento e não sobre a pessoa. Q: O que fazer quando um utente recusa uma sessão de realidade virtual? A: Perceber a razão antes de responder. As mais comuns são não ter percebido o que é, ter receio de ficar sem ver o que o rodeia, ou não ser boa altura por dor, náusea ou visita. Só as razões de informação, de segurança e de conteúdo se resolvem mudando alguma coisa; as restantes resolvem-se aceitando a recusa e propondo noutro momento, ou não voltando a propor. Q: E se a primeira sessão correr mal? A: Parar de imediato, sem perguntar primeiro se a pessoa quer parar. Retirar o equipamento, devolver a orientação dizendo onde está e quem está ali, ficar com ela os minutos seguintes, registar o que aconteceu e em que ponto, e não voltar a propor no mesmo dia. Q: Vale a pena insistir com quem recusa? A: Não. Além da questão de respeito pela decisão da pessoa, tem um efeito prático conhecido: quem é convencido a fazer uma sessão que não queria tende a recusar todas as seguintes. A possibilidade real de dizer não é o que sustenta a proposta ao longo do tempo. ### Quanto tempo deve durar uma sessão, e de quantas em quantas semanas? URL: https://rver.pt/blog/duracao-frequencia-sessao-realidade-virtual/ Date: 20 August 2026 Toda a gente quer um número, e um número dava jeito a toda a gente. O problema é que a literatura não tem um: tem intervalos herdados da logística de cada estudo, e é honesto dizê-lo antes de dizer o que fazemos. «Quanto tempo deve durar?» é das primeiras perguntas de qualquer equipa, e a resposta honesta começa por uma admissão: **não existe uma dose estabelecida de realidade virtual**, no sentido em que existe uma dose de um fármaco. Vale a pena perceber porquê, porque isso muda a forma de decidir. ## O que a literatura usa, e o que isso é Nos trabalhos publicados sobre realidade virtual em contextos de saúde, as sessões costumam andar entre os **dez e os vinte minutos**, com alguns estudos mais curtos em procedimentos e alguns mais longos em reabilitação. É o intervalo que vai encontrar citado por toda a parte. O que quase nunca se diz é de onde vem esse intervalo. Não vem de ensaios que tenham comparado durações para descobrir a melhor. Vem de **decisões de logística**: o tempo que o procedimento demorava, o tempo que a equipa de investigação tinha, a autonomia do equipamento, o que se achou que um participante toleraria. É o que coube, não o que se otimizou. Portanto, quando um fornecedor lhe disser «vinte minutos, duas vezes por semana», pergunte-lhe de onde tirou aquilo. É uma extrapolação de intervalos de estudos com desenhos diferentes, populações diferentes e objetivos diferentes. Nós reunimos os trabalhos na [biblioteca de estudos](/estudos/) precisamente para que se possa ir ver, em vez de acreditar. ## Três situações, três lógicas diferentes Agrupar tudo sob «duração da sessão» é o erro. Há pelo menos três casos e decidem-se de maneiras diferentes. **1. Durante um procedimento.** Aqui a duração não é uma escolha: é a duração do procedimento. Começa antes (o momento de colocar já faz parte) e acaba quando o procedimento acaba. Perguntar «quantos minutos?» não faz sentido: a resposta é «os que a punção, o penso ou a sessão de diálise demorar». **2. Como momento de calma ou de estimulação.** Aqui há escolha, e a regra prática que as equipas convergem é curta: **acabar antes de a pessoa querer acabar.** Uma sessão que termina com a pessoa a pedir mais uma é a que faz com que haja uma próxima. Uma que se arrasta até ao cansaço faz com que a próxima seja recusada. **3. Em reabilitação.** Aqui a duração está subordinada ao exercício e a quem o orienta. Não é o sistema que decide, é o plano do profissional, e a fadiga é o limite real, não o relógio. ## A frequência é uma pergunta de agenda, não de farmacologia Sobre «quantas vezes por semana», a resposta honesta é ainda mais curta: **não há evidência que estabeleça uma frequência ótima.** O que existe é o que a instituição consegue sustentar. E aqui está a observação mais útil que temos: **a frequência que se mantém vale mais do que a frequência ideal.** Um lar que faz duas sessões por semana durante um ano faz mais do que um que planeia cinco e desiste ao segundo mês. A pergunta prática não é «qual é a melhor frequência?», é «qual é a maior frequência que esta equipa consegue manter em fevereiro, com uma pessoa de baixa?». ## Sinais que mandam parar antes do fim Independentemente do que estava planeado, a sessão acaba quando: - a pessoa **pede** para acabar, sem negociação, e isto é o primeiro de todos; - aparecem sinais de [desconforto ou enjoo](/blog/conforto-e-enjoo-realidade-virtual/): palidez, suor, queixa de tonturas, procurar o apoio da cadeira; - a pessoa **deixa de responder** ao que está a acontecer, ou parece perdida em vez de envolvida; - há agitação crescente em vez de decrescente; - quem conduz tem uma dúvida. A dúvida basta. Nenhum destes sinais é uma falha. São informação, e valem mais registados do que lembrados. ## O que o registo resolve, e o que não Como não há dose de referência, o único caminho é olhar para o que acontece na sua instituição. Cada sessão fica [registada](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/): o que correu, quanto tempo, quando foi interrompida. Ao fim de alguns meses isso é uma série sobre a qual se pode discutir: as sessões desta pessoa são sistematicamente interrompidas aos cinco minutos? Este cenário aguenta mais tempo do que aquele? **O que isto não é:** prova de efeito. Um registo diz o que se fez, não que tenha resultado. Um fornecedor que lhe apresente contagens de sessões como resultado clínico está a mudar de assunto: já escrevemos sobre [o que não se consegue provar](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## Em resumo - **Não há dose estabelecida.** Os 10–20 minutos citados são logística de estudos, não um ótimo. - **Durante um procedimento**, a duração é a do procedimento. - **Como momento de calma**, acabar antes de a pessoa querer acabar. - **A frequência sustentável ganha à frequência ideal.** - **Os sinais de paragem vencem sempre o plano**, e a dúvida de quem conduz é um deles. Q: Quanto tempo deve durar uma sessão de realidade virtual? A: Não existe uma dose estabelecida. Os estudos publicados usam sobretudo sessões de dez a vinte minutos, mas esse intervalo reflete a logística de cada trabalho e não uma duração otimizada. Durante um procedimento a duração é a do procedimento; como momento de calma, a regra prática é acabar antes de a pessoa querer acabar. Q: Com que frequência se devem fazer sessões? A: Não há evidência que estabeleça uma frequência ótima. Na prática vale mais a frequência que a equipa consegue manter ao longo do tempo do que uma frequência ambiciosa que se abandona ao segundo mês. A pergunta útil é qual o ritmo sustentável com a equipa real, incluindo períodos de férias e ausências. Q: Quando é que se deve interromper uma sessão? A: Sempre que a pessoa pedir, sem negociação; perante sinais de desconforto ou enjoo como palidez, suor ou queixa de tonturas; se a pessoa deixar de responder ou parecer perdida; se houver agitação crescente; ou sempre que quem conduz tenha dúvidas. A interrupção não é uma falha e deve ficar registada. ### O doente já não comunica: vale a pena uma sessão? URL: https://rver.pt/blog/doente-que-ja-nao-comunica-vale-a-pena-sessao/ Date: 20 August 2026 É a pergunta mais difícil que nos fazem, e a que tem as respostas comerciais mais desonestas. Merece uma resposta que admita o que não se sabe, porque a alternativa é vender esperança a quem está a decidir por outra pessoa. A pergunta chega quase sempre da mesma forma. Uma pessoa com demência avançada que já não fala, ou alguém nos últimos dias de vida. A família pergunta se «aquilo dos óculos» pode fazer bem. E a equipa quer uma resposta honesta. Esta é a zona onde é mais fácil vender esperança, e por isso é a que exige mais cuidado a escrever. ## O que muda quando não há palavras Três coisas ao mesmo tempo, e é a acumulação que torna isto difícil: - **Não há consentimento verbal.** A conversa habitual (explicar, perguntar, ouvir sim ou não) deixa de estar disponível. - **Não há relato.** Ninguém pode dizer se foi bom, se foi estranho, se foi assustador. A experiência da pessoa fica-nos inacessível. - **A observação é falível.** Interpretamos uma expressão, um relaxamento dos ombros, um sorriso. Podemos estar a ler bem. Podemos estar a ler o que queremos ver, e o risco é maior precisamente quando queríamos muito que corresse bem. ## O que a evidência diz, e é pouco Com franqueza: **a investigação sobre realidade virtual em demência avançada e em fim de vida é escassa.** O grosso da literatura em demência é de estádios ligeiros a moderados, com desfechos de bem-estar, humor e [reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/) e mesmo aí com estudos pequenos. Para quem já não comunica verbalmente, o que existe é sobretudo observacional e não sustenta afirmações de benefício. **Quem lhe disser que há evidência de que isto melhora a qualidade de fim de vida está a ir muito além do que existe.** Reunimos os trabalhos na [biblioteca de estudos](/estudos/) e os temas de paliativos e demência estão lá com as contagens à vista, incluindo quando são poucos. ## O que substitui o consentimento Não havendo consentimento informado no sentido habitual, o que existe é uma combinação que vale a pena nomear: - **Autorização por quem representa** a pessoa (família, representante legal) informada com honestidade, incluindo a parte de não se saber; - **Assentimento e dissentimento**: o que a pessoa manifesta no momento, sem palavras. Afastar a cabeça, levar a mão ao equipamento, franzir, tensão. Isto **conta como recusa** e não se negoceia; - **O que se sabia da pessoa antes.** Gostava de mar? Tinha claustrofobia? Recusava aparelhos? A biografia é a melhor fonte disponível quando a pessoa já não pode responder, e costuma estar na família. Já escrevemos sobre [consentimento](/blog/consentimento-informado-realidade-virtual-saude/) em geral; aqui a diferença é que o dissentimento passa a ser o sinal principal, e não uma exceção. ## A pergunta que decide Há uma pergunta que separa cuidar de encenar, e é desconfortável: > **De quem é o benefício que estamos a procurar?** Às vezes a resposta honesta é: da família. Ver a mãe com um sorriso ao ver a terra dela é uma coisa boa e legítima **para a família**, e pode ser a única coisa boa daquela semana. Mas é diferente de dizer que fez bem à mãe, e a diferença deve ser dita em voz alta na altura de decidir. Não estamos a dizer que o benefício da família não conta. Conta, e em cuidados paliativos a unidade de cuidados inclui-a. **Estamos a dizer que se deve chamar pelo nome**, em vez de o vestir de benefício clínico. E há um limite claro do outro lado: se a pessoa mostra desconforto e a sessão continua porque a família quer ver, deixou de ser cuidado. ## Se se avançar, o que faz diferença na prática - **Curto.** Muito mais curto do que noutros contextos. Minutos. - **Conteúdo da biografia**, não conteúdo bonito. O sítio dela, não uma praia genérica. - **Alguém de confiança ao lado**, a falar, com a mão. A voz conhecida faz parte da sessão. - **Posição**: em fim de vida raramente se está sentado. O [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/) existe para o cenário não aparecer torto a quem está reclinado ou na cama. - **Parar ao primeiro sinal**, e o limiar aqui é mais baixo do que em qualquer outro contexto. - **Registar o que se observou** com as palavras do que se viu: «franziu», «acalmou a respiração», e não com conclusões como «gostou». ## Onde nós paramos Sejamos explícitos, porque é uma área onde a tentação de dizer mais é grande: - **O RVer não avalia conforto, dor ou emoção.** Não há medição de estado emocional. O que existe é o registo do que a equipa observou e escreveu. - **Não temos evidência** de benefício nesta população, e não a vamos alegar. - **Não sabemos** o que a pessoa está a experienciar. Ninguém sabe. O que podemos dizer é o que o sistema permite fazer: um cenário escolhido pela equipa, curto, interrompível à distância, com a família presente se fizer sentido. A decisão sobre se faz sentido é clínica, é da equipa e de quem representa a pessoa, e é tomada caso a caso. ## Em resumo - **Sem palavras**, perde-se consentimento, relato e certeza: os três ao mesmo tempo. - **A evidência nesta população é escassa** e não sustenta promessas. - **Dissentimento é recusa**, e é o sinal principal. - **Perguntar de quem é o benefício**, e chamá-lo pelo nome. - **Se a pessoa mostra desconforto e continua**, deixou de ser cuidado. Q: Faz sentido usar realidade virtual com alguém em demência avançada que já não fala? A: Pode fazer, caso a caso, mas sem promessas. A investigação nesta população é escassa e não sustenta afirmações de benefício: o grosso da literatura em demência é de estádios ligeiros a moderados e com desfechos de bem-estar e reminiscência. A decisão é clínica, tomada com quem representa a pessoa, e depende muito da biografia dela. Q: Como se obtém consentimento de quem não comunica? A: Não se obtém no sentido habitual. O que existe é autorização de quem representa a pessoa, informada com honestidade incluindo o que não se sabe, mais o assentimento e o dissentimento manifestados no momento. Afastar a cabeça, levar a mão ao equipamento, franzir ou tensão contam como recusa e não se negoceiam. Q: E se a família pedir e a pessoa parecer indiferente? A: Vale a pena perguntar abertamente de quem é o benefício procurado. O benefício da família é legítimo, sobretudo em cuidados paliativos onde a unidade de cuidados a inclui, mas deve ser chamado pelo nome em vez de apresentado como benefício clínico. Se a pessoa mostrar desconforto e a sessão continuar porque a família quer ver, deixou de ser cuidado. ### Vinte anos depois dos 65, oito com saúde: o que se faz com a diferença URL: https://rver.pt/blog/anos-de-vida-saudavel-portugal-a-diferenca/ Date: 20 August 2026 Portugal é dos países mais velhos da União Europeia e o indicador que mais custa não é a esperança de vida, é o que fica depois de lhe tirar os anos com saúde. É um número desconfortável, e é o número em que trabalha metade do setor social. Há um número em quase todas as apresentações sobre envelhecimento em Portugal: a esperança de vida subiu. É verdade e é boa notícia. Há um segundo número que aparece muito menos, e que muda a conversa toda. Em Portugal, **uma pessoa que chega aos 65 anos tem em média cerca de vinte anos de vida pela frente, e cerca de oito deles em boa saúde**. Os dados de 2023 apontam para perto de 8,4 anos saudáveis depois dos 65, com as mulheres a viverem mais anos no total e menos anos com saúde do que os homens. Portugal está **abaixo da média europeia** neste indicador, ao contrário do que acontece na esperança de vida total. A diferença entre os dois números anda pelos **doze anos**. Não é uma abstração estatística. São doze anos por pessoa, multiplicados por mais de dois milhões e meio de pessoas com 65 ou mais anos, perto de um quarto da população residente. ## Doze anos é onde está o setor Vale a pena perceber de que anos estamos a falar, porque a resposta define quem trabalha lá dentro: - **[lares e estruturas residenciais](/solucoes/lar-residencial/)**, onde a pessoa passa a viver; - **cuidados continuados**, a [RNCCI](/blog/realidade-virtual-cuidados-continuados-rncci/), onde se recupera função ou se estabiliza; - **apoio domiciliário**, quando a casa ainda dá; - **[cuidados paliativos](/solucoes/cuidados-paliativos/)**, quando o objetivo deixa de ser prolongar e passa a ser confortar. Nenhuma destas respostas existe para acrescentar anos saudáveis. Existem todas para tornar **habitáveis** os anos que não são saudáveis. É uma missão diferente, e é frequentemente avaliada com os indicadores errados. ## O que a tecnologia costuma prometer, e o que devia prometer Quase toda a tecnologia vendida ao setor do envelhecimento é vendida do lado da **prevenção**: prevenir quedas, prevenir declínio, adiar a dependência. É um mercado legítimo e, quando funciona, é o melhor investimento que há. Mas o discurso da prevenção tem um efeito colateral: **deixa sem linguagem quem trabalha nos doze anos**. Uma direção técnica de um lar não está a prevenir grande coisa: está a cuidar de pessoas que já atravessaram esse ponto. E quando todo o material promocional fala de prevenir, o que sobra é a sensação de que cuidar bem é um prémio de consolação. Não é. Melhorar um dia mau é um resultado, não um paliativo do discurso. ## Onde é que a realidade virtual entra, e onde não entra Vamos ser diretos, porque é a única forma de isto ser útil. **O que a RVer não faz:** - **não acrescenta anos de vida saudável.** Não há nada na literatura que sustente isso, e nós não o afirmamos; - **não previne dependência, fragilidade ou quedas;** - **não substitui exercício, fisioterapia, nutrição ou convívio**, que são as intervenções com evidência mais sólida do lado da prevenção; - **não é uma intervenção de saúde pública.** É um sistema usado numa sessão, com uma pessoa, sob supervisão de quem cuida. **O que faz, e é o que temos:** ambientes imersivos usados dentro daqueles doze anos, como complemento não farmacológico, sob decisão da equipa clínica: momentos de calma, de [reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/), de distração durante um procedimento incómodo, de [presença da família à distância](/blog/videochamadas-familia-realidade-virtual/). Cada sessão fica registada, o que dá à equipa uma coisa que raramente tem: um registo do que se fez e quando. A investigação publicada nesta área é sobretudo de **bem-estar, ansiedade, dor e qualidade de vida**, não de longevidade. Reunimo-la, com os temas e as contagens à vista, na [biblioteca de estudos](/estudos/). E onde a evidência é fraca, dizemo-lo lá. ## O indicador que falta às instituições Se a missão é a qualidade dos anos e não a quantidade, os indicadores deviam segui-la. Na prática, quase nenhuma instituição mede o que faz nesse eixo: mede ocupação, incidentes e horas de cuidado, que são indicadores de operação. Não temos uma solução fechada para isto, e desconfie de quem tiver. Temos uma observação: quando uma equipa começa a **registar sessões** de qualquer atividade não farmacológica, ganha pela primeira vez uma série temporal sobre a qual discutir. Não prova efeito. Permite conversar com dados em vez de impressões, e já é mais do que existia. ## Em resumo - **Cerca de vinte anos depois dos 65, cerca de oito com saúde.** Portugal está abaixo da média da UE neste indicador. - **A diferença é o terreno de trabalho** dos lares, dos continuados, do domicílio e dos paliativos. - **A realidade virtual não encurta essa diferença.** Trabalha lá dentro. - **Quem lhe prometer anos saudáveis** com um visor está a extrapolar. Q: O que são anos de vida saudável? A: É um indicador que estima quantos anos uma pessoa pode esperar viver sem limitações de atividade por problemas de saúde. Distingue-se da esperança de vida total, que conta todos os anos independentemente do estado de saúde. Em Portugal, aos 65 anos, a esperança de vida ronda os vinte anos e a esperança de vida saudável ronda os oito. Q: A realidade virtual aumenta a esperança de vida saudável? A: Não há evidência que sustente essa afirmação, e não a fazemos. A investigação publicada sobre realidade virtual em contextos de saúde incide sobretudo em bem-estar, ansiedade, dor e qualidade de vida, não em longevidade nem em prevenção de dependência. Q: Então para que serve num lar ou em cuidados continuados? A: Como complemento não farmacológico dentro dos anos vividos com limitação: momentos de calma, reminiscência, distração durante procedimentos e presença da família à distância, sempre sob decisão e supervisão da equipa clínica. Cada sessão fica registada, o que dá à equipa um histórico do que foi feito. ### AI Act: o que mudou a 2 de agosto de 2026 para quem usa IA na saúde URL: https://rver.pt/blog/ai-act-saude-o-que-mudou-agosto-2026/ Date: 20 August 2026 Duas datas mudaram este verão e quase ninguém no setor da saúde as separou. Uma trouxe obrigações que já se aplicam; a outra adiou as pesadas por dois anos. Vale a pena saber em qual delas está o seu fornecedor. Se acompanha o tema de longe, é provável que tenha ficado com a ideia de que "o AI Act entrou em vigor em agosto de 2026". É meia verdade, e a metade que falta é exatamente a que interessa a quem compra software para um serviço de saúde. Aconteceram duas coisas com poucos dias de diferença, e puxam em sentidos opostos. ## As duas datas **27 de julho de 2026.** Entrou em vigor o chamado *Digital Omnibus* sobre IA (Regulamento (UE) 2026/1744). Entre outras coisas, fixou prazos para as obrigações de alto risco que antes estavam presas ao ritmo da normalização técnica, e **adiou-as**. **2 de agosto de 2026.** Passaram a aplicar-se as obrigações de **transparência** do Artigo 50.º. Estas não foram adiadas: estão em vigor agora. O resultado é um calendário com três degraus: | Quando | O quê | |---|---| | 2 fev. 2025 | Proibições do Artigo 5.º e dever de literacia em IA | | 2 ago. 2025 | Obrigações dos modelos de uso geral (GPAI) | | **2 ago. 2026** | **Transparência (Artigo 50.º)** | | 2 dez. 2027 | Alto risco do Anexo III (sistemas autónomos: recrutamento, crédito, educação) | | **2 ago. 2028** | **Alto risco do Anexo I: IA embutida em produtos já regulados, incluindo dispositivos médicos** | É o último degrau que costuma ser mal lido. Um sistema de IA dentro de um dispositivo médico não passa a cumprir requisitos de alto risco este mês: tem até **2 de agosto de 2028**. Mas há duas ressalvas que convém não perder de vista. O adiamento **cai** se o sistema sofrer uma alteração significativa de conceção. E **nada disto mexeu no MDR**: as obrigações do Regulamento 2017/745 continuam exatamente onde estavam. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## O que a transparência obriga, em português O Artigo 50.º não é sobre desempenho nem sobre segurança clínica. É sobre a pessoa do outro lado saber com o que está a lidar. Cobre quatro situações: 1. **Interação direta**: se está a falar com um sistema de IA, tem de lhe ser dito, salvo quando é óbvio. 2. **Conteúdo gerado por IA**: imagem, áudio e vídeo sintéticos têm de ser marcados de forma legível por máquina. 3. **Reconhecimento de emoções e categorização biométrica**: as pessoas expostas têm de ser informadas. 4. **Deepfakes e texto de interesse público**: quando se publica texto gerado por IA para informar o público sobre matérias de interesse público, isso tem de ser declarado. O ponto 4 tem uma isenção que quase nunca é citada: **não se aplica quando o texto passou por revisão humana significativa e alguém assume responsabilidade editorial**. Ou seja, um artigo escrito com assistência de IA e revisto por uma pessoa que responde por ele está, à letra, fora da obrigação. A isenção vale a pena guardar, porque muda a pergunta útil a fazer a quem publica. Não é «isto foi escrito com ajuda de IA?», a resposta é cada vez mais sim, em todo o lado, e daqui a pouco não distingue ninguém. É **quem responde editorialmente por isto?** Neste blog a resposta é a equipa RVer, pela mesma razão por que publicamos [o que não conseguimos provar](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/) sobre retorno. ## Onde é que isto deixa o RVer O RVer é um [dispositivo médico de Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/) registado no INFARMED e na EUDAMED. Tem uma [funcionalidade assistida por IA](/rver-ai/), e ela faz uma coisa só: **ajuda a encontrar um cenário na biblioteca** a partir do tipo de momento: relaxamento, acalmar a agitação, memória, distração, sono, estimulação, orientação. Ordena o conteúdo e explica porque sugeriu. O que ela **não** faz, e é aqui que a conversa fica útil: - não prescreve; - não avalia; - não diagnostica; - não decide nada sozinha, e não há forma de a pôr a decidir. A escolha é sempre da equipa clínica. Isto não é uma posição de circunstância tomada por causa do regulamento: está escrito no site desde antes dele, e já o desenvolvemos em [porque é que a IA não está pronta para ser o clínico](/blog/ia-nao-esta-pronta-para-ser-o-clinico/). ## As perguntas que vale a pena fazer a um fornecedor Se está a avaliar software clínico com IA, três perguntas separam depressa quem pensou no assunto de quem não pensou: - **A IA do vosso produto decide ou sugere?** Se decide, e o produto é um dispositivo médico, está a olhar para o Anexo I e para 2028, e para uma classificação que pode não ser a que o fornecedor lhe disse. - **Onde corre o modelo, e o que sai da instituição?** É uma pergunta de [RGPD](/blog/privacidade-rgpd-realidade-virtual-saude/) antes de ser de AI Act, e as duas cruzam-se. - **Que alterações de conceção estão previstas?** Porque uma alteração significativa faz cair o adiamento. ## O que não sabemos Convém dizer com todas as letras: **isto não é aconselhamento jurídico**. Somos fabricante, não escritório de advogados. Há zonas do Artigo 50.º cuja aplicação prática a sistemas pequenos ainda está a assentar, e as orientações da Comissão continuam a sair. Se a sua instituição precisa de uma posição formal, ela tem de vir de quem a possa assinar. O que podemos dizer é o que fizemos do nosso lado, que é público e verificável. ## Em resumo - **2 de agosto de 2026:** transparência do Artigo 50.º em aplicação. - **2 de agosto de 2028:** alto risco para IA dentro de dispositivos médicos: adiado, não cancelado, e o adiamento cai com alterações significativas. - **O MDR não mudou.** - **No RVer, a IA sugere e a equipa decide.** Q: O AI Act já se aplica ao meu software clínico? A: Depende da obrigação. As de transparência do Artigo 50.º aplicam-se desde 2 de agosto de 2026. As obrigações de alto risco para IA embutida em produtos já regulados, como os dispositivos médicos, só se aplicam a partir de 2 de agosto de 2028, por efeito do Digital Omnibus que entrou em vigor a 27 de julho de 2026. O MDR não foi alterado por nenhum dos dois. Q: Um dispositivo médico com IA passa automaticamente a alto risco? A: Não automaticamente, e a resposta depende do que a IA faz e de como o produto está classificado. O que muda a conversa é a IA decidir em vez de sugerir. No RVer a funcionalidade assistida por IA ordena e explica sugestões de cenários da biblioteca; não prescreve, não avalia, não diagnostica, e a escolha é sempre da equipa clínica. Q: Textos escritos com ajuda de IA têm de ser identificados? A: O Artigo 50.º obriga a declarar texto gerado por IA publicado para informar o público sobre matérias de interesse público, mas isenta o texto que passou por revisão humana significativa com responsabilidade editorial assumida. Os artigos deste blog são revistos pela equipa RVer, que assume essa responsabilidade editorial. ### Solidão e isolamento social: o que a tecnologia resolve, e o que não URL: https://rver.pt/blog/solidao-isolamento-social-idosos-tecnologia/ Date: 20 August 2026 Duas palavras que se usam como sinónimos e não são. Uma mede-se contando pessoas à volta; a outra só a própria pessoa sabe. Confundi-las é a razão por que tantos programas bem-intencionados não mexem no ponteiro. O relatório da Comissão da OMS para a Conexão Social pôs números numa coisa que o setor social já sabia: **uma em cada seis pessoas no mundo sente-se só**, e a solidão está associada a cerca de **871 mil mortes por ano**: perto de cem por hora. O mesmo relatório traz um dado que costuma apanhar as pessoas desprevenidas. Contra a imagem que quase toda a gente tem, **os níveis mais altos de solidão não estão nos mais velhos**: estão nos adolescentes entre os 13 e os 17 anos, com cerca de 21%. A solidão não é uma doença da velhice. O que **é** desproporcionado na idade avançada é outra coisa: o **isolamento social**, que se estima afetar até um em cada três idosos, e que na Europa convive com perto de 20% das pessoas mais velhas a viverem sozinhas. ## Duas coisas diferentes, e é aqui que os programas falham - **Isolamento social** é objetivo. Conta-se: quantos contactos, com que frequência, que rede. Pode ser medido por fora. - **Solidão** é subjetiva. É a distância entre o contacto que a pessoa tem e o que gostaria de ter. Só a própria pessoa a reporta. Uma pessoa pode estar num lar cheio, com atividades todos os dias, rodeada de gente, e estar profundamente só. E pode viver sozinha numa aldeia, ver duas pessoas por semana, e não se sentir só de todo. Isto tem uma consequência prática que se ignora muito: **quase todas as intervenções tecnológicas atacam o isolamento**, porque é o que se consegue contar. Adicionam contactos. Se o problema da pessoa era a solidão, adicionar contactos pode não fazer nada, e o programa vai reportar sucesso à mesma, porque mediu a variável errada. ## O que a evidência aponta como forte Sem rodeios: as intervenções com melhor sustentação não são tecnológicas. São programas de contacto humano (de grupo, com propósito, mantidos no tempo), ligação à comunidade e o que a literatura arruma como intervenções psicológicas quando há sofrimento instalado. Contacto com a natureza e com animais aparece com sinal positivo em vários trabalhos. Se a sua instituição tem de escolher onde pôr dinheiro para atacar solidão, **comece por aí**, não por um visor. Dizemo-lo enquanto fabricante de visores. ## O que a realidade virtual faz nesta conversa Feita a ressalva, há duas coisas concretas em que um sistema como o RVer toca o problema, e nenhuma delas é «curar a solidão». **Presença da família, à distância.** Durante a sessão, o doente pode estar em [videochamada com a família](/blog/videochamadas-familia-realidade-virtual/): vê e ouve os familiares dentro da experiência, e do outro lado a família acompanha em tempo real o cenário que ele está a ver, do telemóvel ou do computador. Para quem tem família longe, emigrada, ou impedida de visitar, isto não é um contacto adicional genérico: é **o contacto que faltava, com as pessoas certas**. É a funcionalidade mais pedida por quem usa o sistema. **Reminiscência.** Levar alguém ao sítio onde viveu, à romaria da terra, ao mar onde ia em criança. A literatura em demência nesta área é sobretudo de [bem-estar e reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/), e o que a equipa observa não é «menos solidão»: é conversa. A pessoa fala, quem cuida ouve coisas que não sabia, e a relação entre as duas muda um bocado. Isso é ligação social, mesmo que o indicador não tenha nome. ## Onde perde, com todas as letras - **Um ecrã não é companhia.** Um cenário bonito visto sozinho é uma pessoa sozinha a ver um cenário bonito. - **A sessão de realidade virtual é individual.** Não é atividade de grupo, e as atividades de grupo são precisamente das que têm mais sustentação. Onde há uma [sala Snoezelen ou um programa de grupo](/blog/sala-snoezelen-ou-realidade-virtual-lares/) a funcionar, isso não se substitui. - **Não há ensaios que digam que a realidade virtual reduz solidão** como desfecho clínico. Há trabalhos pequenos e promissores sobre bem-estar e humor. Quem lhe apresentar isto como intervenção contra a solidão está a ir além do que existe. - **O RVer não avalia nem diagnostica** estados emocionais. Regista sessões. ## O que fazer com isto na segunda-feira Se a solidão é um tema declarado na sua instituição, três passos que não custam dinheiro: 1. **Separe as duas coisas** no que já mede. Contactos por semana é isolamento. Perguntar à pessoa se se sente só é outra coisa, e há escalas curtas validadas para isso. 2. **Veja quem não recebe visitas.** É a lista mais acionável que existe, e costuma estar na cabeça de alguém em vez de estar escrita. 3. **Só depois** pergunte que ferramentas ajudam, e exija que cada fornecedor lhe diga qual das duas está a atacar. ## Em resumo - **Solidão e isolamento não são a mesma coisa**, e a maioria dos programas mede o segundo. - **A solidão não é sobretudo dos idosos**; o isolamento social é que pesa mais na idade avançada. - **As intervenções mais fortes são humanas.** - **A realidade virtual toca o problema em dois pontos**: família à distância e reminiscência, e não substitui presença. Q: Qual é a diferença entre solidão e isolamento social? A: O isolamento social é objetivo e mede-se por fora: número e frequência de contactos, dimensão da rede. A solidão é subjetiva e só a própria pessoa a reporta: é a diferença entre o contacto que tem e o que gostaria de ter. Uma pessoa pode estar acompanhada e sentir-se só, e viver sozinha sem se sentir só. Q: A realidade virtual reduz a solidão? A: Não há ensaios que sustentem a redução da solidão como desfecho clínico, e não o afirmamos. A investigação existente incide sobretudo em bem-estar, humor e reminiscência. As intervenções com melhor sustentação contra a solidão são de contacto humano e de ligação à comunidade. Q: Então o que faz o RVer nesta área? A: Duas coisas concretas: permite que a família esteja presente por videochamada durante a sessão, vendo em tempo real o cenário que o doente vê, e permite sessões de reminiscência com lugares familiares, que costumam gerar conversa entre o utente e quem cuida. Não substitui presença nem atividades de grupo. ### Quem paga não é quem poupa: o problema que trava tecnologia em saúde URL: https://rver.pt/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/ Date: 20 August 2026 Há uma conversa que se repete: toda a gente concorda que faz sentido, ninguém diz que não, e o processo morre. Quase nunca é por causa do preço. É por causa de onde o dinheiro entra e de onde ele sai. Uma instituição de saúde não tem um orçamento. Tem dezenas, com donos diferentes, regras diferentes e incentivos diferentes. É óbvio quando se diz, e é ignorado em quase todas as apresentações comerciais feitas ao setor. O resultado é um padrão que já vimos vezes suficientes para o descrever com confiança: o serviço quer, a direção concorda, os números fecham, e o projeto não avança. Não porque alguém decidiu que não. Porque **quem tem de pagar não é quem vai poupar**, e ninguém no processo tem autoridade sobre os dois lados. ## O mapa Vale a pena pôr isto em duas colunas, porque é aí que a conversa muda. | Quem paga | Onde a poupança aterra | |---|---| | Orçamento do serviço que compra | Anestesia e farmácia (menos sedação) | | | Bloco ou sala de exame (tempo de sala, menos remarcações) | | | Dias de cama (internamento) | | | Horas de equipa (menos tempo a acalmar, a repetir, a convencer) | | | Serviço de urgência (readmissões evitadas) | | | Recursos humanos (rotatividade, absentismo) | Repare numa coisa: **a coluna da esquerda tem uma linha e a da direita tem seis.** Nenhuma das seis pertence a quem assina a despesa. E várias delas nem sequer são orçamentos autónomos: são custos que ninguém contabiliza como poupança porque nunca foram contabilizados como despesa. [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## Um caso concreto Um serviço de imagiologia ou de radioterapia compra o equipamento do seu orçamento de investimento. Se a intervenção reduzir ansiedade ao ponto de evitar algumas sedações, a poupança de fármaco e de tempo de anestesista aparece **no orçamento da anestesia**, não no dele. Se reduzir remarcações, a ganho aparece na produtividade da sala, medida por outro departamento. O diretor do serviço fica na posição absurda de justificar uma despesa cujo benefício vai ser creditado a colegas. Não é má vontade nenhuma quando ele hesita. É a estrutura a funcionar exatamente como foi desenhada. ## Porque é que as apresentações de ROI falham A tentação é somar tudo e apresentar um número grande: «poupa X por ano». Esse número não tem dono. Quem o lê procura a linha dele e não a encontra: encontra um agregado que mistura o orçamento de seis pessoas diferentes, e a reação previsível é desconfiança, não entusiasmo. Um total que ninguém reconhece como seu lê-se como uma peça de marketing, mesmo quando as contas estão certas. Já escrevemos [o guia da conta por instituição](/blog/custo-roi-realidade-virtual-instituicao-saude/) e [onde estão as quatro alavancas de poupança](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/). Este artigo é sobre o passo anterior: **a quem se entrega a conta.** ## O que funciona Três caminhos, por ordem de facilidade. **1. Fazer a conta na moeda de quem paga.** Se o orçamento é do serviço, o argumento tem de fechar dentro do serviço: tempo de equipa, remarcações, capacidade de sala. As poupanças que aterram noutro sítio mencionam-se como bónus, nunca como justificação. Um argumento que precisa da coluna da direita para fechar é um argumento que não fecha. **2. Encontrar o nível acima dos silos.** Direção clínica, administração, direção executiva: alguém que veja as duas colunas ao mesmo tempo. É o caminho mais forte e o mais lento, e exige que o serviço já queira: ninguém acima patrocina uma coisa que ninguém abaixo pediu. **3. Tirar a decisão do investimento.** Se o obstáculo é o orçamento de capital e não o mérito, um modelo de licença anual muda a natureza da despesa e do aprovador. As vias estão em [como financiar](/blog/financiamento-comparticipacao-realidade-virtual-saude/). ## O que não funciona - **Insistir no total agregado.** Repetir um número que não tem dono não o faz ganhar um. - **Pedir ao serviço que "convença" a anestesia.** Estamos a pedir a alguém que faça política interna a favor de um fornecedor. Não acontece. - **Prometer poupanças que dependem de comportamento de terceiros.** «Se evitarem sedações» é uma condição, não um resultado, e depende de decisões clínicas que não são nossas nem de quem compra. ## Onde nós não ajudamos Com franqueza: **não conseguimos mudar a estrutura orçamental da sua instituição, e não devemos tentar.** Não sabemos quem tem discricionariedade sobre o quê no vosso caso, e um fornecedor que se ponha a desenhar a vossa política interna está fora do lugar dele. O que fazemos é dar-lhe a conta partida por orçamento em vez de um total, para que possa entregar a cada pessoa a linha que é dela. E dizer-lhe quando a conta não fecha na coluna de quem paga, porque nesses casos é melhor sabermos os dois antes de gastarmos três meses. ## Em resumo - **Uma linha paga, seis linhas poupam**, e não são a mesma pessoa. - **Um total agregado não tem dono** e lê-se como marketing. - **O argumento tem de fechar dentro do orçamento de quem assina.** - **Sem alguém acima dos silos, ou sem o caso a fechar em baixo**, o projeto fica parado sem que ninguém diga que não. Q: Porque é que projetos aprovados por todos não avançam num hospital? A: Frequentemente porque o orçamento que paga e o orçamento onde a poupança aterra são diferentes. O serviço compra do seu orçamento, enquanto os ganhos aparecem na anestesia, na farmácia, nos dias de cama ou nas horas de equipa. Ninguém no processo tem autoridade sobre os dois lados, e o projeto fica parado sem que ninguém diga que não. Q: Como se constrói o caso económico nessa situação? A: Fechando a conta dentro do orçamento de quem assina (tempo de equipa, remarcações, capacidade de sala) e mencionando as restantes poupanças como bónus, nunca como justificação. Em alternativa, levar a decisão a um nível que veja os vários orçamentos ao mesmo tempo, ou mudar a natureza da despesa através de um modelo de licença anual. Q: Vale a pena apresentar um valor total de poupança anual? A: Raramente. Um total agregado mistura os orçamentos de várias pessoas e não tem dono: quem o lê procura a sua linha, não a encontra, e a reação é desconfiança em vez de interesse. Uma conta partida por orçamento é mais difícil de fazer e muito mais fácil de aprovar. ### Do sim à primeira sessão: quem tem mesmo de autorizar dentro do hospital URL: https://rver.pt/blog/quem-autoriza-realidade-virtual-dentro-do-hospital/ Date: 20 August 2026 A pergunta «quem decide isto?» quase nunca tem uma resposta só. Tem seis, e a ordem por que se percorrem decide se o projeto arranca em seis semanas ou morre à espera de uma reunião que ninguém marcou. Há um padrão em quase todos os processos que encalham, e não é o preço. É este: alguém no serviço entusiasma-se, pede uma proposta, leva-a à administração, e o processo morre num limbo em que ninguém disse que não e ninguém pode dizer que sim. Num hospital, «autorizar» não é um ato. É uma sequência de pessoas com poderes diferentes, e nenhuma delas consegue substituir as outras. ## Os seis sins **1. O serviço que vai usar.** Não é uma formalidade: é a única aprovação insubstituível. Um equipamento que ninguém no turno quer usar não é salvo por nenhuma assinatura acima. É também aqui que se define o caso concreto: que doentes, em que momento, com que objetivo. **2. A direção do serviço ou departamento.** Responde pela prática clínica e por uma pergunta específica: isto encaixa no que fazemos, ou é mais uma coisa para a equipa fazer? Vale a pena chegar aqui com o [fluxo já pensado](/blog/integrar-realidade-virtual-fluxo-clinico/), não com um folheto. **3. A direção de enfermagem.** É quem, na prática, vai conduzir as sessões na maioria dos serviços. Se a enfermagem não foi ouvida antes da decisão, foi ouvida depois, e aí já é uma queixa. A pergunta dela é sobre tempo e sobre quem faz o quê, e há uma [boa resposta a dar](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). **4. Informática e o encarregado de proteção de dados.** São dois papéis, muitas vezes duas pessoas, e as perguntas [são quase sempre as mesmas oito](/blog/informatica-hospital-perguntas-realidade-virtual/): rede, integração, onde ficam os dados, quem é o responsável pelo tratamento, atualizações, continuidade. A resposta que desbloqueia isto mais depressa é poder dizer que o sistema **corre na rede local e não precisa de integração** com o sistema hospitalar. **5. O controlo de infeção.** Nos hospitais portugueses costuma ser o GCL-PPCIRA. Um equipamento que toca a cara de doentes sucessivos é matéria deles, e a conversa é curta se levar uma [rotina de higiene escrita](/blog/higiene-seguranca-equipamento-realidade-virtual/) em vez de uma promessa de que «limpa-se». **6. O aprovisionamento.** Chega no fim e é o que toda a gente subestima. Aqui a pergunta deixa de ser clínica: é cabimento, é procedimento, é plurianual ou não. Vale notar que **o enquadramento da contratação pública está em revisão em 2026**, com alterações aos limiares dos procedimentos ainda a assentar: confirme os valores em vigor com os serviços jurídicos da instituição em vez de os assumir de memória, incluindo a nossa. [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## A ordem que funciona A tentação é começar por cima, porque é onde está a assinatura que parece importar. Na prática, o caminho de menor resistência é quase sempre de baixo para cima: 1. **Serviço**: existe um caso concreto e alguém que o quer? 2. **Direção do serviço e enfermagem**: cabe no que já fazemos? 3. **Informática, proteção de dados, controlo de infeção**: em paralelo, não em série. São três conversas independentes e podem correr ao mesmo tempo. 4. **Aprovisionamento e administração**: com as três anteriores já resolvidas por escrito. Chegar à administração com os pareceres técnicos já dados transforma a decisão: deixa de ser «devo autorizar isto?» e passa a ser «assino uma coisa que os serviços já validaram». ## Um documento por interlocutor, não um dossiê para todos O erro mais caro e mais fácil de evitar: mandar a mesma apresentação de trinta páginas a seis pessoas. Cada uma lê procurando a sua pergunta e não a encontra. O que costuma resolver: - **serviço e direção clínica**: o caso de uso, em uma página; - **enfermagem**: o fluxo da sessão, quem faz o quê, quanto tempo; - **informática e proteção de dados**: arquitetura, dados, responsável pelo tratamento; - **controlo de infeção**: o procedimento de higiene entre doentes; - **aprovisionamento**: o [caderno de encargos](/blog/caderno-de-encargos-realidade-virtual-saude/) e as condições. ## Onde isto encalha, e não é por má vontade - **Nenhum dono.** Se o projeto não tem um nome e um telefone dentro da instituição, não avança. Um fornecedor não pode ser o dono. - **O piloto informalmente autorizado.** Alguém empresta, alguém experimenta, e quando corre bem ninguém sabe transformar aquilo num contrato: porque não havia processo nenhum. Um [piloto útil](/blog/piloto-realidade-virtual-hospital-como-correr/) é combinado por escrito antes de começar, mesmo quando é gratuito. - **A pergunta certa na altura errada.** O controlo de infeção perguntado depois da compra é um problema. Perguntado antes, são dez minutos. ## Onde não podemos ajudar Sem rodeios: **não conseguimos criar dentro da sua instituição a vontade que não exista.** Se ninguém no serviço quiser conduzir sessões, o projeto não sobrevive ao primeiro mês, e nós sabemos reconhecer isso ao telefone. Também não damos pareceres: nem de proteção de dados, nem de infeção, nem jurídicos. Damos as respostas técnicas para que quem os dá os possa dar depressa. ## Em resumo - **São seis sins**, e o primeiro é o do serviço que vai usar. - **De baixo para cima**, com os três técnicos em paralelo. - **Um documento por interlocutor.** - **Sem dono interno, não há projeto**, e nenhum fornecedor pode ocupar esse lugar. Q: Quem tem de autorizar realidade virtual num hospital? A: Na prática há seis aprovações: o serviço que vai usar, a direção do serviço ou departamento, a direção de enfermagem, a informática em conjunto com o encarregado de proteção de dados, o controlo de infeção (nos hospitais portugueses tipicamente o GCL-PPCIRA) e o aprovisionamento. Nenhuma substitui as outras. Q: Por onde se deve começar? A: Pelo serviço que vai usar, não pela administração. Sem um caso de uso concreto e alguém que o queira conduzir, as assinaturas de cima não sustentam o projeto. As conversas com informática, proteção de dados e controlo de infeção podem correr em paralelo, e a administração deve receber a decisão com esses pareceres já dados. Q: É preciso integrar com o sistema informático do hospital? A: Não. O sistema funciona de forma independente e corre na rede local da instituição, sem necessidade de integração com o sistema hospitalar existente. É habitualmente a resposta que desbloqueia mais depressa a conversa com a informática. ### Onde vive o equipamento entre sessões: a pergunta que nunca está no caderno de encargos URL: https://rver.pt/blog/onde-vive-o-equipamento-realidade-virtual-hospital/ Date: 20 August 2026 Os cadernos de encargos pedem resolução, peso e autonomia. Nenhum pergunta onde é que a coisa dorme, quem a carrega e de quem é a chave do armário, e é aí que se decide se vai ser usada. Já vimos projetos bem escolhidos, bem financiados e bem autorizados pararem por uma razão que nunca aparece em nenhuma proposta: **ninguém tinha decidido onde é que aquilo ficava.** O equipamento chega, é usado com entusiasmo duas semanas, e depois entra num ciclo previsível: fica sem bateria, alguém o guarda «por segurança» num sítio que só essa pessoa sabe, o turno seguinte não o encontra, e ao fim de um mês está numa gaveta. Não houve nenhuma decisão de o abandonar. Houve ausência de decisões pequenas. Vale a pena tomá-las antes da entrega. São cinco. ## 1. Onde carrega Parece trivial e não é. A pergunta real não é «tem tomada?», é **quem liga**. Um equipamento partilhado sem uma pessoa responsável por o pôr a carregar no fim do dia está sempre a 40% quando é preciso. As instituições que resolvem isto fazem sempre a mesma coisa: o carregamento entra na **rotina de fecho de turno**, como qualquer outra verificação, e não depende de quem se lembrar. Do nosso lado, a bateria de cada equipamento é visível na frota a partir do browser, o que muda a conversa de «acho que estava carregado» para uma percentagem à vista antes de alguém ir buscá-lo. [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## 2. Onde dorme, e quem tem a chave Um armário fechado é o mínimo, mas o problema raramente é roubo: é **disponibilidade**. Um equipamento trancado num gabinete que fecha às 17h não existe para o turno da noite. O equilíbrio que costuma funcionar: guarda fechada mas **acessível a todos os turnos que o vão usar**, e não à pessoa que o comprou. Vale a pena escrever quem tem acesso, em vez de deixar isso emergir. A parte de impedir uso indevido não tem de ser resolvida com a fechadura: o equipamento pode ficar **bloqueado por PIN**, de forma a que fora de uma sessão conduzida pela equipa não seja utilizável como um aparelho de consumo. Isso separa duas perguntas que normalmente andam coladas: o acesso físico e o uso. ## 3. Quem o transporta entre serviços É aqui que quase todas as partilhas entre serviços falham. Se dois serviços partilham o equipamento e ninguém definiu quem o move, ele fica onde estiver. Na prática só há dois modelos que funcionam: - **casa fixa.** O equipamento pertence a um serviço e os outros vão lá buscá-lo, com um registo simples de quem o levou; - **carrinho com dono.** O equipamento anda, mas há uma pessoa ou função responsável por saber onde está. O que não funciona é a partilha simétrica sem dono. Não é um problema de boa vontade: é que a responsabilidade dividida por dois serviços é responsabilidade de nenhum. ## 4. Higiene entre doentes Esta costuma estar pensada, porque o controlo de infeção pergunta. Fica só a ligação para o [procedimento](/blog/higiene-seguranca-equipamento-realidade-virtual/), e uma nota logística: o material de limpeza tem de estar **onde o equipamento está**, não no outro extremo do corredor. Uma rotina de higiene que obriga a uma caminhada é uma rotina que se degrada. ## 5. Fins de semana, férias e a pessoa que sai O teste honesto de um projeto: **funciona na semana em que a pessoa que o trouxe está de férias?** Se a resposta é não, ainda não há projeto: há um entusiasta. A correção é aborrecida e eficaz: duas pessoas formadas por turno em vez de uma, e o procedimento escrito onde o equipamento está, não num email de agosto. ## O que o sistema resolve, e o que não **Resolve:** ver a bateria e o estado de cada equipamento a partir do browser, sem ir ao sítio; bloquear o uso fora de sessão; conduzir a sessão a partir de um PC ou tablet na mesma rede, o que significa que quem comanda não tem de estar com o equipamento na mão. Isso e o [registo de cada sessão](/blog/acompanhamento-clinico-sessoes-realidade-virtual/), que também responde a «foi usado?» sem depender de memória. **Não resolve:** nada disto inventa um sítio. Não decide de quem é a chave, não transporta o equipamento entre pisos e não põe ninguém a carregá-lo. Um fornecedor que lhe diga que a plataforma trata da logística está a vender-lhe uma coisa que não existe: a logística é uma decisão da instituição, e é uma decisão de dez minutos se for tomada antes da entrega em vez de três meses depois. ## A lista de dez minutos Antes de o equipamento chegar, escreva as respostas a estas cinco: 1. Em que sala fica, e em que armário? 2. Quem tem acesso, em cada turno? 3. Quem o põe a carregar no fim do dia, por função e não por nome? 4. Se for partilhado, tem casa fixa ou dono? 5. Onde está o material de higiene? Cinco linhas coladas na porta do armário valem mais do que qualquer secção do caderno de encargos. ## Em resumo - **Um equipamento sem morada acaba numa gaveta**, e nunca por decisão. - **A carga entra na rotina de fecho de turno**, não na boa memória. - **Partilha sem dono não funciona**: casa fixa ou carrinho com dono. - **Se falha nas férias de uma pessoa**, é um entusiasta e não um projeto. Q: Onde se deve guardar o equipamento de realidade virtual num hospital? A: Em guarda fechada mas acessível a todos os turnos que o vão usar, e não apenas a quem o adquiriu. Um equipamento trancado num gabinete que fecha ao fim da tarde não existe para o turno da noite. Convém escrever quem tem acesso em vez de deixar isso emergir com o uso. Q: Como se evita que esteja sempre sem bateria? A: Pondo o carregamento na rotina de fecho de turno, atribuído a uma função e não a uma pessoa em concreto. No RVer a bateria de cada equipamento é visível na frota a partir do browser, o que permite verificar antes de ir buscá-lo em vez de descobrir no momento. Q: Dois serviços podem partilhar o mesmo equipamento? A: Podem, desde que haja casa fixa ou um dono. Ou o equipamento pertence a um serviço e os outros vão buscá-lo com registo, ou anda num carrinho com uma função responsável por saber onde está. A partilha simétrica sem dono definido é o modelo que falha. ### O que o sistema de saúde mede, e porque é que isto fica invisível URL: https://rver.pt/blog/o-que-o-sistema-de-saude-mede-e-o-que-fica-invisivel/ Date: 20 August 2026 Um sistema faz aquilo que mede. Não por cinismo: porque medir é a única forma de prestar contas a quem paga. O problema é o que fica de fora da folha, e o que acontece a quem trabalha nesse lado. Um serviço de saúde presta contas por números, e os números são poucos e antigos: **demora média de internamento, taxa de ocupação, tempos de resposta, produção: consultas, cirurgias, exames.** Em Portugal, os tempos máximos de resposta garantidos e as metas de produção estruturam boa parte do que um hospital tem de reportar. Nenhum destes indicadores vê se alguém teve medo. ## Isto não é uma queixa da gestão Convém dizê-lo porque a crítica fácil é injusta. Estes indicadores existem por uma razão boa: são **auditáveis**. Contam-se da mesma maneira em Bragança e em Faro, não dependem de quem os regista, e permitem comparar. Um sistema público que gasta dinheiro de todos precisa exatamente disso. O problema não é os indicadores serem maus. É serem **incompletos de uma forma enviesada**: o que é fácil de contar entra, o que é difícil de contar fica de fora, e depois passa a parecer que o que ficou de fora não existe. ## O que fica de fora - Se o doente **teve medo** durante o exame. - Se a hora antes da cirurgia foi passada em pânico ou em calma. - Se a pessoa com demência **passou a tarde agitada** ou tranquila. - Se a família esteve presente ou ficou de fora. - Se alguém foi tratado com **dignidade** no pior dia da sua vida. Nada disto é um indicador. Portanto nada disto compete por orçamento, aparece num contrato-programa ou justifica uma decisão de investimento. ## A consequência prática É aqui que deixa de ser filosofia. Uma intervenção que melhore **apenas o que é invisível** não tem como se justificar dentro do sistema, mesmo que funcione. Não é rejeitada: é **incomparável**, o que na prática é pior, porque nem sequer entra na lista onde as coisas são decididas. É a mesma família de problema do orçamento por silos, que descrevemos em [quem paga não é quem poupa](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/): ali o benefício existe mas aterra no bolso errado; aqui existe e não aterra em lado nenhum, porque não há linha onde o pousar. E há um efeito secundário mais desagradável: **quem trabalha no lado invisível fica sem linguagem.** Uma equipa de paliativos, um lar, um serviço que cuida bem não tem números que digam isso. Fica a defender o seu trabalho com adjetivos, contra departamentos que se defendem com tabelas. ## O que se pode contar, de facto Não temos solução para o problema grande, e desconfie de quem tiver. Temos três observações úteis. **1. Contar o que se fez é possível, e é mais do que existia.** Cada sessão de qualquer intervenção não farmacológica pode ficar [registada](/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/): quando, com quem, quanto tempo, se foi interrompida. Ao fim de meses é uma série temporal. Não prova efeito. Permite discutir com dados em vez de impressões. **2. Os instrumentos de experiência do doente existem e são pouco usados.** Os PREM, medidas reportadas pelo doente sobre a experiência, são a única família de indicadores que olha para este lado, e a maior parte das instituições não os aplica. É uma decisão da instituição, não uma limitação da tecnologia, e é provavelmente a coisa mais eficaz que uma direção pode fazer aqui. **3. Distinguir sempre atividade de resultado.** «Fizemos 340 sessões» é atividade. Não é um desfecho clínico, e apresentá-lo como se fosse é o erro que mais desacredita quem trabalha neste lado. Desenvolvemos isso em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## Onde nós paramos Sendo específicos, porque é aqui que a indústria se porta pior: - **O RVer não mede estado emocional.** Não há pontuação de bem-estar, não há índice de conforto, não há inferência de humor a partir de nada. - **Um fornecedor que lhe venda um «índice de bem-estar» calculado pelo equipamento está a inventar um indicador**, e a inventá-lo precisamente porque o mercado precisa de um. Um número inventado é pior do que nenhum, porque desloca a conversa e não se pode auditar. - **Não conseguimos tornar o conforto num indicador.** Ninguém consegue, para já. O que existe é o registo do que a equipa fez e observou, com as palavras dela. ## Em resumo - **O sistema mede o que é auditável**, e tem razões boas para isso. - **Conforto, medo e dignidade não são indicadores**, portanto não competem. - **Uma intervenção só do lado invisível não é rejeitada: é incomparável.** - **Contar sessões não é medir resultado**, e trocar as duas coisas desacredita quem o faz. - **Desconfie de qualquer pontuação de bem-estar** produzida por um equipamento. Q: Que indicadores estruturam o financiamento de um hospital? A: Sobretudo indicadores auditáveis e comparáveis: demora média de internamento, taxa de ocupação, tempos de resposta e volumes de produção como consultas, cirurgias e exames. Existem por uma boa razão, contam-se da mesma maneira em qualquer instituição, mas não captam a experiência do doente. Q: Porque é que intervenções de conforto têm dificuldade em ser financiadas? A: Porque melhoram sobretudo aquilo que o sistema não mede. Não são rejeitadas por análise: ficam incomparáveis, sem linha onde apresentar o benefício, e por isso não entram na lista onde as decisões de investimento são tomadas. Q: O RVer mede bem-estar ou conforto do doente? A: Não. Não existe pontuação de bem-estar, índice de conforto nem inferência de estado emocional. O que existe é o registo do que a equipa fez e observou, escrito por ela. Um fornecedor que apresente um índice de bem-estar calculado pelo equipamento está a inventar um indicador. ### A imobilidade custa mais do que a doença que trouxe o doente URL: https://rver.pt/blog/imobilidade-no-internamento-o-custo-de-estar-parado/ Date: 20 August 2026 Um doente entra por uma coisa e sai pior de outra. A perda de função durante o internamento é das coisas mais caras que acontecem num hospital e das que menos aparecem em qualquer relatório. Há uma conta que quase nenhum hospital faz, e é das que mais pesa. Um doente é internado por uma pneumonia, uma fratura, uma descompensação. O problema que o trouxe é tratado. E, entretanto, aconteceu outra coisa: passou dias na cama, e a perda de função que isso provoca pode ser maior e mais duradoura do que o episódio agudo. ## Os números, com as ressalvas devidas A literatura de repouso no leito é consistente na direção e muito variável na magnitude, portanto convém dar intervalos e não certezas: - **Perda de força** entre cerca de 1% e 3% por dia de repouso, com valores mais altos referidos em pessoas mais velhas. - **Perda de massa muscular** que se acumula depressa nos primeiros dias, e que em pessoas mais velhas imobilizadas vários trabalhos situam numa ordem de grandeza de vários pontos percentuais ao fim de uma semana. - **A recuperação não é simétrica.** É frequentemente citado que cada dia de repouso absoluto pode exigir até duas semanas de recondicionamento para voltar ao ponto de partida. Esse último ponto é o que muda a conversa. **Perde-se em dias e recupera-se em semanas**, e o que se perde primeiro são precisamente os músculos antigravíticos: os de levantar da cadeira, de subir um degrau, de ficar de pé. Que são os que decidem se alguém volta para casa ou vai para uma instituição. ## Onde isto custa dinheiro ao sistema A fatura não aparece na linha «imobilidade». Aparece espalhada: - **Mais dias de cama**, porque a alta depende de função e não só do problema agudo; - **Destino de alta pior**: para cuidados continuados ou para uma instituição, em vez de casa. É a diferença mais cara de todas, e é para sempre; - **Quedas**, no internamento e nas semanas seguintes, com o que se lhes segue; - **Readmissões**, com um doente que saiu mais frágil do que a doença justificava; - **Carga de cuidados** que passa para a família, e que ninguém contabiliza. E nenhuma destas linhas pertence ao orçamento do serviço onde o doente esteve parado: o que é exatamente o problema que descrevemos em [quem paga não é quem poupa](/blog/quem-paga-nao-e-quem-poupa-orcamentos-saude/). ## Porque é que é tão difícil resolver Não é por ignorância. Toda a gente num serviço sabe que é melhor levantar o doente. O que falta é **tempo de equipa**, que é o recurso mais escasso que um hospital tem, e que a mobilização consome muito: são duas pessoas, dez minutos, várias vezes ao dia, para uma coisa que não é urgente hoje e cujo benefício aparece daqui a duas semanas noutro sítio. A segunda dificuldade é a adesão. Muitos doentes não querem. Está cansado, tem dor, não vê o objetivo, e o exercício orientado é aborrecido de uma forma que não ajuda ninguém a repeti-lo. ## Onde a realidade virtual entra, com todas as ressalvas Vamos ser exatos, porque esta é uma zona onde é fácil vender de mais. **O que a realidade virtual não faz:** - **Não mobiliza ninguém.** Não levanta um doente da cama. - **Não substitui um fisioterapeuta** nem um protocolo de mobilização precoce. - **Sobre tempo de internamento, a evidência é inconsistente.** Há trabalhos que o mediram e os resultados não são concordantes, uma meta-análise em cuidados intensivos não encontrou diferença significativa na demora, e as análises económicas que mostram poupança *assumem* essa redução como premissa do modelo, uma delas fixando o limiar em 14,6%. - **As intervenções com melhor sustentação neste problema** são protocolos de mobilização e dotação de fisioterapia. - **Se tiver de escolher entre um fisioterapeuta e um visor, escolha o fisioterapeuta**, dizemo-lo enquanto fabricante de visores. **O que pode fazer:** tornar o movimento orientado mais aceitável para quem o recusa. A hipótese, e é uma hipótese, é que um exercício com um objetivo visível seja repetido mais vezes do que um exercício sem ele, e a adesão é metade do problema. Já escrevemos sobre [adesão à fisioterapia em idosos](/blog/realidade-virtual-fisioterapia-idosos-adesao/). **Uma ressalva regulatória que não se pode saltar:** o apoio ao movimento orientado é o **RVer Motion**, um módulo **em desenvolvimento e não abrangido pelo registo de dispositivo médico Classe I**, que cobre o produto base. Quem lhe apresentar o módulo como parte do dispositivo registado está a induzi-lo em erro. E para quem não se levanta de todo, o que existe é outra coisa e não se deve confundir com reabilitação: conforto e presença, com o [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/) a alinhar o horizonte para quem está reclinado. ## O que medir, se quiser mesmo saber Não meça tempo de internamento: tem demasiadas causas e nunca vai conseguir atribuir a diferença. Meça o que está mais perto: - **sessões de mobilização propostas e realizadas**, com e sem o sistema; - **recusas**, que é onde o efeito, a existir, aparece primeiro; - **função na alta** com um instrumento simples e consistente. Nenhuma destas prova efeito clínico. Todas lhe dizem se a coisa está a ser usada e se a adesão mudou, que é o que um piloto consegue responder: o resto está em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## Em resumo - **Perde-se em dias, recupera-se em semanas**, e primeiro vão os músculos de levantar. - **A fatura aparece no destino de alta**, não na linha da imobilidade. - **A realidade virtual não mobiliza ninguém** e não substitui fisioterapia. - **Onde pode ajudar é na adesão**, e o módulo que a suporta está em desenvolvimento e fora do registo. Q: Quanta força se perde por dia de repouso no leito? A: A literatura aponta perdas na ordem de 1% a 3% por dia, com valores mais altos referidos em pessoas mais velhas, e a perda concentra-se nos músculos antigravíticos: os de levantar da cadeira e ficar de pé. É frequentemente citado que cada dia de repouso absoluto pode exigir até duas semanas de recondicionamento para regressar ao ponto de partida. Q: A realidade virtual reduz o tempo de internamento? A: A evidência é inconsistente e não o afirmamos. Há trabalhos que mediram tempo de internamento e os resultados não são concordantes, uma meta-análise em cuidados intensivos não encontrou diferença significativa na demora, e as análises económicas que mostram poupança assumem essa redução como premissa do modelo. As intervenções com melhor sustentação contra o descondicionamento hospitalar são protocolos de mobilização precoce e dotação de fisioterapia. Onde a realidade virtual pode contribuir é na adesão ao movimento orientado, que é uma parte do problema e não a solução dele. Q: O apoio ao exercício faz parte do dispositivo registado? A: Não. O apoio ao movimento orientado é o módulo RVer Motion, que está em desenvolvimento e não é abrangido pelo registo de dispositivo médico Classe I no INFARMED e na EUDAMED, o qual cobre o produto base. Qualquer apresentação que junte os dois está a induzir em erro. ### Precisa de parecer da comissão de ética para usar realidade virtual? URL: https://rver.pt/blog/comissao-de-etica-realidade-virtual-quando-e-preciso/ Date: 20 August 2026 É das primeiras perguntas que aparece, e costuma vir com a resposta já formada, em qualquer das duas direções. Ambas as certezas estão erradas com a mesma frequência. Duas respostas circulam, e são as duas perigosas. Uma diz «isto é um equipamento, é como comprar um cadeirão, não precisa de nada». A outra diz «é tecnologia com doentes, tem de ir à comissão de ética». Consoante o caso, qualquer uma pode estar certa, e é por isso que a pergunta útil é outra. ## A pergunta que separa tudo **Está a cuidar de um doente, ou está a produzir conhecimento?** É esta fronteira que decide, e não o facto de haver tecnologia envolvida. **Cuidado assistencial.** Usar um dispositivo médico registado, dentro da [finalidade prevista](/blog/dispositivo-medico-classe-1-realidade-virtual/), com um doente concreto, porque a equipa entende que lhe faz bem naquele momento, é uma decisão clínica. Do mesmo tipo que escolher pôr música, mudar a iluminação ou chamar a família. Não gera, por si, necessidade de parecer de comissão de ética. **Investigação.** A partir do momento em que existe um **protocolo**, um **objetivo de conhecimento** e recolha de dados **para além do que o cuidado exige**, mudou de categoria. E aí é matéria de comissão de ética, com o enquadramento próprio da investigação clínica, que para dispositivos médicos tem regras específicas ao abrigo do MDR (Regulamento (UE) 2017/745) e, em Portugal, a intervenção da comissão de ética competente. [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## O que muda de lado sem se dar por isso Na prática, quase nunca alguém decide «vamos fazer investigação». Escorrega-se para lá. Os gatilhos mais comuns: - **decidir publicar.** Um pósteres num congresso é divulgação de conhecimento. Se os dados vieram de doentes, a pergunta ética aparece, mesmo que a recolha tenha sido feita a pensar noutra coisa; - **alocar doentes** a receber ou não receber, para comparar. Isto é desenho de estudo, mesmo quando informal; - **aplicar escalas** que não se aplicariam de outra forma, ou aplicá-las em momentos definidos por um protocolo e não pelo cuidado; - **usar fora da finalidade prevista** do dispositivo; - **recolher dados sistematicamente** com um formulário próprio, para análise posterior. Nenhum destes gatilhos é proibido. Só mudam o processo, e mudá-lo depois de começar é onde as pessoas se magoam. ## A armadilha do piloto É o caso mais frequente e vale a pena dizê-lo com todas as letras. Um serviço faz um [piloto](/blog/piloto-realidade-virtual-hospital-como-correr/) para decidir se compra. Correu bem. Alguém diz: «isto dava um artigo». E aí descobre-se que os dados foram recolhidos sem enquadramento de investigação, sem consentimento para esse fim e sem parecer. **Um parecer não se obtém retroativamente para dados já recolhidos como se nada fosse.** Mesmo o uso retrospetivo de dados de rotina para publicação costuma exigir parecer da comissão de ética da instituição e uma base de licitude ao abrigo do RGPD. A prevenção é barata e dura cinco minutos: **antes de começar o piloto, decida se vai querer publicar.** Se a resposta for «talvez», trate disso como investigação desde o início. É muito mais fácil ter um parecer que não chega a ser usado do que produzir dados que não se podem usar. ## Consentimento não é a mesma coisa Convém não confundir dois consentimentos que vivem em planos diferentes: - o **consentimento para a sessão**: informar o doente do que vai acontecer, do que pode sentir e de que pode parar a qualquer momento. Isto aplica-se sempre, e já o [desenvolvemos noutro artigo](/blog/consentimento-informado-realidade-virtual-saude/); - o **consentimento informado de investigação**: específico, escrito, aprovado no âmbito do protocolo. Ter o primeiro não dispensa o segundo. E o segundo não substitui o primeiro. ## O que a comissão vai perguntar Se for por esse caminho, as perguntas são previsíveis, e prepará-las acelera tudo: qual é o desenho, quem são os participantes e como são selecionados, que dados se recolhem e porquê, que riscos existem e como se mitigam, como se obtém e regista o consentimento, quem tem acesso aos dados e por quanto tempo, e o que acontece se o participante desistir. Repare que quase todas são sobre **dados e sobre pessoas**, não sobre a tecnologia. É o erro de preparação mais comum: leva-se uma explicação técnica do equipamento a uma comissão que quer falar de participantes. ## O que não fazemos **Não damos pareceres de ética, e desconfie de qualquer fornecedor que lhe diga com segurança que «não precisa».** Não somos a comissão de ética da sua instituição, não conhecemos o seu protocolo, e isto não é aconselhamento jurídico. Quem decide se o seu caso é assistencial ou investigação é a instituição, e em dúvida a própria comissão, que costuma responder depressa a uma pergunta bem feita. O que fazemos é dar-lhe o que ela vai pedir sobre o sistema: o que regista, onde ficam os dados, o que sai da instituição, e a finalidade prevista escrita. ## Em resumo - **Cuidar não é investigar**, e é isso que decide. - **Uso assistencial dentro da finalidade prevista** é decisão clínica. - **Publicar, alocar, aplicar escalas por protocolo** ou recolher dados sistematicamente muda o processo. - **Decida antes do piloto** se vai querer publicar. - **Em dúvida, pergunte à comissão.** É mais barato do que a alternativa. Q: Preciso de parecer da comissão de ética para usar realidade virtual com doentes? A: Se o uso é assistencial (um dispositivo médico registado, usado dentro da finalidade prevista, por decisão clínica da equipa e para benefício daquele doente), trata-se de uma decisão clínica e não gera, por si, necessidade de parecer. Se existir um protocolo, um objetivo de conhecimento e recolha de dados para além do que o cuidado exige, é investigação e passa a ser matéria de comissão de ética. Q: Fiz um piloto e agora quero publicar os resultados. Posso? A: Não sem enquadramento. Um parecer não se obtém retroativamente para dados recolhidos fora de um contexto de investigação, e mesmo o uso retrospetivo de dados de rotina para publicação costuma exigir parecer da comissão de ética da instituição e uma base de licitude ao abrigo do RGPD. Se houver hipótese de querer publicar, trate o piloto como investigação desde o início. Q: O consentimento para a sessão chega? A: Não, são coisas diferentes. Informar o doente sobre a sessão, o que pode sentir e que pode parar a qualquer momento aplica-se sempre. O consentimento informado de investigação é específico, escrito e aprovado no âmbito do protocolo. Um não dispensa o outro. ### Como correr um piloto de realidade virtual num serviço de saúde URL: https://rver.pt/blog/piloto-realidade-virtual-hospital-como-correr/ Date: 16 August 2026 Quase todas as instituições querem experimentar antes de decidir, e poucas definem o que é experimentar. É por isso que tantos pilotos acabam sem conclusão. Quase todas as instituições querem experimentar antes de decidir. Poucas definem o que é experimentar, e é por isso que tantos pilotos acabam sem conclusão, com o equipamento a voltar para a caixa e ninguém a saber dizer porquê. Um piloto não é «ter os headsets cá uns tempos». É uma pergunta com data de resposta. ## Antes de começar: escreva a pergunta Um piloto tem de poder falhar. Se não houver um resultado que faça a instituição dizer «não avançamos», não é um piloto: é uma demonstração prolongada. Escreva uma frase, e ponha-a por escrito antes de o equipamento chegar. Por exemplo: *«Ao fim de oito semanas, queremos saber se a equipa do serviço consegue integrar sessões na rotina sem que isso lhe custe tempo que não tem.»* Repare no que essa frase **não** diz. Não diz «queremos provar que reduz a ansiedade». Um piloto de oito semanas num serviço não tem desenho, dimensão nem grupo de comparação para responder a isso, e prometer que responde é a forma mais rápida de acabar com um relatório que ninguém pode usar. [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## O que um piloto consegue mesmo responder Estas são perguntas de **implementação**, e um piloto responde-lhes bem: - **A equipa usa?** É a pergunta número um, e a que mais pilotos reprova. - **Quanto tempo demora,** na verdade, montar e conduzir uma sessão? - **Onde é que encrava?** Higienização, carregamento, Wi-Fi, quem vai buscar o equipamento, onde é que ele dorme. - **Os utentes aceitam?** Quantos recusam, quantos param a meio, e porquê. - **Quem é que assume o papel?** Quase sempre há uma pessoa que agarra aquilo. Ou não há, e isso é a resposta. ## O que um piloto não consegue responder Vale a pena dizê-lo à cabeça, para não haver desilusão no fim: - **Eficácia clínica.** Sem grupo de comparação, sem aleatorização e com dezenas de sessões, não há conclusão de eficácia a tirar. Isso são ensaios, e são outra coisa. - **Retorno financeiro a sério.** Oito semanas não mostram poupança anual. - **Efeito a longo prazo.** Por definição. :::note Desconfie de um fornecedor que lhe proponha um piloto com objetivos de resultado clínico. Ou não percebeu o desenho de estudo, ou percebeu e está a contar que não perceba. ::: ## Um desenho que funciona **Duração: seis a oito semanas.** Menos não chega para passar a novidade; mais e o piloto perde-se na rotina sem nunca ser avaliado. **Âmbito: um serviço, não três.** Um piloto espalhado por três alas produz três meias-experiências e nenhuma conclusão. **Pessoas: nomes, não «a equipa».** Duas ou três pessoas designadas, com formação feita antes de começar. Equipamento que é responsabilidade de toda a gente acaba no armário: é o padrão mais previsível que existe nisto. **Um ponto de decisão marcado no calendário**, com data, antes de o piloto começar. Sem essa data, o piloto não termina: dissolve-se. ## O que medir, e como Poucas coisas, e simples: 1. **Sessões realizadas por semana.** A curva diz quase tudo. Se sobe e estabiliza, entrou na rotina. Se sobe e cai, não entrou. 2. **Quem as conduziu.** Se for sempre a mesma pessoa, o serviço não adotou: uma pessoa adotou. 3. **Tempo por sessão**, incluindo montar e limpar. É o número que decide se é sustentável. 4. **Recusas e interrupções,** com o motivo em duas palavras. 5. **Uma frase de quem conduziu,** no fim de cada semana. Vale mais do que qualquer painel. O RVer regista automaticamente as sessões e o que correu em cada uma, e a app Companion permite que uma pessoa acompanhe vários equipamentos, o que reduz o esforço de recolher os pontos 1 e 3. O resto é conversa com a equipa. ## Antes de assinar: as perguntas que ficam No fim, três perguntas resolvem a decisão: - **A curva de sessões estabilizou** num nível que faz sentido para o serviço? - **Mais do que uma pessoa** conduziu sessões com à-vontade? - **O que encravou** tem solução conhecida, ou é estrutural? Se as três respostas forem boas, o caso de negócio faz-se sozinho. Se não forem, o piloto poupou-lhe uma compra, que é exatamente para o que serve. ## Como corremos os nossos O equipamento chega configurado e a formação está incluída, o sistema funciona sem internet durante a sessão, e as sessões ficam registadas para a equipa interpretar. Não prometemos resultado clínico num piloto, e se alguém do nosso lado o prometer, diga-nos. Sobre quem pode conduzir as sessões durante o piloto, escrevemos à parte em [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Sobre o que perguntar antes disso, em [como escrever um caderno de encargos](/blog/caderno-de-encargos-realidade-virtual-saude/). Q: Quanto tempo deve durar um piloto de realidade virtual? A: Seis a oito semanas, num único serviço. Menos não chega para passar o efeito de novidade e perceber se as sessões entram mesmo na rotina; mais e o piloto dissolve-se no dia a dia sem nunca ser avaliado. O essencial é marcar no calendário, antes de começar, a data do ponto de decisão. Q: O que se deve medir num piloto de realidade virtual? A: Sessões realizadas por semana (a curva diz quase tudo), quem as conduziu, tempo por sessão incluindo montar e limpar, recusas e interrupções com o motivo, e uma frase de quem conduziu no fim de cada semana. Poucas coisas e simples valem mais do que um painel complexo que ninguém preenche. Q: Um piloto prova que a realidade virtual funciona? A: Não, e é importante não o prometer. Sem grupo de comparação, sem aleatorização e com algumas dezenas de sessões não há conclusão de eficácia clínica a tirar: isso são ensaios clínicos, que são outra coisa. Um piloto responde a perguntas de implementação: a equipa usa, quanto tempo demora, onde encrava, se os utentes aceitam. Q: Qual é o erro mais comum num piloto? A: Não designar pessoas com nome. Equipamento que é responsabilidade de toda a gente não é responsabilidade de ninguém e acaba no armário: é o padrão mais previsível nesta área. O segundo erro é espalhar o piloto por vários serviços, o que produz várias meias-experiências e nenhuma conclusão. ### A realidade virtual faz mal? Efeitos secundários, riscos e contraindicações URL: https://rver.pt/blog/realidade-virtual-faz-mal-efeitos-secundarios/ Date: 16 August 2026 Fazem-na famílias, enfermeiros e direções clínicas, e merece uma resposta direta: o que está descrito, o que não está, e as situações concretas em que se recomenda precaução. A pergunta aparece sempre, e quase sempre com a mesma redação: **isto faz mal?** Fazem-na famílias antes de deixarem um pai experimentar, enfermeiros antes de proporem a um doente, e direções clínicas antes de assinarem um contrato. Merece uma resposta direta, e não uma brochura. **Resposta curta:** para a grande maioria das pessoas, uma sessão de realidade virtual conduzida por alguém com formação é bem tolerada. O efeito indesejado mais comum é o enjoo, é temporário, e há maneiras conhecidas de o reduzir. Há um conjunto pequeno e específico de situações em que se recomenda precaução ou avaliação clínica prévia: estão listadas mais abaixo, sem rodeios. ## O enjoo é o efeito mais comum, e o mais evitável Chama-se *cybersickness* e parece-se com o enjoo de viagem: náusea, tontura, suor frio, por vezes dor de cabeça. Aparece quando o que os olhos veem não corresponde ao que o ouvido interno sente. É por isso que o **tipo de conteúdo importa mais do que o equipamento**. Vídeo 360° gravado de um ponto fixo, sem movimento de câmara brusco, é muito menos provável de provocar enjoo do que um ambiente gerado por computador em que o utilizador se desloca. Sessões curtas, pessoa sentada e possibilidade de parar a qualquer momento fazem o resto. Se acontecer: tirar o headset, ficar sentado, esperar. Passa. ## E os olhos? É o receio mais repetido e o que tem menos fundamento estabelecido. O que está descrito na literatura é **fadiga visual temporária**: a mesma que se tem depois de horas ao computador. Não existe hoje evidência estabelecida de dano permanente à visão provocado por uso normal de um visor destes. Dito isto, é uma área ainda em estudo, sobretudo em crianças, e é precisamente por isso que o fabricante do equipamento publica as suas próprias [recomendações de saúde e segurança](https://www.meta.com/legal/quest/health-and-safety-warnings/) e que os limites de idade existem. ## Epilepsia fotossensível: o aviso a levar a sério Uma percentagem muito pequena da população tem crises desencadeadas por luzes intermitentes ou padrões. Este aviso não é específico da realidade virtual, vem dos videojogos e da televisão, mas aplica-se. Quem tenha epilepsia não controlada ou historial de crises fotossensíveis não deve usar sem avaliação clínica prévia. Não é uma formalidade. ## Pessoas idosas: o risco real é a queda, não o ecrã Com pessoas idosas, o que preocupa não é a imagem: é o equilíbrio. Alguém de pé, com o campo de visão ocupado, pode desorientar-se. A resposta é simples e é operacional, não tecnológica: **sessão sentada, sempre acompanhada**. É também por isso que existe [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/): para quem está acamado ou reclinado poder ter a experiência sem se levantar. ## Crianças e adolescentes Os fabricantes de equipamento definem limites de idade próprios, e há razões de desenvolvimento visual por trás disso. No caso do RVer, a resposta pública é que **não se destina a menores de 10 anos**. ## Higiene Um equipamento partilhado entre utentes precisa de [rotina de limpeza](/ferramentas/higiene/) entre sessões, com atenção às zonas de contacto com a pele. Não é um risco exótico: é a mesma lógica de qualquer material clínico reutilizável. ## As situações em que recomendamos precaução Estas estão publicadas e são as mesmas que constam da nossa [página de perguntas frequentes](https://rver.pt/faq/): - historial de enjoo de movimento grave ou perturbações vestibulares; - epilepsia não controlada ou perturbações convulsivas fotossensíveis; - incapacidade de seguir instruções de segurança por défice cognitivo grave. Em caso de dúvida, a decisão é sempre do profissional de saúde responsável. Os passos de segurança de cada contexto estão nos [guias de implementação](/guia/). :::note Uma lista de contraindicações publicada não é um sinal de que o produto é perigoso. É o contrário: é o mínimo que se deve exigir a quem vende tecnologia para usar com doentes. Desconfie de quem não tem nenhuma. ::: ## O que muda quando é um dispositivo médico registado Um registo não torna nada mágico. O que muda é concreto: existe documentação técnica, existe avaliação de risco, existe um fabricante identificado e responsável, e existe um caminho formal para comunicar um incidente: ao fabricante e ao [Infarmed](https://www.infarmed.pt/web/infarmed/entidades/dispositivos-medicos/colocacao-no-mercado). O produto base do RVer está registado como dispositivo médico de Classe I no INFARMED, com o n.º CDM 94571546, e na EUDAMED, com o Basic UDI-DI 56006195127RVERTZ, e ostenta marcação CE ao abrigo do MDR 2017/745. Uma aplicação de entretenimento descarregada numa loja não tem nada disto: o que não a torna perigosa, torna-a apenas outra coisa. ## Em resumo 1. **Enjoo**: o efeito mais comum, temporário, muito reduzido por conteúdo filmado e sessão sentada. 2. **Olhos**: fadiga temporária está descrita; dano permanente não está. 3. **Epilepsia fotossensível**: o aviso a levar a sério. 4. **Idosos**: o risco é a queda: sentado e acompanhado. 5. **Contraindicações**: publicadas, curtas e específicas. O RVer é utilizado sob supervisão de profissionais de saúde ou cuidadores com formação, como complemento não farmacológico. Não se destina a autoadministração e não substitui avaliação nem julgamento clínico. Q: A realidade virtual faz mal aos olhos? A: O que está descrito na literatura é fadiga visual temporária, semelhante à de horas ao computador. Não existe hoje evidência estabelecida de dano permanente à visão provocado por uso normal de um visor destes. É uma área ainda em estudo, sobretudo em crianças, e por isso os fabricantes de equipamento publicam recomendações próprias e definem limites de idade. Q: Quais são os efeitos secundários mais comuns da realidade virtual? A: O mais comum é o enjoo (náusea, tontura, por vezes dor de cabeça) que acontece quando o que os olhos veem não corresponde ao que o ouvido interno sente. É temporário e passa depois de tirar o headset. Reduz-se muito com vídeo 360° filmado de um ponto fixo, sessões curtas e a pessoa sentada. Q: A realidade virtual é segura para pessoas idosas? A: Na grande maioria dos casos sim, com uma precaução operacional: a sessão deve ser feita sentada e sempre acompanhada. Com pessoas idosas o risco relevante não é a imagem, é o equilíbrio: alguém de pé, com o campo de visão ocupado, pode desorientar-se. Existe também modo deitado, para quem está acamado ou reclinado. Q: Quem não deve usar realidade virtual? A: Recomenda-se precaução ou avaliação clínica prévia a quem tenha historial de enjoo de movimento grave ou perturbações vestibulares, epilepsia não controlada ou perturbações convulsivas fotossensíveis, ou incapacidade de seguir instruções de segurança por défice cognitivo grave. O RVer não se destina a menores de 10 anos. Em caso de dúvida, a decisão cabe ao profissional de saúde responsável. Q: O enjoo da realidade virtual é permanente? A: Não. O enjoo de movimento na realidade virtual é passageiro: as náuseas, as tonturas ou o mal-estar costumam aliviar pouco depois de tirar o headset e ficar sentado a descansar. Se os sintomas não passarem, deve procurar um médico. ### Quem pode conduzir uma sessão de realidade virtual com utentes? URL: https://rver.pt/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/ Date: 16 August 2026 Um lar quer saber se uma auxiliar pode fazê-lo. Uma clínica quer saber se precisa do fisioterapeuta na sala. Ninguém quer descobrir a resposta depois de comprar. É a pergunta que aparece sempre a seguir a «quanto custa», e quase nunca está respondida em lado nenhum: **quem é que pode, na prática, pôr o headset num utente e conduzir a sessão?** Um lar quer saber se uma auxiliar de ação direta pode fazê-lo. Uma clínica quer saber se precisa do fisioterapeuta presente na sala. Um hospital quer saber quem assina. E ninguém quer descobrir a resposta depois de comprar. ## A resposta curta O utilizador previsto do RVer são **profissionais de saúde e cuidadores com formação**. A sessão é sempre acompanhada. O sistema **não se destina a autoadministração**: não é para se deixar o equipamento com o utente e voltar mais tarde. Dentro disso, quem conduz a sessão em concreto é uma decisão da instituição, não do fornecedor. E há uma boa razão para isso. [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## Porque é que a resposta não pode vir do fornecedor A finalidade prevista do produto define o **tipo** de utilizador. Não define, nem pode, o organigrama de um serviço. Quem pode fazer o quê dentro de uma instituição de saúde depende do enquadramento profissional de cada carreira, das regras internas de governação clínica e da responsabilidade de quem dirige o serviço. Um fabricante de equipamento que respondesse «pode ser qualquer pessoa» estaria a dizer algo que não lhe compete dizer, e a passar-lhe o risco à frente. O que compete ao fabricante é ser claro sobre três coisas: para que serve, quem é o utilizador previsto, e o que o produto não faz. O resto é decisão clínica. :::note Isto não é aconselhamento jurídico nem sobre âmbito profissional. A decisão sobre quem conduz sessões pertence à direção clínica da instituição, que conhece as suas carreiras, os seus protocolos e a sua responsabilidade. ::: ## O que a sessão exige, na prática Vale a pena separar «conduzir uma sessão» do que as pessoas imaginam. Na prática, quem conduz precisa de: - **Saber escolher o conteúdo** adequado ao momento e à pessoa; - **Reconhecer as contraindicações** e saber quando não avançar; - **Perceber os sinais de desconforto** (enjoo, cansaço, desorientação) e parar; - **Higienizar o equipamento** entre utentes; - **Saber parar à distância**, se estiver a gerir mais do que um equipamento. Nada disto é uma competência clínica avançada. É formação específica sobre um equipamento, que faz parte da licença e é dada na instituição. ## O que decidir antes de comprar Três decisões que valem mais do que qualquer funcionalidade: 1. **Quem são as pessoas designadas.** Não «a equipa»: nomes. Um equipamento que é responsabilidade de toda a gente não é responsabilidade de ninguém, e acaba no armário. 2. **Quem decide o que é adequado a cada utente.** Escolher conteúdo para alguém com demência avançada não é o mesmo que escolher para alguém em diálise. Essa decisão tem dono. 3. **O que fica registado, e quem o lê.** O registo de sessão é matéria-prima para a equipa interpretar: não é um relatório que decide nada sozinho. ## Uma pessoa pode gerir vários equipamentos A app Companion abre no browser de qualquer PC ou tablet na mesma rede, sem instalar nada. Cada equipamento aparece como um cartão: escolher cenário, reproduzir, pausar, atribuir utente, e uma paragem de emergência à distância. Isto muda a resposta à pergunta original de uma forma prática: não é preciso um profissional por equipamento. É preciso **um responsável pela sessão**, que pode estar a acompanhar mais do que uma ao mesmo tempo, desde que as pessoas estejam acompanhadas na sala. ## E o registo de dispositivo médico, diz alguma coisa sobre isto? Diz o essencial e nada além disso. O produto base está registado como dispositivo médico de Classe I no INFARMED, com o n.º CDM 94571546, e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. A documentação que acompanha o registo identifica o **utilizador previsto** (profissionais de saúde e cuidadores com formação) e exclui a autoadministração. O que o registo **não** faz é dizer a um hospital português qual das suas carreiras profissionais pode operar o equipamento. Isso nunca esteve no âmbito de um registo de dispositivo, e desconfie de quem lhe disser o contrário. O [manual de utilização](https://rver.pt/manual/) está público e diz isto por extenso, incluindo as contraindicações e a via para comunicar um incidente grave. ## Em resumo - **Utilizador previsto:** profissionais de saúde e cuidadores com formação. - **Nunca autoadministração.** O utente está sempre acompanhado. - **Quem em concreto:** decisão da instituição, não do fornecedor. - **Formação:** incluída na licença. - **Uma pessoa, vários equipamentos:** possível pelo Companion. Q: Preciso de ser terapeuta para usar realidade virtual com utentes? A: O utilizador previsto do RVer são profissionais de saúde e cuidadores com formação, e a sessão é sempre acompanhada. Quem em concreto conduz a sessão dentro de uma instituição é decisão da direção clínica, que conhece o enquadramento profissional das suas carreiras e a sua própria governação, e não é o fornecedor que o define. Q: Uma auxiliar de ação direta pode conduzir uma sessão? A: A finalidade prevista abrange cuidadores com formação, portanto não está excluído à partida. Mas a decisão pertence à instituição: depende das regras internas, do enquadramento de cada carreira e de quem assume a responsabilidade clínica. Um fabricante que respondesse «pode qualquer pessoa» estaria a dizer o que não lhe compete. Q: O utente pode usar sozinho? A: Não. O sistema não se destina a autoadministração e o utente está sempre acompanhado. Não é para deixar o equipamento com a pessoa e voltar mais tarde. Q: É preciso um profissional por cada equipamento? A: Não. A app Companion abre no browser de qualquer PC ou tablet na mesma rede e mostra cada equipamento como um cartão: escolher cenário, reproduzir, pausar, atribuir utente e paragem de emergência à distância. É preciso um responsável pela sessão, que pode acompanhar mais do que uma ao mesmo tempo, desde que as pessoas estejam acompanhadas na sala. ### Realidade virtual ou um tablet? Qual a diferença, e quando o tablet ganha URL: https://rver.pt/blog/realidade-virtual-ou-tablet-qual-a-diferenca/ Date: 16 August 2026 «Um tablet com vídeos de natureza custa duzentos euros. Porque é que havemos de comprar isto?» É a objeção mais honesta que nos fazem, e merece a resposta toda. É a objeção mais honesta que nos fazem, e normalmente vem de alguém que já teve de justificar uma compra: *«um tablet com vídeos de natureza custa duzentos euros. Porque é que havemos de comprar isto?»* A resposta merece ser dada a sério, incluindo a parte em que o tablet ganha. ## O que muda fisicamente Há três diferenças concretas, e nenhuma delas é opinião. **O campo de visão fica ocupado.** Com um tablet, a pessoa vê o ecrã e vê a sala: a agulha, a máquina, o profissional. Com um visor, vê o cenário e mais nada. Isto é a diferença central, e é dela que decorrem quase todas as outras. **A imagem responde a olhar em volta.** Vídeo 360° acompanha o movimento da cabeça, portanto olhar para o lado mostra o que está do lado. Num tablet, virar a cabeça mostra a parede. **O som é espacial.** Vem de direções, não de um altifalante à frente. ## O que isso significa na prática Para procedimentos, ocupar o campo de visão **é o objetivo**, não um efeito secundário. Alguém com medo de agulhas que não consegue ver a agulha está numa situação diferente de alguém que a vê ao lado de um ecrã. Para pessoas acamadas, um tablet tem de ser segurado ou apoiado, e fica sempre no sítio errado. Um visor com modo deitado alinha o horizonte com a inclinação da cabeça: a imagem aparece direita mesmo com a pessoa a 30° ou a 90°. Para reminiscência, estar num sítio não é o mesmo que ver um sítio. Se essa diferença se traduz em benefício mensurável, é outra conversa, e é a conversa a seguir. ## O que a evidência diz sobre esta comparação em concreto Pouco, e é preciso dizê-lo. Há bastante investigação sobre realidade virtual em contextos de saúde, e há bastante sobre distração como estratégia. **Estudos que comparem diretamente um visor com um tablet, no mesmo procedimento e com o mesmo conteúdo, são poucos.** Portanto qualquer pessoa que lhe garanta que a realidade virtual é *x por cento* melhor do que um ecrã está a extrapolar. Nós não o afirmamos. A nossa [biblioteca de estudos](https://rver.pt/estudos/) está aberta precisamente para que veja o que existe e o que não existe. :::note A pergunta certa não é «qual é melhor». É «qual é adequado a este momento, neste serviço, com esta pessoa», e há muitos momentos em que a resposta é o tablet. ::: ## Quando o tablet é a resposta certa Digamo-lo por escrito, porque é verdade: - **Quando a pessoa precisa de continuar a ver a sala**: porque está ansiosa por perder a referência, porque precisa de comunicar por gestos, ou porque a equipa precisa de lhe ver a cara. - **Quando a família quer ver também.** Um tablet é partilhável; um visor é uma experiência de uma pessoa de cada vez. - **Quando há contraindicação.** Enjoo grave, perturbações vestibulares, epilepsia não controlada: a lista está na nossa [página de perguntas frequentes](https://rver.pt/faq/). - **Quando a pessoa simplesmente não quer** tapar os olhos. Acontece, e é uma razão suficiente. - **Quando o orçamento não chega.** Um tablet com bons conteúdos é melhor do que um visor que ninguém comprou. ## O que se compra além do visor Se a comparação for só «visor contra tablet», o tablet ganha em preço, sempre. A comparação honesta é entre **um equipamento e um sistema**: - conteúdo escolhido para o contexto clínico, e não uma lista de vídeos; - gestão de vários equipamentos a partir de um ecrã, com paragem à distância; - registo do que correu em cada sessão, para a equipa interpretar; - funcionamento sem internet durante a sessão; - formação da equipa, incluída; - um fabricante identificado, com documentação técnica, avaliação de risco e um caminho formal para comunicar incidentes. O produto base do RVer está registado como dispositivo médico de Classe I no INFARMED, com o n.º CDM 94571546, e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Um tablet com uma aplicação de vídeos não tem nada disto: o que não o torna pior, torna-o outra coisa. ## Em resumo - **A diferença física é real:** o campo de visão fica ocupado, a imagem acompanha a cabeça, o som tem direção. - **A diferença de resultado clínico entre os dois está pouco estudada.** Quem lhe der um número está a extrapolar. - **Em vários casos o tablet é a escolha certa,** e um fornecedor que nunca o admita está a vender-lhe alguma coisa. - **O que distingue não é o visor**: é o que vem à volta dele. Se está a decidir entre os dois para um serviço concreto, diga-nos qual é o momento clínico. Se a resposta for o tablet, dizemos-lho. Q: Qual é a diferença entre realidade virtual e ver um vídeo num tablet? A: Três diferenças físicas: com um visor o campo de visão fica ocupado e a pessoa não vê a sala, a imagem em 360° acompanha o movimento da cabeça, e o som é espacial. Num tablet a pessoa continua a ver o ecrã e a sala à volta. Para procedimentos, ocupar o campo de visão é precisamente o objetivo; noutros contextos é uma desvantagem. Q: A realidade virtual funciona melhor do que um tablet? A: Não há base sólida para afirmar isso. Existe investigação sobre realidade virtual em saúde e sobre distração como estratégia, mas estudos que comparem diretamente um visor com um tablet, no mesmo procedimento e com o mesmo conteúdo, são poucos. Quem lhe der uma percentagem está a extrapolar. Q: Quando é que um tablet é a melhor opção? A: Quando a pessoa precisa de continuar a ver a sala, quando a família quer acompanhar, quando há contraindicação para o visor, quando a pessoa não quer tapar os olhos, e quando o orçamento não chega: um tablet com bons conteúdos é melhor do que um visor que ninguém comprou. Q: Então o que é que se compra além do visor? A: Conteúdo escolhido para o contexto clínico, gestão de vários equipamentos a partir de um ecrã com paragem à distância, registo do que correu em cada sessão, funcionamento sem internet durante a sessão, formação incluída, e um fabricante identificado com documentação técnica, avaliação de risco e via formal de comunicação de incidentes. ### Realidade virtual e doença de Parkinson: o que a investigação anda a estudar URL: https://rver.pt/blog/realidade-virtual-doenca-de-parkinson/ Date: 16 August 2026 Reunimos oito publicações sobre realidade virtual e Parkinson. Seis olham para a mesma tríade (equilíbrio, marcha e queda), e o que falta decidir diz tanto como o que já se sabe. A doença de Parkinson é uma perturbação neurodegenerativa do movimento. Os sinais motores mais conhecidos são a lentidão, a rigidez, o tremor em repouso e a instabilidade postural, e é esta última que, com o tempo, se torna a mais limitante no dia a dia, porque é a que traz o medo de cair. A fisioterapia e o exercício orientado são parte estabelecida do acompanhamento. A pergunta que aparece cada vez mais é se a realidade virtual acrescenta alguma coisa a esse trabalho, e é aí que convém separar o que está a ser estudado do que já está demonstrado. ## O que a literatura anda a estudar Reunimos oito publicações sobre Parkinson na nossa [biblioteca de estudos](/estudos/tema/parkinson/). Lidas em conjunto, o que salta à vista é onde a investigação se concentra: - **Benefits of Virtual Reality Balance Training for Patients With Parkinson Disease: Systematic Review, Meta-analysis** - **The Effectiveness of Virtual Reality in Improving Balance and Gait in People with Parkinson's Disease** - **Efeitos da realidade virtual no equilíbrio e marcha de indivíduos com doença de Parkinson: uma revisão sistemática** - **The Effectiveness of Virtual Reality Exercises to Reduce Fall Risk in Parkinson's Disease: A Literature Review** - **Precision intervention of virtual reality training for balance and gait in Parkinson's disease: a dose–response analysis** - **Effects of Virtual Reality in the Rehabilitation of Parkinson's Disease: A Systematic Review** - **Supporting Tremor Rehabilitation Using Optical See-Through Augmented Reality Technology** - **Designing Virtual Reality Assisted Psychotherapy for Anxiety in Older Adults Living with Parkinson's Disease** Seis das oito olham para a mesma tríade: **equilíbrio, marcha e risco de queda**. Uma pergunta pela **dose** (quanto, com que frequência, durante quanto tempo), que é a pergunta que uma equipa clínica faz a seguir a «funciona?». Uma sai do motor e vai para a **ansiedade** em pessoas idosas com Parkinson, que é um lado da doença de que se fala menos. E uma trata de **tremor**, com realidade aumentada em vez de virtual, que é tecnologia diferente. ## O que isso diz, e o que não diz Diz que existe um corpo de investigação organizado à volta de um problema concreto e bem definido: o equilíbrio e a queda. Não é um tema de moda à procura de aplicação: é o contrário, uma necessidade clínica antiga à procura de ferramentas. Não diz que o assunto está fechado. Revisões sistemáticas e meta-análises existem precisamente porque os estudos individuais discordam entre si, e o facto de haver uma análise dose-resposta na lista é o sinal mais claro de que os parâmetros ainda estão em discussão. E há uma distinção que se perde muitas vezes: **«realidade virtual» não é uma intervenção única.** Um ambiente gerado por computador com deslocação, um jogo de consola com sensor de movimento e um vídeo 360° real filmado de um ponto fixo são coisas diferentes, com riscos diferentes e provavelmente com efeitos diferentes. Uma revisão que agregue as três está a somar peras com maçãs, e as boas revisões dizem-no. :::note Estes estudos são sobre realidade virtual como tecnologia. Não são estudos clínicos do RVer, não foram feitos com o RVer, e não constituem uma afirmação de desempenho do produto. Estão na biblioteca porque são o contexto em que o produto existe, não porque o validem. ::: ## Onde é que o RVer se posiciona nisto Com honestidade: o produto base do RVer é uma biblioteca de vídeo 360° para conforto, distração, relaxamento, reminiscência e atividade guiada. **Não é um programa de reabilitação do equilíbrio para a doença de Parkinson, e não afirmamos que trate a doença nem que reduza quedas.** O RVer Motion (movimento acompanhado, com registo de repetições e amplitude por sessão) é um módulo **em desenvolvimento e não abrangido** pelo registo de dispositivo médico Classe I, que cobre o produto base. Quem lhe chamar reabilitação está a ir à frente do que existe. O que o sistema faz, e faz bem, é entregar conteúdo sob supervisão de uma equipa de saúde, com registo do que correu na sessão para a equipa interpretar. A decisão clínica é de quem está na sala. ## Para quem trabalha com Parkinson Se está a ponderar realidade virtual num serviço de neurologia ou numa unidade de reabilitação, três perguntas poupam tempo: 1. **Que tipo de realidade virtual?** Vídeo filmado e ambiente gerado por computador não são a mesma proposta, nem em risco nem em efeito. 2. **Que evidência é sobre este produto**, e que evidência é sobre a tecnologia em geral? São coisas distintas e um fornecedor sério distingue-as. 3. **Quem conduz a sessão, e com que formação?** As oito publicações estão na [biblioteca de estudos](/estudos/tema/parkinson/), acessíveis para leitura direta. Não é preciso acreditar em nós. Q: A realidade virtual ajuda na doença de Parkinson? A: Existe um corpo de investigação organizado sobre o tema, concentrado no equilíbrio, na marcha e no risco de queda: reunimos oito publicações na nossa biblioteca de estudos. O assunto não está fechado: as revisões sistemáticas existem porque os estudos individuais discordam, e os parâmetros de dose ainda estão em discussão. São estudos sobre realidade virtual como tecnologia, não sobre o RVer. Q: O RVer trata a doença de Parkinson? A: Não, e não o afirmamos. O produto base do RVer é uma biblioteca de vídeo 360° para conforto, distração, relaxamento, reminiscência e atividade guiada, utilizada sob supervisão de profissionais de saúde. Não é um programa de reabilitação do equilíbrio e não reivindica reduzir quedas. Q: O que é que a investigação sobre Parkinson e realidade virtual estuda mais? A: Equilíbrio, marcha e risco de queda: seis das oito publicações que reunimos tratam desta tríade. Uma analisa a dose (quanto, com que frequência, durante quanto tempo), uma trata da ansiedade em pessoas idosas com Parkinson, e uma aborda o tremor com realidade aumentada, que é tecnologia diferente. Q: Todas as formas de realidade virtual são iguais nestes estudos? A: Não, e é uma distinção que se perde com frequência. Um ambiente gerado por computador com deslocação, um jogo com sensor de movimento e um vídeo 360° real filmado de um ponto fixo têm riscos diferentes e provavelmente efeitos diferentes. Uma revisão que os agregue está a somar coisas distintas, e as boas revisões assinalam-no. ### É preciso consentimento para usar realidade virtual com um utente? URL: https://rver.pt/blog/consentimento-informado-realidade-virtual-saude/ Date: 16 August 2026 É uma pergunta que aparece tarde e devia aparecer cedo, normalmente com o equipamento já em cima da mesa e uma reunião de governação clínica marcada. É uma pergunta que aparece tarde e devia aparecer cedo: **é preciso consentimento para pôr um visor de realidade virtual a um utente?** Quem pergunta normalmente já tem o equipamento em cima da mesa e uma reunião de governação clínica marcada. Vale a pena chegar lá com a resposta preparada. :::note Isto não é aconselhamento jurídico. A decisão sobre a forma de consentimento pertence à direção clínica e ao enquadramento da instituição. O que se segue é o que a experiência mostra que as equipas ponderam. ::: ## Comece por classificar o que está a fazer A pergunta anterior ao consentimento é: **o que é isto, no vosso protocolo?** Se a sessão for entendida como uma atividade de conforto e ocupação (como pôr música, ler em voz alta ou ver um filme com alguém) está numa categoria. Se for entendida como parte de um plano de intervenção com objetivos definidos, está noutra. A forma de consentimento segue essa classificação, e não o contrário. Muitas instituições resolvem isto colocando as sessões dentro de um consentimento geral de cuidados que já existe. Outras preferem um registo específico. As duas são posições defensáveis; o que não é defensável é nunca se ter decidido. ## O que distingue isto de pôr um filme Uma coisa, e é concreta: **o visor ocupa o campo de visão**. A pessoa deixa de ver a sala. É esta a diferença que justifica explicar antes, mesmo quando a instituição conclua que não é preciso assinatura nenhuma. Alguém que não percebeu o que ia acontecer e de repente deixa de ver o quarto tem uma experiência diferente da pretendida. Na prática, três frases resolvem: **o que vai ver, quanto tempo dura, e que pode parar quando quiser.** ## O direito a parar é a parte que importa mais Mais do que a assinatura, o que protege é o poder de interromper. - A pessoa sabe que pode dizer «tire-me isto» e que isso acontece de imediato? - Há alguém na sala para o ouvir? - A equipa consegue parar à distância se a pessoa não conseguir pedir? No RVer, a sessão é sempre acompanhada e a app Companion tem paragem de emergência à distância. Isto não substitui a explicação prévia: sustenta-a. ## Quando a pessoa não pode consentir É o caso mais frequente em lares e em demência avançada, e é onde as equipas hesitam mais. O enquadramento habitual combina três coisas: a autorização de quem tem legitimidade para decidir, o **assentimento** da própria pessoa no momento (quer dizer, aceitar, não resistir, não demonstrar desconforto) e a leitura contínua de sinais por quem está a conduzir. Recusar não tem de ser verbal. Tirar o visor, afastar a cabeça, ficar agitado: é tudo recusa, e trata-se como tal. Uma sessão que continua contra sinais destes não tem consentimento nenhum, esteja o que estiver assinado. ## A verificação de contraindicações vem antes Não é consentimento, mas pertence à mesma conversa e faz-se primeiro. Recomenda-se precaução ou avaliação clínica prévia a quem tenha historial de enjoo grave ou perturbações vestibulares, epilepsia não controlada ou perturbações convulsivas fotossensíveis, ou não consiga seguir instruções de segurança. A lista está na [página de perguntas frequentes](https://rver.pt/faq/) e no [manual](https://rver.pt/manual/). ## E o consentimento para dados? Esta parte é mais simples do que se receia, porque **não há dados pessoais do utente a sair do equipamento**. O que é enviado são estatísticas de utilização por dispositivo (que conteúdo correu, em que equipamento, quando) que não identificam ninguém. A atribuição de um utente a um equipamento acontece na rede local e não chega a servidor nenhum. A instituição é a responsável pelo tratamento dos dados dos seus utentes. Quem escreve o texto de consentimento agradece este parágrafo: não é preciso pedir autorização para transferir dados clínicos que não são transferidos. ## Um circuito que costuma funcionar 1. **Antes:** verificar contraindicações. 2. **Antes:** explicar em três frases: o que vai ver, quanto tempo, pode parar. 3. **Durante:** alguém na sala, atento a sinais. 4. **Depois:** registar que a sessão aconteceu, como qualquer outra atividade. 5. **Uma vez, no início:** decidir em que categoria isto entra no vosso protocolo, e escrevê-lo. O quinto ponto é o único que precisa de reunião. Os outros quatro são rotina. Sobre quem pode conduzir as sessões, escrevemos em [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Sobre segurança e contraindicações, em [«A realidade virtual faz mal?»](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Q: É preciso consentimento informado para uma sessão de realidade virtual? A: Depende de como a instituição classifica a sessão no seu protocolo: atividade de conforto e ocupação, ou parte de um plano de intervenção. Muitas instituições integram-na num consentimento geral de cuidados que já existe; outras preferem um registo específico. As duas são defensáveis. A decisão pertence à direção clínica, e o que não é defensável é nunca se ter decidido. Q: O que se deve explicar à pessoa antes de uma sessão? A: Três frases chegam: o que vai ver, quanto tempo dura, e que pode parar quando quiser. O que distingue isto de pôr um filme é que o visor ocupa o campo de visão e a pessoa deixa de ver a sala: é essa diferença que justifica explicar antes, mesmo quando não é exigida assinatura. Q: E se a pessoa não puder consentir, por exemplo em demência avançada? A: O enquadramento habitual combina a autorização de quem tem legitimidade para decidir, o assentimento da própria pessoa no momento (aceitar, não resistir, não mostrar desconforto) e a leitura contínua de sinais por quem conduz. A recusa não tem de ser verbal: tirar o visor, afastar a cabeça ou ficar agitado é recusa e trata-se como tal. Q: É preciso consentimento para os dados na realidade virtual? A: A parte dos dados é mais simples do que se receia, porque nenhum dado pessoal ou clínico do utente sai do equipamento. O que é enviado são estatísticas de utilização por dispositivo, que não identificam ninguém. A atribuição de um utente a um equipamento acontece na rede local e não chega a servidor nenhum. ### Como escrever um caderno de encargos para realidade virtual em saúde URL: https://rver.pt/blog/caderno-de-encargos-realidade-virtual-saude/ Date: 16 August 2026 Quem compra num hospital não escolhe um produto: escreve um documento. E é no documento que a decisão é feita, muito antes de haver propostas. Quem compra num hospital público não escolhe um produto: escreve um documento. E é no documento que a decisão é feita, muito antes de haver propostas em cima da mesa. O problema é que a realidade virtual em saúde ainda não tem uma especificação tipo. O resultado são cadernos de encargos que pedem a coisa errada: resolução do ecrã em vez de finalidade declarada, número de jogos em vez de enquadramento regulamentar, e depois uma cláusula de «solução terapêutica certificada» que nenhum fornecedor honesto consegue cumprir, porque não existe. Este é o esqueleto que usaríamos. Não é para nos favorecer: é para que quem responder tenha de dizer a verdade. ## 1. Comece pela finalidade, não pelo equipamento A pergunta que ordena tudo o resto é **para que é que isto vai ser usado neste serviço**. Conforto durante um procedimento não é a mesma coisa que estimulação cognitiva num lar, e não é a mesma coisa que apoio ao exercício orientado. Peça ao concorrente a **finalidade prevista declarada** do produto, tal como consta da documentação técnica, e não a lista de aplicações do folheto. São documentos diferentes e às vezes dizem coisas diferentes. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## 2. Enquadramento regulamentar: peça o que é verificável Aqui é onde os cadernos de encargos mais escorregam. Três formulações que funcionam: - **«Indicar se o produto é dispositivo médico e, em caso afirmativo, a classe, o número de registo e a autoridade competente.»** Um número de registo é verificável; a palavra «certificado» não é. - **«Indicar se ostenta marcação CE e ao abrigo de que regulamento.»** - **«Indicar se houve intervenção de organismo notificado e, em caso afirmativo, qual.»** Esta última é a mais útil e quase nunca aparece. Em Classe I não estéril e sem função de medição **não há organismo notificado**. Um concorrente que responda a esta pergunta com um número de organismo notificado ou está numa classe superior, ou está a inventar. Nos dois casos ficou a saber alguma coisa. Peça também a **Declaração de Conformidade UE** e a **etiqueta do dispositivo** como anexos. São documentos que qualquer fabricante a sério entrega. :::note Não escreva «solução certificada como dispositivo médico terapêutico». Não existe essa categoria, e a cláusula ou exclui toda a gente ou obriga alguém a mentir para responder. ::: ## 3. Separe o produto base dos módulos Muitos sistemas são modulares, e nem todos os módulos estão no mesmo estado regulamentar. Uma linha resolve: > «Indicar que componentes do sistema estão abrangidos pelo registo de dispositivo > médico e quais não estão.» Se a resposta for «tudo», peça o documento. ## 4. Dados: onde ficam, e o que sai do equipamento Três perguntas fechadas, sem espaço para prosa: - Que dados de utente são recolhidos, se algum? - O que sai do equipamento, para onde, e com que fundamento de licitude? - O sistema funciona sem ligação à internet durante a sessão? A última é operacional e regulatória ao mesmo tempo: um serviço com Wi-Fi irregular não pode depender de streaming, e um sistema que funciona offline tem menos superfície de exposição. ## 5. Contraindicações e segurança Peça a **lista de contraindicações** e o **procedimento de comunicação de incidentes graves**. Um fornecedor que não tenha nem uma nem outra não pensou no assunto, e essa é a informação mais útil que uma resposta a concurso lhe pode dar. ## 6. Operação: quem usa, e com que formação - Quem é o utilizador previsto? - A formação está incluída? É presencial? - Uma pessoa pode gerir vários equipamentos em simultâneo? - Quem escolhe o conteúdo para cada utente? ## 7. Custo total, não preço unitário Peça o custo a três anos com tudo dentro: licença, equipamentos, conteúdo, atualizações, substituições, suporte e formação. E pergunte explicitamente **o que acontece no fim do contrato**: se o equipamento fica inutilizável, isso é parte do preço. ## 8. Evidência: distinga as duas coisas Uma cláusula que separa o sério do resto: > «Indicar que evidência publicada existe sobre ESTE produto e que evidência é > sobre a tecnologia em geral, distinguindo claramente as duas.» A maioria dos fornecedores só tem a segunda. Não faz mal nenhum: desde que o diga. ## O que não pedir - **Resolução, campo de visão e número de píxeis.** É o mesmo punhado de equipamentos no mercado; especificar isto não distingue ninguém e exclui soluções por acidente. - **Número de cenários.** Cem cenários maus valem menos do que vinte adequados. - **Certificações que não existem.** Ver acima. ## Se quiser confirmar as nossas respostas O que responderíamos está público: o produto base do RVer está registado como dispositivo médico de Classe I no INFARMED, com o n.º CDM 94571546, e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745, sem organismo notificado, porque em Classe I não estéril e sem função de medição não há nenhum. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e **não** estão abrangidos por esse registo. As contraindicações estão na [página de perguntas frequentes](https://rver.pt/faq/), o âmbito do registo está em [ciência e regulação](https://rver.pt/ciencia/), e o [manual de utilização](https://rver.pt/manual/) está aberto. Se estiver a escrever um caderno de encargos e quiser que alguém o leia antes de sair, dizemos-lhe o que está impossível de cumprir, mesmo que a cláusula nos favorecesse. Sobre a pergunta que separa fornecedores quando alguém afirma poupança, ver [o ROI que não se consegue provar](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). Q: O que deve constar num caderno de encargos para realidade virtual em saúde? A: A finalidade prevista declarada do produto, o enquadramento regulamentar verificável (é dispositivo médico? que classe? que número de registo? que autoridade? houve organismo notificado?), que componentes estão abrangidos pelo registo, que dados saem do equipamento, se funciona offline, as contraindicações, o procedimento de comunicação de incidentes, quem é o utilizador previsto, e o custo total a três anos. Q: Posso exigir que a solução seja «certificada como dispositivo médico terapêutico»? A: Não deve, porque essa categoria não existe. Em dispositivos médicos fala-se de registo, classe e marcação CE. Numa Classe I não estéril e sem função de medição não há sequer organismo notificado. Uma cláusula assim ou exclui todos os concorrentes ou obriga alguém a responder incorretamente. Q: Como é que confirmo se um fornecedor é mesmo dispositivo médico? A: Peça o número de registo e a autoridade competente, e peça como anexos a Declaração de Conformidade UE e a etiqueta do dispositivo. Um número de registo é verificável junto da autoridade; a palavra «certificado» não é verificável coisa nenhuma. Pergunte também se houve intervenção de organismo notificado: a resposta diz-lhe muito. Q: O que não vale a pena pedir num concurso de realidade virtual? A: Resolução, campo de visão e contagem de píxeis: é o mesmo punhado de equipamentos no mercado, não distingue concorrentes e exclui soluções por acidente. Número de cenários, porque cem maus valem menos do que vinte adequados. E certificações que não existem. ### Acessibilidade: que utentes conseguem mesmo usar realidade virtual URL: https://rver.pt/blog/acessibilidade-realidade-virtual-quem-pode-usar/ Date: 16 August 2026 Depois do preço, a pergunta é sempre esta. A resposta divide-se em três: o que não é obstáculo, o que exige cuidado, e onde a resposta é mesmo não. Quando um serviço avalia realidade virtual, a pergunta que costuma vir a seguir ao preço é esta: **os nossos utentes conseguem usar isto?** É uma boa pergunta, e a resposta honesta divide-se em três: há limitações que não são problema nenhum, há limitações que exigem cuidado, e há limitações que significam que a resposta é não. Vale a pena saber qual é qual antes de comprar. ## Não é preciso mexer em nada A confusão mais comum vem dos videojogos: as pessoas assumem comandos, botões e destreza manual. Na biblioteca base do RVer não há nada disso. É vídeo 360°, e **quem escolhe e comanda é a equipa**, a partir da app Companion no browser. A pessoa que está com o visor não tem de operar coisa nenhuma: vê e ouve. Isto resolve, de uma vez, um conjunto grande de situações: tremor, artrite, hemiparesia, amputação, força reduzida, ou simplesmente não saber usar tecnologia. Nenhuma delas impede uma sessão. Os módulos RVer Motion, RVer Neuro e RVer Exposure já usam comandos e movimento: são outra proposta, estão em desenvolvimento e não estão abrangidos pelo registo de dispositivo médico. A biblioteca base não. ## Mobilidade reduzida e pessoas acamadas **Sentado é o modo recomendado para toda a gente**, não só para quem tem dificuldade. O risco relevante numa sessão não é a imagem: é alguém de pé desequilibrar-se com o campo de visão ocupado. Para quem está acamado ou reclinado há modo deitado, que alinha o horizonte da experiência com a inclinação da cabeça. A imagem aparece direita com a pessoa a 30° ou a 90°: na cama, em cadeirão de hemodiálise ou em cadeira de dentista. Aplica-se a todos os cenários da biblioteca, sem ser preciso conteúdo filmado de propósito. Cadeira de rodas: sem particularidade nenhuma, é uma sessão sentada. ## Comunicação Não é preciso falar para participar. Não há instruções verbais a cumprir nem respostas a dar. Isto torna a sessão acessível a quem tem afasia, disartria, ou simplesmente não comunica verbalmente. **Mas levanta uma exigência à equipa:** se a pessoa não consegue dizer «tire-me isto», quem está na sala tem de ler os sinais (agitação, levar as mãos ao visor, afastar a cabeça) e a app permite parar à distância. Combinar as duas coisas resolve. Nenhuma delas sozinha chega. ## Visão e audição Aqui é preciso ser franco, porque é onde se prometem coisas a mais. **Baixa visão:** depende inteiramente do grau e do tipo. O ecrã está muito perto dos olhos e é grande no campo visual, o que ajuda algumas pessoas, mas não é um auxiliar de visão e não deve ser vendido como tal. Testar com a pessoa é a única forma de saber. **Cegueira:** a experiência é visual. O áudio espacial existe, mas seria desonesto apresentar isto como uma proposta para quem não vê. **Surdez ou perda auditiva:** o cenário mantém-se, com menos uma camada. Vários cenários funcionam bem sem som. **Óculos graduados:** é uma questão prática que vale a pena resolver na instalação, com a equipa, e não no dia da primeira sessão. ## Cognição A biblioteca base não exige compreender regras nem cumprir tarefas: ver uma praia não tem instruções. Por isso funciona com pessoas com défice cognitivo moderado, e a reminiscência é um dos usos mais frequentes em lares. O limite está escrito nas contraindicações e é de segurança, não de compreensão: **quem não consegue seguir instruções de segurança** por défice cognitivo grave não deve usar sem avaliação clínica prévia. ## Quando a resposta é não Por honestidade, e porque é curto: - historial de enjoo de movimento grave ou perturbações vestibulares; - epilepsia não controlada ou perturbações convulsivas fotossensíveis; - incapacidade de seguir instruções de segurança por défice cognitivo grave; - menores de 10 anos; - e, a mais importante de todas, **quem não quer**. Tapar os olhos não é neutro para toda a gente, e recusar é uma resposta completa. A lista está na [página de perguntas frequentes](https://rver.pt/faq/) e no [manual](https://rver.pt/manual/). :::note Uma nota sobre linguagem: «acessível» não quer dizer «para todos». Quer dizer que as barreiras evitáveis foram removidas e que as que restam estão escritas. É o que se pode prometer. ::: ## Em resumo | situação | resposta | |---|---| | Sem destreza manual, tremor, hemiparesia | Sem problema: a equipa comanda | | Cadeira de rodas, mobilidade reduzida | Sem problema: sessão sentada | | Acamado ou reclinado | Modo deitado | | Afasia, sem comunicação verbal | Possível, com leitura de sinais pela equipa | | Baixa visão | Depende do caso; testar | | Cegueira | Não é a proposta | | Perda auditiva | Sem problema | | Défice cognitivo moderado | Um dos usos mais frequentes | | Défice cognitivo grave com risco de segurança | Avaliação clínica prévia | Sobre riscos e contraindicações por extenso, ver [a realidade virtual faz mal?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Sobre quem conduz a sessão, ver [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Q: É preciso saber usar comandos para uma sessão de realidade virtual? A: Na biblioteca base do RVer não. É vídeo 360° e quem escolhe e comanda é a equipa, a partir da app Companion no browser: a pessoa com o visor vê e ouve, não opera nada. Isso resolve tremor, artrite, hemiparesia, amputação, força reduzida ou simplesmente não saber usar tecnologia. Q: Uma pessoa acamada ou em cadeira de rodas pode usar realidade virtual? A: Sim. Sentado é aliás o modo recomendado para toda a gente, porque o risco relevante é alguém de pé desequilibrar-se com o campo de visão ocupado. Para quem está acamado ou reclinado há modo deitado, que alinha o horizonte da experiência com a inclinação da cabeça, a 30° ou a 90°. Q: Uma pessoa com afasia ou que não fala consegue participar? A: Consegue: não há instruções verbais a cumprir nem respostas a dar. Mas exige mais da equipa: se a pessoa não consegue pedir para parar, quem está na sala tem de ler sinais como agitação, levar as mãos ao visor ou afastar a cabeça, e a app permite parar à distância. Q: Uma pessoa com baixa visão ou cega pode usar? A: Baixa visão depende inteiramente do grau e do tipo: o ecrã está muito perto e é grande no campo visual, o que ajuda algumas pessoas, mas não é um auxiliar de visão e não deve ser apresentado como tal: testar é a única forma de saber. Para quem é cego, a experiência é visual e seria desonesto apresentá-la como proposta. ### O ROI que não se consegue provar, e o que medir em vez disso URL: https://rver.pt/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/ Date: 16 August 2026 «Poupa X euros por doente» é a frase que um comprador informado testa primeiro, e quase sempre a primeira a cair. A conclusão não é que não há retorno: é que ele se mede noutro sítio. Há uma frase que aparece em quase todos os materiais comerciais de realidade virtual em saúde, com números diferentes: *«poupa X euros por doente»*. É a frase que um comprador informado testa primeiro, e é quase sempre a primeira a cair. Este artigo faz parte do [guia do ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/). Vale a pena perceber porquê, porque a conclusão não é «não há retorno». É que **o retorno tem de ser medido na vossa casa**, e há uma forma correta de o fazer. ## O estado real da literatura económica Em outubro de 2026, a nossa biblioteca pública tinha **130 estudos** sobre realidade virtual em contextos de saúde. Destes, **oito** são de custos e retorno, e mesmo esses são de contextos muito específicos: imagiologia pediátrica sem sedação, dor pós-operatória, um programa de saúde mental no Reino Unido. Oito em cento e trinta não é um acaso da nossa seleção. É o estado do campo: a investigação clínica sobre realidade virtual é abundante, a económica é escassa. Quem apresenta um número de poupança como se fosse consensual está a generalizar a partir de muito pouco. ## Porque é que os números não transferem Mesmo quando um estudo económico é bom, três coisas impedem que o número dele seja o vosso: **1. A população não é a mesma.** Um ensaio em imagiologia pediátrica mede crianças que, sem realidade virtual, seriam sedadas. Se no vosso serviço essas crianças não são sedadas, a poupança que o estudo calcula não existe para si: não porque a tecnologia falhe, mas porque o custo evitado não estava lá. **2. O comparador não é o mesmo.** «Poupa face a quê?» decide o resultado inteiro. Face a nada é fácil. Face à distração que a enfermeira já faz com conversa, um tablet ou a presença da mãe, é outra conversa, e é essa a comparação honesta. **3. Quem paga não é o mesmo.** Um estudo feito na perspetiva do pagador público conta coisas diferentes de um feito na perspetiva do hospital, e ambos contam coisas diferentes de um lar privado. Uma poupança que aparece no orçamento do Estado pode não aparecer no vosso. ## O que fazer em vez de acreditar no número Medir. Um piloto de três meses responde melhor do que qualquer folheto, desde que se decida **antes** o que se vai contar. Quatro métricas chegam: 1. **Sessões realizadas por semana**: a única que diz se a coisa entrou mesmo na rotina. Uma solução que ninguém usa tem retorno zero, independentemente da literatura. 2. **Quem participou que antes não participava.** É o valor mais defensável num lar ou num serviço com atividade de grupo: chegar a quem estava de fora. 3. **Tempo real da equipa por sessão.** Cronometrado, não estimado. É o custo verdadeiro e é sempre maior do que a estimativa inicial. 4. **Recusas e interrupções.** Quantos disseram que não, quantos tiraram o equipamento antes do fim. Diz mais sobre adequação do que qualquer inquérito de satisfação. Nenhuma destas quatro é uma métrica clínica, e isso é deliberado: um piloto responde bem a perguntas de implementação (a equipa usa? onde encrava?) e **não responde de todo a eficácia clínica**, por muito que lho prometam. ## Como escrever isto num caderno de encargos Se está a preparar um concurso, a pergunta que separa fornecedores é esta: > «Indique os estudos que sustentam a poupança que afirma, com população, > comparador e perspetiva do pagador.» Quem tem, mostra. Quem não tem, responde com casos de sucesso e testemunhos: o que é uma resposta perfeitamente legítima, desde que não seja apresentada como evidência económica. :::note Nós próprios não afirmamos poupança. O que dizemos é o que se pode verificar: o que o equipamento faz, o que fica registado, quanto tempo de equipa consome, e onde a conta de uma instituição costuma fechar-se. O registo Classe I cobre o produto base e não é, nem nunca foi, um argumento de eficácia. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Os oito estudos de custos estão no tema [Custos e retorno](/estudos/tema/custos-e-roi/) da biblioteca pública, com os restantes 122. Sobre como correr o piloto, ver [como correr um piloto num serviço de saúde](/blog/piloto-realidade-virtual-hospital-como-correr/). Sobre a conta de um lar, ver [quanto rende num lar](/blog/roi-realidade-virtual-lar-de-idosos/). Q: Há estudos que provem poupança com realidade virtual em saúde? A: Há poucos, e de contextos muito específicos: imagiologia pediátrica sem sedação, dor pós-operatória, um programa de saúde mental. Na nossa biblioteca eram oito em 130 estudos, em outubro de 2026. A investigação clínica é abundante; a económica é escassa, e um número de poupança apresentado como consensual está a generalizar a partir de muito pouco. Q: Porque é que a poupança de um estudo não se aplica ao meu serviço? A: Por três razões: a população pode não ser a mesma (se os seus doentes não seriam sedados, o custo evitado não existe), o comparador pode não ser o mesmo (poupa face a nada, ou face à distração que a equipa já faz?) e a perspetiva do pagador pode não ser a mesma: uma poupança no orçamento público pode nunca aparecer no seu. Q: O que deve medir um piloto de três meses? A: Sessões realizadas por semana, quem participou que antes não participava, tempo real da equipa por sessão (cronometrado, não estimado) e recusas ou interrupções. Nenhuma é uma métrica clínica: um piloto responde a perguntas de implementação e não responde a eficácia clínica. ### Quanto rende num lar? A conta de ROI que um hospital não faz URL: https://rver.pt/blog/roi-realidade-virtual-lar-de-idosos/ Date: 16 August 2026 A conta do hospital (sedação evitada, tempo de bloco) não existe num lar. A variável que decide tudo é outra, e provavelmente já a conhece de cor. Quase tudo o que está escrito sobre o retorno da realidade virtual em saúde foi escrito a pensar num hospital: sedação evitada, tempo de bloco, procedimentos mais curtos. Num lar, nada disso existe. Não há bloco, não há anestesista, não há procedimento para encurtar. A conta de um lar é outra, e é mais simples de fazer, desde que se comece pela variável certa. ## A variável que domina tudo: a ocupação Num lar, a diferença entre um mês bom e um mês mau raramente está nos custos. Está numa cama vazia. Uma vaga por preencher representa uma mensalidade inteira que não entra, todos os meses em que ficar assim. É por isso que a pergunta útil não é «quanto poupa este equipamento?», mas: > **Isto ajuda a preencher uma vaga, ou a segurar uma família que está a > comparar dois lares?** Se a resposta for sim uma vez por ano, a conta fecha-se sozinha com o valor da vossa mensalidade: não é preciso mais nenhuma alavanca. Se for não, nenhuma das outras linhas vai justificar o serviço. Isto não é uma promessa: é onde a conta se decide. A família que visita três lares no mesmo mês decide por diferenças visíveis, e o que se mostra numa visita conta. ## A segunda linha: tempo de equipa A atividade individual tem um custo real e mensurável: **o tempo de quem a conduz.** Contando cerca de cinco minutos para escolher o cenário e colocar o equipamento, mais dez de sessão, são quinze minutos por residente. Isso dá, com uma pessoa, doze a dezasseis sessões por semana sem desfazer o resto do plano. Multiplicado pelo custo-hora real da vossa equipa, é um número que sai da vossa folha de vencimentos e não da nossa. A comparação relevante não é com «não fazer nada»: é com a atividade que ficaria no lugar desta. ## A terceira: o que já se paga e passa a estar coberto Vale a pena olhar para o que já sai do orçamento e pode ficar coberto: - animação contratada ao exterior que vem uma vez por semana; - material de estimulação comprado avulso todos os anos; - obras adiadas para uma sala que não existe (é aqui que entra a comparação com uma [sala multissensorial](/blog/sala-snoezelen-ou-realidade-virtual-lares/)); - horas extra em dias de chuva, quando o passeio é cancelado e é preciso inventar tarde. ## A quarta: o que se mostra sem trabalho manual Registo automático do que foi feito, com quem e durante quanto tempo. Não é poupança direta: é tempo de direção técnica que deixa de ser gasto a reconstruir memória para uma família, para uma auditoria ou para um relatório de atividades. ## Um modelo de seis linhas Preencha com os vossos valores. Não publicamos números que não controlamos, e os que interessam aqui são todos vossos: | Linha | O que preencher | |---|---| | 1. Mensalidade média | valor de uma vaga, por mês | | 2. Vagas por preencher | média dos últimos 12 meses | | 3. Custo-hora da equipa | de quem vai conduzir as sessões | | 4. Sessões por semana | 12 a 16 é o ritmo com uma pessoa | | 5. Custo já existente | animação externa e material que passa a estar coberto | | 6. Custo do serviço | serviço anual com os equipamentos incluídos, por mês | A conta que interessa é: **(1) × (probabilidade de segurar uma vaga) + (5) − (3 × horas) − (6)**. Se a linha 1 for suficientemente grande, e num lar é quase sempre, o resto do modelo é detalhe. ## O que não se pode contar Não conte com redução de medicação, com menos quedas ou com melhoria clínica. Não temos ensaios que sustentem isso para o nosso produto, e apresentar qualquer dessas linhas num caderno de encargos é construir um caso que não sobrevive à primeira pergunta difícil. O que se pode contar é o que se mede na casa: sessões realizadas, quem participou que antes não participava, tempo real da equipa, e o que a família diz na visita seguinte. :::note A realidade virtual em contexto de lar é uma atividade de conforto, estimulação e bem-estar, conduzida por profissionais ou cuidadores com formação. Não é tratamento, não substitui avaliação clínica nem terapêutica prescrita, e nenhuma linha deste modelo deve ser apresentada como benefício clínico. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Esta é uma das três contas do [guia do ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/), e o uso do RVer num lar está em [lares e ERPI](/solucoes/lar-residencial/). Sobre onde as sessões entram na semana, ver [o plano de atividades de um lar](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). Sobre a conta feita do lado do hospital, ver [onde está a poupança](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/). Q: Como se calcula o ROI da realidade virtual num lar de idosos? A: Começando pela ocupação: uma vaga por preencher representa uma mensalidade inteira por mês. A seguir entram o tempo de equipa por sessão (cerca de quinze minutos por residente), os custos que já existem e passam a estar cobertos, e o custo da solução. O modelo de seis linhas deste artigo usa apenas valores da própria instituição. Q: Posso contar com poupança em medicação ou menos quedas? A: Não. Não há ensaios que sustentem essas linhas para o nosso produto, e apresentá-las num caderno de encargos constrói um caso que não sobrevive à primeira pergunta difícil. Conte o que se mede na casa: sessões realizadas, quem passou a participar, tempo real da equipa. Q: Quanto tempo de equipa custa cada sessão? A: Cerca de cinco minutos para escolher o cenário e colocar o equipamento, mais dez de sessão. Com uma pessoa a conduzir, doze a dezasseis sessões por semana cabem sem desfazer o resto do plano de atividades. ### Agitação ao entardecer na demência: o que a equipa pode mudar no ambiente URL: https://rver.pt/blog/agitacao-fim-da-tarde-demencia-sundowning/ Date: 16 August 2026 Às cinco da tarde a casa muda. Antes de falar em atividades, há uma lista física a excluir, e depois três coisas no ambiente que costumam fazer mais diferença do que qualquer novidade. Às cinco da tarde a casa muda. Quem esteve calmo o dia todo levanta-se, procura a porta, pergunta pela mãe, quer ir para casa. A equipa do turno da tarde conhece isto melhor do que ninguém. ## O que é o sundowning *Sundowning* é o nome, em inglês, de um padrão em que a inquietação, a confusão e a ansiedade aumentam no fim da tarde e ao anoitecer em pessoas com demência. Vem de *sundown*, o pôr do sol. Em português diz-se **agitação ao entardecer**, ou síndrome do pôr do sol; «efeito» ou «fenómeno» *sundowning* são outros nomes para a mesma coisa. Não é um diagnóstico e não tem uma causa única. O que existe é um conjunto de coisas que costumam contribuir, e algumas delas estão ao alcance de quem está na sala. ## Primeiro, o que não é comportamento Antes de mudar o ambiente, vale a pena excluir o que é físico. Boa parte do que se lê como agitação é outra coisa a manifestar-se: - **dor** que ninguém nomeou, sobretudo em quem já não a descreve; - **vontade de ir à casa de banho**, obstipação, retenção urinária; - **fome ou sede**: o jantar ainda vem longe; - **infeção**, em particular urinária, que em pessoas mais velhas aparece muitas vezes como confusão antes de aparecer como febre; - **efeitos de medicação**, incluindo alterações recentes. Esta lista é a primeira coisa a fazer, sempre. E qualquer decisão sobre medicação é da equipa clínica: nada do que vem a seguir a substitui. ## Depois, o ambiente O fim da tarde junta três coisas: a luz cai, o barulho sobe (turnos a trocar, visitas a sair, televisão ligada) e o corpo está cansado. As equipas que conseguem baixar a agitação mexem quase sempre nestes pontos: - **Luz.** Acender antes de escurecer, e não depois. A transição brusca de claro para escuro é o gatilho mais citado. - **Ruído.** Menos fontes ao mesmo tempo. Uma televisão ligada numa sala onde ninguém a vê é ruído, não é companhia. - **Rotina.** A mesma coisa, à mesma hora, feita pela mesma pessoa quando possível. A previsibilidade faz mais do que qualquer atividade nova. - **Cafeína e sestas longas** ao fim do dia: os dois costumam aparecer nas recomendações. - **Uma tarefa com sentido.** Dobrar toalhas, pôr a mesa, tratar de uma planta. Ocupar não é entreter. ## Onde é que um cenário calmo entra É aqui que entra o que fazemos, e convém ser exato sobre o que é e o que não é. Um cenário de vídeo 360° (uma praia ao entardecer, um jardim, uma aldeia conhecida) é **mais uma opção de ambiente calmo**, ao lado da música, da fotografia e da conversa. O que tem de diferente é ocupar o campo de visão: a sala com o barulho do turno fica de fora durante alguns minutos. Sobre isto é preciso dizer três coisas com clareza: 1. **A investigação publicada sobre realidade virtual em demência é sobretudo sobre bem-estar, envolvimento e reminiscência, e não sobre agitação ao entardecer em particular.** Não temos ensaios que digam que resolve *sundowning*, e não é isso que afirmamos. 2. **Não serve para toda a gente.** Quem está muito agitado não vai aceitar nada na cabeça, e insistir piora. A janela útil costuma ser *antes* do pico, não durante. 3. **A sessão é sempre acompanhada** e para quando a pessoa quiser. Tapar os olhos não é neutro para quem está desorientado. Na prática, as equipas que usam isto ao fim da tarde fazem-no cedo, por volta das quatro, e curto: cinco a dez minutos, sentados, com alguém ao lado. ## Uma lista para o turno da tarde 1. Excluir dor, casa de banho, fome, sede e infeção. 2. Acender as luzes antes de escurecer. 3. Baixar o número de fontes de ruído. 4. Manter a mesma sequência todos os dias. 5. Oferecer uma tarefa com sentido, ou um ambiente calmo, **antes** do pico. 6. Registar o que aconteceu e a que horas: é o que permite ver o padrão. O ponto 6 é o que costuma faltar. Sem registo, cada turno recomeça do zero e ninguém sabe se o que se tentou ontem resultou. :::note Nada disto é tratamento nem substitui avaliação clínica. Uma alteração persistente no comportamento merece observação médica: pode ser dor, infeção ou efeito de medicação. As decisões sobre terapêutica são da equipa clínica. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Sobre o uso em demência, ver [reminiscência, calma e momentos de presença](/blog/realidade-virtual-demencia-alzheimer/). Sobre quem consegue usar o equipamento, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Q: O que é o sundowning? A: É o nome dado ao padrão em que a inquietação, a confusão e a ansiedade aumentam ao fim do dia em pessoas com demência. Não é um diagnóstico nem tem uma causa única, e a primeira coisa a fazer é excluir dor, necessidade de ir à casa de banho, fome, infeção e efeitos de medicação. Q: A realidade virtual resolve a agitação ao entardecer? A: Não afirmamos isso. A investigação publicada sobre realidade virtual em demência trata sobretudo de bem-estar, envolvimento e reminiscência, e não de agitação ao entardecer em particular. Um cenário calmo é mais uma opção de ambiente, ao lado da música e da conversa, e é usado antes do pico de agitação, não durante. Q: Quanto tempo deve durar uma sessão ao fim da tarde? A: Curta. As equipas que usam isto nesta hora fazem-no por volta das quatro da tarde, sentadas, cinco a dez minutos, sempre com alguém ao lado e parando assim que a pessoa quiser. ### Sala Snoezelen ou realidade virtual? O que cada uma faz num lar URL: https://rver.pt/blog/sala-snoezelen-ou-realidade-virtual-lares/ Date: 16 August 2026 Compensa construir a sala, ou a realidade virtual substitui-a? Não fazem a mesma coisa, e a escolha decide-se no espaço disponível e em quem não sai do quarto. Quase todos os lares com quem falamos já ouviram falar de uma sala Snoezelen, e muitos ponderaram construir uma. A pergunta que nos fazem é quase sempre a mesma: **compensa fazer a sala, ou a realidade virtual substitui-a?** A resposta honesta é que não fazem a mesma coisa, e a escolha depende menos da tecnologia do que do espaço, da equipa e de quem são os residentes. ## O que é uma sala Snoezelen Uma sala Snoezelen (ou de estimulação multissensorial) é um espaço fixo, preparado para estimular os sentidos de forma controlada: luz suave e colunas de bolhas, som ambiente, texturas, aromas, por vezes uma cama de água ou uma cadeira vibratória. A pessoa entra, escolhe-se o que está ligado, e alguém da equipa acompanha. O princípio é o mesmo que está por trás da realidade virtual em contextos de saúde: **um ambiente controlado, acompanhado, para conforto e estimulação**, e não uma terapia autoadministrada. ## O que cada uma faz melhor A sala ganha em tudo o que envolve o corpo. Tato, temperatura, vibração, peso, cheiro: nada disso passa por um visor. Para uma pessoa que não tolera nada na cabeça, ou que responde sobretudo ao toque, a sala é a resposta certa. E é partilhável: duas ou três pessoas podem estar lá dentro ao mesmo tempo. A realidade virtual ganha em três coisas concretas: - **Não precisa de sala.** Vai ao quarto, ao cadeirão, à sala de convívio. Num edifício onde cada metro quadrado está contado, isto não é um detalhe. - **Muda de cenário sem obras.** Uma praia hoje, uma aldeia amanhã, a vindima no outono. A sala fica com o ambiente que foi instalado. - **Deixa registo.** Fica escrito o que foi feito, com quem e durante quanto tempo, sem ninguém transcrever nada à mão. E há uma diferença que costuma decidir: a sala obriga a levar a pessoa até ela. Quem está acamado, quem está em isolamento, quem não sai do quarto ao fim da tarde: esses raramente chegam à sala. ## O que custa cada uma Não vamos publicar números que não controlamos, mas a **forma** do custo é diferente e vale a pena perceber: | Critério | Sala Snoezelen | Realidade virtual | |---|---|---| | Investimento | obra e equipamento fixo | equipamento e subscrição | | Espaço | uma divisão permanente | nenhum | | Mudar de ambiente | nova compra ou obra | novo conteúdo | | Chega ao quarto | não | sim | | Estimulação tátil | sim | não | | Grupo em simultâneo | sim | um de cada vez | ## Quatro perguntas antes de decidir 1. **Tem uma divisão para dispensar de forma permanente?** Se não tem, a pergunta acaba aqui. 2. **Quantos residentes não saem do quarto?** Quanto maior for esse número, mais peso tem a solução que se desloca. 3. **Quem vai acompanhar as sessões?** Ambas exigem alguém ao lado. Uma solução que ninguém tem tempo de usar não é solução nenhuma. 4. **O que quer registar?** Se precisa de mostrar o que foi feito (à família, à direção técnica, numa auditoria), convém que fique escrito sozinho. :::note **Nem uma nem outra é um tratamento.** São ambientes de conforto e estimulação, usados sob supervisão de quem cuida. Não substituem avaliação clínica nem qualquer terapêutica prescrita, e a decisão sobre o plano de cuidados é sempre da equipa. ::: ## Também podem coexistir Os lares onde isto funciona melhor não escolheram: usam a sala para quem responde ao toque e ao movimento, e a realidade virtual para quem está no quarto ou para quem gosta de ir a sítios. São duas ferramentas na mesma caixa, com custos e limitações diferentes. Se está a começar por uma, comece pela que responde ao problema que tem hoje, e não pela que impressiona quem vem de visita. O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Sobre quem consegue usar o equipamento, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Sobre o uso em demência, ver [reminiscência, calma e momentos de presença](/blog/realidade-virtual-demencia-alzheimer/). Q: A realidade virtual substitui uma sala Snoezelen? A: Não. A sala estimula o tato, a temperatura e o movimento, coisas que não passam por um visor, e permite estar mais do que uma pessoa ao mesmo tempo. A realidade virtual chega ao quarto, muda de ambiente sem obras e deixa registo da sessão. Muitos lares acabam por usar as duas. Q: Qual das duas é melhor para pessoas com demência? A: Depende da pessoa, não do diagnóstico. Quem responde ao toque e ao movimento tira mais partido da sala; quem gosta de lugares e histórias responde melhor a cenários. Nenhuma das duas é um tratamento, e ambas são usadas com um profissional ao lado. Q: Preciso de uma divisão só para a realidade virtual? A: Não. O equipamento é usado onde a pessoa estiver: no quarto, num cadeirão, na sala de convívio. É a diferença prática mais citada por quem já tem uma sala e não consegue lá levar metade dos residentes. ### As oito perguntas que a informática do hospital vai fazer sobre realidade virtual URL: https://rver.pt/blog/informatica-hospital-perguntas-realidade-virtual/ Date: 16 August 2026 O serviço quer, a administração está aberta, e o processo vai à informática. É aí que muitos projetos morrem, não por rejeição, mas à espera de respostas que ninguém preparou. Há um momento previsível na adoção de qualquer tecnologia num hospital: o serviço quer, a administração está aberta, e o processo vai à informática. É aí que muitos projetos morrem, não por rejeição, mas por ficarem à espera de respostas que ninguém preparou. Vale a pena antecipar as perguntas. São quase sempre as mesmas oito. ## 1. «Isto vai ligar-se à nossa rede?» A pergunta por trás é: **quanta superfície nova é que isto me acrescenta?** Vale a pena separar duas coisas que se confundem. Uma é o equipamento precisar de internet **durante a sessão**: se precisar, uma falha de Wi-Fi interrompe um utente a meio, e isso é um problema clínico antes de ser informático. Outra é haver uma aplicação de gestão que corre na rede local. No RVer, a reprodução de conteúdo corre inteiramente no equipamento e não precisa de internet durante a sessão. A app Companion abre no browser de qualquer PC ou tablet **na mesma rede local**, sem instalar nada e sem passar pela nuvem. [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## 2. «Precisa de integração com o nosso sistema?» Esta é a pergunta que a informática mais teme, porque integração significa projeto, e projeto significa meses. A resposta certa, quando é verdade, é *não*. O RVer funciona de forma independente e não requer integração com sistemas hospitalares. Isso significa que não há interface a construir, não há mapeamento de identificadores e não há dependência de uma equipa que já está com trabalho a mais. Se um fornecedor lhe disser que «integra com tudo», pergunte quanto tempo demora e quem paga. ## 3. «Que dados de doente é que isto guarda?» A pergunta a fazer não é «cumprem o RGPD», toda a gente diz que sim. É **que dados concretos saem do equipamento, para onde, e com que fundamento**. No RVer, nenhum dado pessoal ou clínico do utente sai do equipamento. O que é enviado são estatísticas de utilização por dispositivo (que conteúdo correu, em que equipamento, quando) que não identificam ninguém. A atribuição de um utente a um equipamento acontece na rede local e não chega a servidor nenhum. Isto tem uma consequência prática que a informática vai gostar: **se não há dados pessoais a sair, o risco associado é muito menor**, e a avaliação de impacto simplifica-se. ## 4. «Quem é o responsável pelo tratamento?» A instituição. O RVer é fornecido a instituições de saúde, que são responsáveis pelos dados dos seus utentes. É a resposta que o encarregado de proteção de dados precisa de ouvir, e deve estar escrita no contrato, não numa conversa. ## 5. «E se a empresa desaparecer?» Pergunta legítima e raramente feita a tempo. A resposta depende de uma coisa: **o sistema funciona offline?** Se funcionar, o desaparecimento do fornecedor não desliga nada: cada equipamento continua a reproduzir a biblioteca que tem instalada. Se não funcionar, está a comprar uma dependência, e isso deve constar da avaliação de risco. ## 6. «Quem faz as atualizações, e quando?» Interessa saber se as atualizações são obrigatórias, se podem ser adiadas, e se alguma vez forçam uma janela de indisponibilidade num serviço. Num equipamento que corre offline, uma atualização é uma operação planeada, não uma interrupção. ## 7. «Isto é um dispositivo médico? Muda alguma coisa para nós?» Muda três coisas que a informática deve conhecer: - Existe **documentação técnica e avaliação de risco** que podem ser pedidas. - Existe um **fabricante identificado e responsável**. - Existe um **caminho formal de comunicação de incidentes graves**: ao fabricante e à autoridade competente. O produto base do RVer está registado como dispositivo médico de Classe I no INFARMED, com o n.º CDM 94571546, e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. ## 8. «Quem gere as contas?» Não há contas de utilizador para os utentes. As definições do equipamento estão atrás de um menu protegido que os clientes não alcançam, e a configuração é feita na instalação. Menos contas é menos superfície. :::note Uma boa forma de testar um fornecedor: peça-lhe estas oito respostas **por escrito, antes** de haver reunião com a informática. Quem as tiver preparadas já passou por isto. Quem improvisar, vai improvisar também depois da compra. ::: ## Um resumo para colar no email - Reprodução **offline**; sem internet durante a sessão. - App de gestão em **browser, rede local**, sem instalação e sem nuvem. - **Sem integração** com sistemas hospitalares. - **Nenhum dado pessoal ou clínico do utente sai do equipamento.** - Responsável pelo tratamento: **a instituição**. - Dispositivo médico **Classe I registado no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), com marcação CE (MDR 2017/745)**; módulos não abrangidos. - Sem contas de utente; definições protegidas. Sobre segurança da própria plataforma escrevemos à parte em [«O estado da segurança na plataforma RVer»](/blog/nis2-o-estado-da-seguranca-na-plataforma-rver/), e sobre proteção de dados em [privacidade e RGPD](/blog/privacidade-rgpd-realidade-virtual-saude/). Q: A realidade virtual precisa de integração com o sistema informático do hospital? A: No caso do RVer, não. O sistema funciona de forma independente e não requer integração com sistemas hospitalares: não há interface a construir nem mapeamento de identificadores. A gestão é feita por uma aplicação que abre no browser de qualquer PC ou tablet na mesma rede local, sem instalar nada. Q: Que dados de doente saem do equipamento? A: Nenhum dado pessoal ou clínico do utente sai do equipamento. O que é enviado são estatísticas de utilização por dispositivo (que conteúdo correu, em que equipamento, quando) que não identificam ninguém. A atribuição de um utente a um equipamento acontece na rede local e não chega a servidor nenhum. Q: A realidade virtual funciona sem internet no hospital? A: A reprodução de conteúdo corre inteiramente no equipamento e não precisa de internet durante a sessão. Isto importa por duas razões: uma falha de Wi-Fi não interrompe um utente a meio, e um sistema que corre offline continua a funcionar mesmo que o fornecedor desapareça. Q: Quem é o responsável pelo tratamento dos dados? A: A instituição de saúde. O sistema é fornecido a hospitais e clínicas, que assumem a qualidade de responsáveis pelo tratamento dos dados dos seus utentes. Deve estar escrito no contrato, e é a resposta que o encarregado de proteção de dados precisa de ter. ### Plano de atividades num lar: onde a realidade virtual encaixa (e onde não) URL: https://rver.pt/blog/plano-de-atividades-lar-idosos-realidade-virtual/ Date: 16 August 2026 Não é uma atividade de grupo, não substitui o convívio e não dispensa a animadora. Dito isso, encaixa exatamente nos buracos que o plano de grupo nunca cobre. O plano de atividades de um lar é feito de restrições: uma animadora para sessenta residentes, uma sala que também é refeitório, dias de chuva em que ninguém sai, e um terço das pessoas que não vai a nada em grupo. Esta é uma nota prática sobre onde a realidade virtual encaixa nesse plano, e, com a mesma clareza, onde não encaixa. ## Onde não encaixa Convém começar por aqui, porque é o que evita comprar mal. - **Não é uma atividade de grupo.** É um de cada vez, com alguém ao lado. Se o problema é encher a tarde de quarta-feira para vinte pessoas, isto não o resolve. - **Não substitui o convívio.** Ninguém deve ficar mais isolado por causa disto. É uma sessão curta e acompanhada, não uma forma de ocupar alguém sozinho. - **Não é entretenimento contínuo.** Sessões longas cansam e perdem efeito. O que vemos funcionar são cinco a quinze minutos. - **Não dispensa a animadora.** Alguém escolhe o cenário, coloca o equipamento e fica a acompanhar. ## Onde encaixa Encaixa exatamente nos buracos que o plano de grupo não cobre: **Quem não vai a nada.** Há sempre um conjunto de residentes que recusa atividades de grupo: por timidez, por perda auditiva, por não gostar de barulho. Uma sessão individual de dez minutos no cadeirão é uma porta de entrada para quem nunca aparece na sala. **Quem não sai do quarto.** Acamados, em isolamento, em recuperação de uma fratura. É o grupo que o plano de atividades costuma perder por completo, e é onde uma solução que se desloca faz mais diferença. Há modo deitado para quem está reclinado. **Dias de chuva e agosto.** O passeio que foi cancelado, a semana em que metade da equipa está de férias. Ter uma atividade que não depende do tempo nem de transporte tira pressão ao calendário. **Conversa a partir de um lugar.** Ver a vindima, uma praia conhecida ou uma aldeia costuma abrir conversa melhor do que uma pergunta direta. A atividade não acaba quando o equipamento sai da cabeça: muitas vezes é aí que começa. **Momentos com a família.** Uma visita que não sabe o que dizer tem ali um assunto: escolher o sítio, ver a reação, falar sobre isso a seguir. ## Uma semana realista Não é um plano para copiar: é a forma que costuma resultar quando se junta ao que já existe: | Dia | Manhã | Tarde | |---|---|---| | Segunda | ginástica de grupo | 4 sessões individuais (quartos) | | Terça | ateliê | passeio ou, se chover, cenários na sala | | Quarta | música | 4 sessões individuais (novos residentes) | | Quinta | jogos de mesa | visitas de família, sessão a dois | | Sexta | missa / conversa | 4 sessões individuais (acamados) | Doze a dezasseis sessões por semana, com uma pessoa. Ao ritmo de cinco minutos para escolher e colocar, mais dez de sessão, cabe numa tarde sem desfazer o resto. ## O que registar Duas colunas resolvem quase tudo: **quem** e **o quê**. Quem esteve, que cenário, quanto tempo, e uma linha sobre a reação. Serve para três coisas que uma direção técnica precisa de ter: mostrar à família o que foi feito, perceber o que resulta com cada pessoa, e responder numa auditoria sem reconstruir a memória de ninguém. No RVer esse registo é automático: fica escrito o que foi visto, com que equipamento e durante quanto tempo. O que não fica registado é nenhum dado clínico do residente: isso não sai do equipamento. :::note A realidade virtual em contexto de lar é uma atividade de conforto, estimulação e bem-estar, conduzida por profissionais ou cuidadores com formação, e nunca autoadministrada. Não é tratamento, não substitui avaliação clínica nem terapêutica prescrita, e a decisão de a incluir no plano de cada residente é da equipa. ::: ## Três perguntas antes de a pôr no plano 1. **Quem vai conduzir?** Sem nome e sem hora marcada, não acontece. 2. **A quem vai primeiro?** Comece por quem não vai a nada: é onde se nota. 3. **Como vai saber se resultou?** Se não ficar registado, daqui a três meses a resposta é uma opinião. O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Sobre quem pode conduzir as sessões, ver [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Sobre residentes acamados, ver [modo deitado](/blog/realidade-virtual-modo-deitado-acamados/). Sobre a conta que justifica isto à direção, ver [quanto rende num lar](/blog/roi-realidade-virtual-lar-de-idosos/). Q: A realidade virtual é uma atividade de grupo? A: Não. É uma sessão individual, de cinco a quinze minutos, sempre com alguém ao lado. Serve para chegar a quem não participa em atividades de grupo e a quem não sai do quarto, e não substitui o convívio nem a animação em grupo. Q: Quantas sessões cabem numa tarde? A: Contando cerca de cinco minutos para escolher o cenário e colocar o equipamento, mais dez de sessão, quatro sessões cabem numa tarde sem desfazer o resto do plano. Doze a dezasseis por semana é o ritmo que vemos com uma pessoa a conduzir. Q: Quem pode conduzir as sessões num lar? A: Profissionais ou cuidadores com formação: animadores socioculturais, auxiliares, enfermagem, dependendo de como a instituição organiza a atividade. Nunca é autoadministrada. Quem em concreto conduz é decisão da instituição. ### NIS2: onde está a RVer, e o que fica do lado da instituição URL: https://rver.pt/blog/nis2-o-estado-da-seguranca-na-plataforma-rver/ Date: 9 August 2026 A NIS2 mudou uma coisa para as instituições de saúde: a segurança dos vossos fornecedores passou a ser um assunto vosso. Aqui fica o estado da RVer, e a divisão de responsabilidades que propomos. A NIS2 é hoje um dos primeiros pontos de qualquer conversa com um departamento de sistemas de informação na saúde. E com razão: a diretiva alargou o universo de entidades abrangidas, subiu o nível de exigência técnica e, a parte que mais muda o dia a dia, **responsabilizou as entidades pela segurança da sua cadeia de fornecimento**. Ou seja: a partir do momento em que um equipamento da RVer entra numa instituição abrangida, a postura de segurança da RVer deixa de ser um assunto só nosso. Passa a ser um item do vosso dossiê. Este artigo responde à pergunta como ela costuma ser feita: *em que estado está a RVer?* ## O estado, em duas frases A plataforma RVer **cumpre os requisitos técnicos aplicáveis** do regime. Uma parte dos requisitos da NIS2, porém, é **organizacional e não técnica**, e essa parte não pertence a nenhum fornecedor: pertence à instituição. Sobre essa, o que fazemos é **recomendar, documentar e apoiar**. Essa distinção é a coisa mais útil que podemos trazer para a reunião, e é o resto deste artigo. [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## Do nosso lado: as medidas técnicas Por razões evidentes não publicamos configurações, versões ou detalhes de implementação: descrever a fechadura em público é trabalhar contra o objetivo. Na generalidade, e é isto que consta da documentação que entregamos: - **Os dados são cifrados**, em trânsito e em repouso. As cópias de segurança são igualmente cifradas, e a chave de recuperação não vive na mesma infraestrutura que protege. - **Autenticação forte obrigatória** em todos os acessos administrativos, com segundo fator. Sem exceções por conveniência. - **Menor privilégio por perfil**: cada utilizador vê e faz apenas o que a sua função exige. - **Registo de auditoria** de acessos, alterações e operações sensíveis, com quem, quando e o quê. - **Proteção contra tentativas de acesso abusivas**, com bloqueio automático. - **Infraestrutura e dados em jurisdição europeia**, incluindo as cópias de segurança. - **Atualizações e correções de segurança** aplicadas de forma controlada, com procedimento de reposição. Nada disto é vendido como um selo. É a linha de base que consideramos mínima para pôr equipamento dentro de uma instituição de saúde. ## Os dados do utente não saem do equipamento Esta é, na prática, a resposta que resolve metade das reuniões de segurança. **Nenhum dado de utilização do utente sai do equipamento.** O registo de sessão, as estatísticas de atividade, as leituras associadas a uma pessoa: tudo isso fica no equipamento e dentro do perímetro da instituição. Não é enviado para a RVer, não alimenta nenhum painel nosso e não existe do nosso lado. O que efetivamente circula são duas coisas, e só duas: 1. **Informação técnica para atualização e suporte remoto** do equipamento: estado do dispositivo, versões, diagnóstico de falhas. É o que permite manter uma frota atualizada sem deslocar alguém a cada sala. 2. **Dados agregados sobre o funcionamento do produto**, que usamos para o melhorar: como se comporta, onde falha, o que é lento. Nenhuma destas categorias inclui conteúdo clínico de uma sessão nem leituras associadas a um utente identificado. O efeito prático para o vosso encarregado de proteção de dados é simples: **a instituição é a responsável pelo tratamento** desses dados e a RVer não fica com uma cópia deles. A superfície de risco que teria de ser avaliada, negociada e monitorizada... não chega a existir. ## Do vosso lado: o que a NIS2 não deixa delegar Esta é a parte que às vezes apanha as instituições de surpresa. Uma parte substancial da NIS2 não é sobre tecnologia, é sobre governação. E não há fornecedor no mercado que a possa cumprir por vocês: - **Responsabilidade do órgão de gestão**: a direção responde pelas medidas, e tem de as conhecer. - **Análise de risco e política de segurança** da própria organização. - **Gestão de acessos e do ciclo de vida das contas**: quem entra, quem sai, quem deixa de precisar. Nós damos as ferramentas; a política é vossa. - **Plano de resposta a incidentes e deveres de notificação**, com prazos apertados e um destinatário definido. - **Continuidade de negócio e recuperação**, incluindo os testes que provam que o plano funciona. - **Formação e sensibilização** das pessoas que usam os sistemas. - **Gestão de risco da cadeia de fornecimento**: na qual nós somos um dos itens a avaliar. Sobre estes pontos, o que a RVer faz é **sugerir e apoiar**: entregamos as recomendações aplicáveis ao nosso equipamento, documentamos as nossas próprias medidas para o vosso processo de avaliação de fornecedores, e temos um canal definido para comunicação de incidentes que envolvam o nosso produto. ## O que vos entregamos para o dossiê Quando uma instituição nos pede a documentação de segurança, o que segue é: - descrição das medidas técnicas aplicadas ao produto e à plataforma; - localização e jurisdição dos dados, incluindo as cópias de segurança; - que categorias de dados saem do equipamento, e, sobretudo, quais não saem; - política de retenção e de eliminação; - canal e prazos de contacto para incidentes de segurança; - recomendações de configuração do lado da instituição (rede, contas, gestão do equipamento). É material pensado para ser anexado ao vosso processo, não para ser lido como marketing. ## Porque é que isto importa a quem compra Um equipamento que obriga a abrir uma exceção de segurança custa muito mais do que o preço de tabela. Custa reuniões, custa um parecer, custa risco assumido por alguém que assina. A posição da RVer foi construída para o caso contrário: **dados de utente que não saem, cifra por omissão, autenticação forte obrigatória, jurisdição europeia e um registo de auditoria que responde à pergunta "quem fez o quê"**. O que fica por fazer fica do lado certo, o da governação da própria instituição, e nós dizemo-lo à partida, em vez de deixar que apareça na auditoria. A plataforma RVer tem como produto base um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED, com registo de sessões em conformidade com o RGPD. Numa versão mais curta e prática para uma reunião: [as oito perguntas da informática](/blog/informatica-hospital-perguntas-realidade-virtual/). Q: A RVer cumpre a NIS2? A: A plataforma cumpre os requisitos técnicos aplicáveis do regime: cifra em trânsito e em repouso, autenticação forte obrigatória nos acessos administrativos, menor privilégio, registo de auditoria, proteção contra tentativas de acesso abusivas e dados em jurisdição europeia. Parte dos requisitos da NIS2 é organizacional (governação, resposta a incidentes, formação, gestão da cadeia de fornecimento) e pertence à instituição; sobre esses, a RVer recomenda, documenta e apoia. Q: Que dados do utente saem do equipamento? A: Nenhum. O registo de sessão, as estatísticas de utilização e as leituras associadas a uma pessoa ficam no equipamento e dentro do perímetro da instituição. O que circula é informação técnica para atualização e suporte remoto do equipamento, e dados agregados sobre o funcionamento do produto para melhoria do serviço, sem conteúdo clínico de sessão e sem leituras associadas a um utente identificado. Q: Os dados estão cifrados? A: Sim, em trânsito e em repouso, incluindo as cópias de segurança. Por razões de segurança não detalhamos publicamente configurações, versões ou implementação; a descrição das medidas é entregue às instituições para o seu processo de avaliação de fornecedores. Q: Onde ficam alojados os dados? A: Em infraestrutura em jurisdição europeia, incluindo as cópias de segurança, que são igualmente cifradas. Q: Que obrigações NIS2 ficam do lado da instituição? A: As organizacionais: responsabilidade do órgão de gestão, análise de risco e política de segurança, gestão de acessos e do ciclo de vida das contas, plano de resposta a incidentes e deveres de notificação, continuidade e recuperação, formação das pessoas, e gestão de risco da cadeia de fornecimento. Nenhum fornecedor as pode cumprir pela instituição; a RVer entrega as recomendações aplicáveis ao seu equipamento e a documentação das suas próprias medidas. Q: Que documentação de segurança recebemos? A: Descrição das medidas técnicas, localização e jurisdição dos dados e das cópias de segurança, que categorias de dados saem e não saem do equipamento, política de retenção e eliminação, canal e prazos para comunicação de incidentes, e recomendações de configuração do lado da instituição. ### O que a equipa clínica vê no registo de sessão da RVer URL: https://rver.pt/blog/o-que-a-equipa-clinica-ve-no-registo-de-sessao/ Date: 8 August 2026 A pergunta chega em quase todas as reuniões: enquanto clínico, que dados é que eu consigo tirar disto? A resposta honesta tem duas metades: o que registamos, e o que deliberadamente não fazemos. Há uma pergunta que aparece em quase todas as reuniões com equipas clínicas, normalmente logo na primeira conversa: *que dados é que eu consigo tirar disto?* É a pergunta certa. E merece uma resposta com duas metades: porque tão importante como o que a RVer regista é o que a RVer, por desenho, não faz com esse registo. ## A regra que define tudo o resto O produto base da RVer é um **Dispositivo Médico Classe I** registado no INFARMED e na EUDAMED. Essa classe não é um detalhe administrativo: é ela que define a fronteira do que o sistema pode fazer. Na regulamentação europeia, o software de saúde divide-se, muito resumidamente, em três faixas: - **Não é dispositivo**: bem-estar e estilo de vida, sem finalidade médica. - **Classe I**: tem finalidade médica, mas **não fornece informação usada para decisões de diagnóstico ou terapêuticas**. - **Classe IIa ou superior**: fornece informação que alimenta essas decisões, ou monitoriza processos fisiológicos. A RVer está registada na faixa do meio, e é aí que quer estar. Um sistema que pontuasse, comparasse com normas, sinalizasse desvios ou sugerisse condutas estaria a fornecer informação para uma decisão clínica, e seria outro dispositivo, com outra classe, outra avaliação de conformidade e outro preço para as instituições. Por isso a regra interna é simples e não se negoceia: **a RVer regista; quem lê é a equipa.** ## O que a aplicação Companion regista A aplicação Companion é o painel que a equipa usa para preparar, acompanhar e fechar cada sessão. De cada sessão fica um registo objetivo: - **quem**: o utente associado ao equipamento nessa sessão; - **quando**: data, hora de início e duração real; - **o quê**: o conteúdo escolhido, e o que foi efetivamente reproduzido; - **como terminou**: sessão concluída, interrompida ou terminada pela equipa; - **histórico**: a sequência de sessões do mesmo utente ao longo do tempo, para se ver consistência e adesão. Na prática, isto substitui a pergunta *"como é que correu ontem?"* por um registo que não depende de memória nem de relato. ## Com um módulo de movimento ativo Quando o equipamento tem um módulo de movimento ativo, o registo ganha uma camada adicional: **leituras de posição das mãos** e, quando aplicável ao módulo, **das pernas**. A partir daí ficam registados a contagem de repetições, a amplitude do movimento e o desempenho por sessão. É importante ser literal quanto ao que isto é: **são leituras de posição no espaço**: números de movimento produzidos pelos sensores do equipamento. Não são medições clínicas, não estão normalizadas por população, não têm limiares, não têm classificação e não vêm acompanhadas de qualquer juízo. São matéria-prima para a equipa olhar. :::note RVer Motion e RVer Neuro são módulos em desenvolvimento, **ainda** não abrangidos pelo registo de Dispositivo Médico Classe I, que cobre o produto base: a biblioteca de vídeo RVer. O produto base ostenta marcação CE ao abrigo do MDR 2017/745. ::: [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## As escalas são vossas, e é assim que tem de ser Esta é a parte que costuma resolver a conversa. A RVer **não fornece instrumentos de avaliação**. Não traz escalas embutidas, não as aplica, não as pontua e não as interpreta. O que a plataforma dá é o **campo e a linha do tempo**: o clínico regista, ao lado do registo da sessão, o instrumento que ele próprio escolheu, aplicou segundo as suas próprias regras e valorizou segundo o seu próprio critério. A diferença é toda: o instrumento é do clínico, a aplicação é do clínico, a leitura é do clínico. À RVer cabe garantir que esse registo fica guardado, datado, associado ao utente certo e disponível quando a equipa precisar dele. Não é uma limitação disfarçada de virtude. É o que separa um sistema que ajuda a equipa a organizar o seu próprio trabalho de um sistema que se arroga uma leitura clínica que não lhe compete. ## O que a RVer não faz Para não restar dúvida, e porque é isto que as equipas precisam de poder dizer aos seus próprios órgãos de gestão e de qualidade, a RVer **não**: - pontua, classifica ou atribui níveis; - compara o utente com normas, populações ou valores de referência; - sinaliza desvios, alertas clínicos ou "pioras"; - sugere condutas, exercícios ou ajustes terapêuticos; - avalia função, capacidade ou estado; - diagnostica, despista ou rastreia. A RVer **não é um equipamento de diagnóstico** e não substitui qualquer avaliação clínica nem a decisão da equipa. ## Onde é que os dados ficam O registo de sessão de um utente **fica no equipamento e na instituição**. Não é enviado para a RVer, não alimenta nenhum painel nosso e não sai do vosso perímetro. A instituição é a responsável pelo tratamento desses dados, no seu próprio enquadramento de RGPD; a RVer não fica com uma cópia deles. O que efetivamente circula é outra coisa: informação técnica necessária para atualizações e para suporte remoto ao equipamento, e dados agregados sobre o funcionamento do produto que usamos para o melhorar. Nada disso inclui o conteúdo clínico da sessão nem as leituras associadas ao utente. ## O resumo, para levar para a reunião seguinte A RVer entrega à equipa clínica um **registo objetivo e datado** do que aconteceu em cada sessão, e, com um módulo de movimento ativo, leituras de posição das mãos e das pernas. Entrega também o sítio certo para o clínico guardar os seus próprios instrumentos ao lado desse registo. O que não entrega é uma leitura. Essa é, e continuará a ser, da equipa. Q: Que dados é que a equipa clínica consegue ver de cada sessão? A: O utente associado ao equipamento, a data, a hora de início e a duração real, o conteúdo escolhido e efetivamente reproduzido, se a sessão foi concluída ou interrompida, e o histórico de sessões do mesmo utente ao longo do tempo. Com um módulo de movimento ativo, ficam também registadas leituras de posição das mãos e, quando aplicável, das pernas: repetições, amplitude e desempenho por sessão. Q: A RVer avalia, pontua ou diagnostica? A: Não. A RVer regista atividade de sessão e, quando o módulo aplicável está ativo, leituras de posição. Não pontua, não classifica, não compara com normas, não sinaliza desvios, não sugere condutas e não diagnostica. Não é um equipamento de diagnóstico e não substitui qualquer avaliação clínica nem a decisão da equipa. Q: Posso usar as minhas escalas dentro da plataforma? A: Sim, e é o clínico que as gere de ponta a ponta. A RVer não fornece instrumentos de avaliação, não os aplica, não os pontua e não os interpreta; disponibiliza o campo e a linha do tempo para o clínico registar, ao lado do registo da sessão, o instrumento que ele próprio escolheu e aplicou segundo o seu próprio critério. Q: Porque é que a RVer não dá interpretações ou sugestões automáticas? A: Porque o produto base está registado como Dispositivo Médico Classe I. Software que fornece informação usada para decisões de diagnóstico ou terapêuticas cai numa classe superior, com outra avaliação de conformidade. Manter a fronteira é uma decisão deliberada: a plataforma regista, a leitura clínica é da equipa. Q: Os dados de utilização do utente saem do equipamento? A: Não. O registo de sessão fica no equipamento e na instituição, que é a responsável pelo tratamento desses dados. O que circula é informação técnica para atualizações e suporte remoto ao equipamento, e dados agregados sobre o funcionamento do produto para melhoria do serviço, sem conteúdo clínico da sessão nem leituras associadas ao utente. Q: Os módulos de movimento estão abrangidos pelo registo de dispositivo médico? A: Ainda não. O registo de Dispositivo Médico Classe I no INFARMED e na EUDAMED abrange o produto base: a biblioteca de vídeo RVer. RVer Motion e RVer Neuro são módulos em desenvolvimento, ainda não abrangidos por esse registo, e o produto base ostenta marcação CE ao abrigo do MDR 2017/745. ### Quando um serviço pede algo que ainda não existe URL: https://rver.pt/blog/quando-um-servico-pede-algo-que-ainda-nao-existe/ Date: 6 August 2026 Num produto que é uma coisa só, tudo o que se acrescenta acrescenta-se a toda a gente. Numa plataforma de módulos, um pedido específico pode ser construído para quem o fez. Uma coordenadora de terapias descreve a sessão que faz às quintas de manhã, com um grupo específico, de uma forma específica, e pergunta se o headset consegue fazer aquilo. Às vezes já consegue. Outras vezes não, e na maior parte do software é aí que a conversa acaba. O pedido vai para uma lista. Compete com todos os outros pedidos de todos os outros clientes e, se algum dia sair, sai para toda a gente, dezoito meses depois, numa versão limada até caber na média. Não é falta de boa vontade. É o que acontece quando um produto é uma coisa só. Tudo o que se acrescenta, acrescenta-se a tudo. O RVer não é uma coisa só. É uma base mais módulos, e isso muda a resposta. ## O que um módulo realmente permite O RVer é uma plataforma nativa para o Meta Quest 3 e corre inteiramente no equipamento. Sem contas, sem login, sem dependência da nuvem: nenhum dado de utente sai da instituição. A capacidade é empacotada em módulos, licenciados e ativados por dispositivo: - **RVer**: a biblioteca base de vídeo imersivo 360° - **RVer Motion**: atividades de movimento acompanhado - **RVer Neuro**: atividades cognitivas Como a capacidade vive em módulos, e não fundida numa aplicação única, algo novo não tem de ser feito para toda a gente para poder existir. Pode ser feito para um caso de uso: um tipo de sessão, uma população, uma maneira própria de uma equipa trabalhar. Pode ser feito para um único cliente. Pode ficar ativo num só dispositivo, numa só sala, se for aí que faz sentido. Portanto a coordenadora não está a pedir que se altere um produto de que dependem todos os outros serviços. Está a pedir um módulo. É uma pergunta muito mais pequena, e muito mais respondível. ## Os serviços que não pediram nunca o veem Esta parte importa mais do que parece. Software que acumula tudo o que alguém alguma vez quis torna-se pesado para quem o usa todos os dias. Uma auxiliar que vai iniciar uma sessão antes do almoço deve ver as poucas coisas que o seu serviço faz, e não um menu carregado com os requisitos de outra instituição. Os módulos mantêm isso verdadeiro. Um dispositivo leva aquilo que o seu serviço ativou e mais nada. O crescimento da plataforma não se transforma em confusão no headset, e ninguém é formado em funcionalidades que eram para outra pessoa. Também significa que um módulo à medida não é uma versão à parte. Está tudo na mesma base, gerido da mesma maneira, atualizado da mesma maneira. Uma frota, seja qual for a combinação de capacidades a correr nela. ## E chega sem que ninguém se desloque Os módulos são ativados remotamente, e tanto a aplicação como os conteúdos atualizam pela rede. Uma decisão tomada numa terça-feira está ativa na frota. Sem reinstalação, sem ninguém no corredor, sem headsets encaixotados e enviados para parte nenhuma. Quando um módulo que o serviço já tem ganha novas atividades, elas simplesmente aparecem. Foi assim que a versão mais recente chegou às frotas que já a corriam: nas versões em desenvolvimento, o RVer Motion e o RVer Neuro ganharam novas atividades, e os dados de movimento que o RVer Motion entrega ao clínico tornaram-se mais detalhados. Nada foi instalado à mão e nenhum equipamento mudou. O lado comercial disto (pagar apenas pelos módulos que se ativa, e apenas nos dispositivos em que se ativa) já escrevemos à parte, em [porque é que um software modular é melhor para uma instituição de saúde](/blog/software-modular-vantagens-saude/). Aqui o ponto é mais estreito: o que a arquitetura permite construir, e não o que permite poupar. ## O que isto é, e o que não é O RVer Motion é um auxiliar de exercício e registo de movimento. O RVer Neuro são atividades cognitivas com registo da atividade da sessão. Ambos são módulos em desenvolvimento e não estão abrangidos pelo registo de Dispositivo Médico Classe I, que abrange o produto base. Ambos apoiam o clínico: nenhum o substitui, e nenhum toma decisões clínicas. O que se adapta aqui é comercial e operacional: que capacidade fica ativa, em que dispositivos, em que sala. O juízo clínico continua onde estava. ## De onde vem o roteiro Outros módulos estão em desenvolvimento, e a resposta honesta sobre a sua origem é simples: foram serviços que pediram. Isso só é viável porque uma boa ideia para uma instituição não tem de se tornar uma alteração para todas as instituições. O pedido que seria demasiado específico para um produto monolítico (demasiado pequeno, demasiado particular, demasiado a maneira de trabalhar de uma equipa) é exatamente o pedido a que uma plataforma modular consegue dizer que sim. Se o vosso serviço tem um desses, preferimos ouvi-lo. Sobre como desenhar essa experiência para ela terminar com uma decisão, ver [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/). Q: É possível ter capacidade feita à medida de um serviço? A: Sim. Como a capacidade é empacotada em módulos, algo novo pode ser construído para um caso de uso, para um cliente, ou ficar ativo apenas num dispositivo, sem alterar o que os outros serviços usam. Q: Os outros serviços passam a ver esse módulo? A: Não. Cada dispositivo leva apenas os módulos que o seu serviço ativou. O crescimento da plataforma não acrescenta confusão ao headset de quem não pediu. Q: Ativar um módulo obriga a instalar alguma coisa nos equipamentos? A: Não. Os módulos são ativados remotamente e tanto a aplicação como os conteúdos atualizam pela rede, sem deslocação e sem equipamento novo. Q: Um módulo à medida cria uma versão separada da aplicação? A: Não. Assenta na mesma base, é gerido da mesma maneira e atualizado da mesma maneira. Continua a ser uma frota só. Q: Os dados de utente saem da instituição? A: Não. O RVer corre inteiramente no Meta Quest 3, sem contas, sem login e sem dependência da nuvem. ### AVC e realidade virtual: o que a evidência mostra (e o que não mostra) URL: https://rver.pt/blog/avc-realidade-virtual-o-que-diz-a-evidencia/ Date: 3 August 2026 Reunimos seis revisões sistemáticas e meta-análises recentes, incluindo a Cochrane de 2025, para perceber o que a realidade virtual faz, e não faz, na reabilitação depois de um AVC. Depois de um AVC, cerca de 80% dos sobreviventes ficam com algum grau de disfunção motora do membro superior. A reabilitação funciona, mas é lenta, exige repetição em grande volume e depende de uma coisa difícil de garantir na prática: que a pessoa faça mais tempo de terapia do que consegue tolerar num ginásio convencional. É exatamente aí que a realidade virtual tem sido estudada. Reunimos seis revisões sistemáticas e meta-análises recentes (incluindo a revisão Cochrane de referência, atualizada em 2025) para responder a uma pergunta simples: **o que é que a evidência mostra, e o que é que ainda não mostra?** ## O maior benefício vem de acrescentar, não de substituir É o achado mais consistente de todos, e o mais fácil de ignorar. A [revisão Cochrane](https://pmc.ncbi.nlm.nih.gov/articles/PMC12178777/) (Laver et al., 2025) encontra evidência de certeza moderada a baixa de que a RV é ligeiramente mais benéfica do que abordagens alternativas na função do membro superior, no equilíbrio e na limitação de atividade. Mas sublinha que o benefício é mais claro quando a RV é **acrescentada aos cuidados habituais**, aumentando o tempo total de terapia, do que quando os substitui. A leitura correta não é "a RV é melhor do que o fisioterapeuta". É que a RV permite fazer mais dose de reabilitação, e a dose conta. ## Na marcha e no equilíbrio, a evidência é sólida A revisão de [Corbetta et al.](https://pubmed.ncbi.nlm.nih.gov/26093805/) (2015), sobre 15 ensaios aleatorizados e 341 participantes, mostrou que substituir parte ou a totalidade da reabilitação convencional por reabilitação com RV produziu melhorias significativas na **velocidade da marcha, no equilíbrio e na mobilidade**. Quando acrescentada à terapia convencional, o benefício manteve-se na mobilidade. ## No membro superior, o efeito é amplo, e a janela temporal importa A maior revisão do conjunto, de [Soleimani et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11127427/) (2024), rastreou 11 834 estudos e incluiu 55, com 2142 doentes. A RV superou a terapia convencional na função motora do membro superior, na independência funcional, na qualidade de vida, na espasticidade e na destreza. Dois parâmetros práticos saem dessa revisão: - intervenções com **mais de seis semanas** deram melhores resultados; - **iniciar nos primeiros seis meses** após o AVC otimizou os desfechos. [Villarroel et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11973539/) (2025) acrescenta duas notas úteis: os ganhos são mais pronunciados nas fases aguda e subaguda, e **combinar RV com terapia convencional deu melhores resultados do que RV isolada**. Curiosamente, se o software é um jogo comercial ou uma aplicação desenvolvida para reabilitação não alterou os desfechos. ## Onde a evidência ainda discorda: a imersão Aqui não há consenso, e seria desonesto fingir que há. [Soleimani](https://pmc.ncbi.nlm.nih.gov/articles/PMC11127427/) concluiu que a RV totalmente imersiva obteve os **maiores** ganhos na motricidade grosseira, com as abordagens não imersivas a destacarem-se na destreza fina. Mas a meta-análise em rede de [Zhang et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11996652/) (2025), com 34 ensaios e 1704 participantes, ordenou as modalidades de outra forma: o Microsoft Kinect foi o mais eficaz na função motora do membro superior, seguido da Nintendo Wii e da RV não imersiva, e os **dispositivos imersivos de cabeça não mostraram diferença estatisticamente significativa** face à terapia convencional. E [Kenea et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11943060/) (2025), sobre RV imersiva, encontrou melhorias estatisticamente significativas na escala Fugl-Meyer e no Box and Block Test que, nas palavras dos próprios autores, **não atingiram os limiares de significado clínico**. :::note Uma diferença estatisticamente significativa não é automaticamente uma diferença que o doente sente. É uma distinção que vale a pena exigir de qualquer fornecedor de tecnologia de saúde, incluindo nós. ::: ## E o custo? Estes estudos não respondem Vale a pena dizê-lo com clareza: **nenhuma destas seis revisões mediu custos, tempo até à alta ou retorno do investimento.** Medem função motora, equilíbrio, destreza, independência e qualidade de vida. Existe evidência económica sobre RV em saúde, mas incide sobretudo em dor e internamento, não no AVC. A pergunta "a RV torna a reabilitação do AVC mais barata?" continua, honestamente, em aberto, e desconfie de quem lhe disser o contrário sem citar um estudo. ## O que isto significa na prática Lendo as seis em conjunto, o padrão que emerge é razoavelmente claro: 1. **A RV é um complemento, não um substituto.** O ganho vem sobretudo de mais dose de terapia, com supervisão clínica. 2. **Começar cedo e manter.** Primeiros seis meses, programas acima de seis semanas. 3. **A modalidade importa e ainda está em discussão.** Quem afirmar o contrário está a vender, não a citar. 4. **O caso económico ainda não está feito** para o AVC especificamente. O RVer é um sistema de realidade virtual concebido para ser utilizado **sob supervisão de profissionais de saúde**, como complemento não farmacológico dos programas de reabilitação existentes, nunca em substituição de cuidados médicos. O módulo de movimento guiado, [RVer Motion](/modulos/motion/), está em desenvolvimento e não está abrangido pelo registo Classe I, que cobre o produto base. As seis revisões citadas estão ligadas ao longo do artigo, e as restantes referências estão no tema [reabilitação](/estudos/tema/reabilitacao/) da biblioteca: cinco têm texto integral livre no PubMed Central e a sexta tem resumo aberto no PubMed. Não é preciso acreditar em nós: leia as fontes. O mesmo exercício, feito para outra condição neurológica: [realidade virtual e doença de Parkinson](/blog/realidade-virtual-doenca-de-parkinson/). Q: A realidade virtual substitui a fisioterapia depois de um AVC? A: Não. O achado mais consistente da revisão Cochrane de 2025 é que o benefício é mais claro quando a RV é acrescentada aos cuidados habituais, aumentando o tempo total de terapia, do que quando os substitui. É um complemento usado sob supervisão clínica. Q: Quando se deve começar a usar RV na reabilitação do AVC? A: A meta-análise de Soleimani et al. (2024) concluiu que iniciar nos primeiros seis meses após o AVC otimizou os desfechos, e que programas com mais de seis semanas deram melhores resultados. Villarroel et al. (2025) encontrou ganhos mais pronunciados nas fases aguda e subaguda. Q: A realidade virtual imersiva é melhor do que a não imersiva? A: A evidência é contraditória. Soleimani et al. (2024) encontrou os maiores ganhos na motricidade grosseira com RV totalmente imersiva, mas a meta-análise em rede de Zhang et al. (2025) não encontrou diferença estatisticamente significativa para dispositivos imersivos de cabeça. É uma questão em aberto na literatura. Q: A realidade virtual torna a reabilitação do AVC mais barata? A: Nenhuma das seis revisões analisadas mediu custos, tempo até à alta ou retorno do investimento. Existe evidência económica sobre RV em saúde, mas incide sobretudo em dor e internamento, não especificamente no AVC. ### App Companion: controlar os headsets VR à distância, sem instalar nada URL: https://rver.pt/blog/app-companion-controlo-remoto-realidade-virtual/ Date: 20 July 2026 A promessa da Realidade Virtual para uso clínico é que o doente relaxa enquanto a equipa mantém o controlo. A app Companion é a peça que torna esse controlo simples: a partir do browser, sem instalar nada. ## Quem controla a sessão? Numa terapia por Realidade Virtual bem desenhada, o doente só vê e relaxa. Quem escolhe o cenário, ajusta o volume e decide quando parar é a **equipa**, e não o doente, que muitas vezes está fragilizado, com défice cognitivo ou simplesmente a descansar dentro da experiência. O desafio é prático: como é que uma pessoa controla um headset que está na cabeça de outra, do outro lado da sala, e como é que gere vários ao mesmo tempo, numa enfermaria ou num lar? É para isto que existe a app Companion. [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## Um browser, uma frota A Companion abre no **browser** de qualquer PC ou tablet na mesma rede Wi-Fi. Não há nada para instalar, configurar ou atualizar: o endereço aparece na própria app do headset. Cada headset surge como um **cartão** no ecrã, e a partir daí o clínico: - escolhe o cenário e reproduz ou pausa; - avança ou recua ±10 segundos; - ajusta o **volume e o brilho** à distância; - atribui o paciente à sessão; - faz uma **paragem de emergência** imediata. Uma só pessoa gere assim uma frota inteira de headsets a partir de um único ecrã, útil quando há várias sessões a decorrer em simultâneo. :::note Tudo corre na **rede local**. A Companion não depende da internet nem de contas na nuvem, e nenhum dado do doente sai do equipamento, em conformidade com o RGPD por defeito. ::: ## Porque é que "sem instalar nada" importa Num serviço de saúde, cada software novo é um pedido ao departamento de informática, uma aprovação, uma manutenção. Ao correr no browser, a Companion evita tudo isso: funciona em qualquer PC ou tablet que já exista no serviço, sem integração com os sistemas hospitalares e sem instalação. A equipa começa a usar no mesmo dia. ## O papel do RVer A Companion faz parte do RVer, um Dispositivo Médico Classe I (produto base, registado no INFARMED e na EUDAMED, MDR 2017/745). A filosofia é sempre a mesma: a tecnologia amplifica a equipa clínica, não a substitui. O doente vive a experiência; a equipa mantém o controlo, do primeiro toque à paragem de emergência. Gerir vários equipamentos a partir de um ecrã muda a resposta a [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Q: Como é que a equipa controla o headset de Realidade Virtual durante a sessão? A: Através da app Companion, que abre no browser de qualquer PC ou tablet na mesma rede Wi-Fi, sem instalar nada. Cada headset aparece como um cartão: escolher cenário, reproduzir ou pausar, ajustar volume e brilho, atribuir paciente e fazer uma paragem de emergência à distância. Q: É preciso instalar software para usar a Companion? A: Não. A Companion corre no browser através do endereço que a própria app do headset mostra. Não há nada para instalar, configurar ou atualizar, e funciona em qualquer PC ou tablet da rede. Q: Posso gerir vários headsets ao mesmo tempo? A: Sim. Cada headset aparece como um cartão na mesma página, por isso uma única pessoa pode controlar e monitorizar uma frota inteira a partir de um só ecrã. Q: A Companion envia dados para a nuvem? A: Não. Tudo corre na rede local, sem depender da internet nem de contas na nuvem. Nenhum dado do doente sai do equipamento, em conformidade com o RGPD. ### Modo deitado: Realidade Virtual para doentes acamados URL: https://rver.pt/blog/realidade-virtual-modo-deitado-acamados/ Date: 20 July 2026 A maioria das experiências de Realidade Virtual assume que o doente está sentado e de pé. Muitos não estão. O modo deitado torna a experiência imersiva possível para quem passa o dia na cama, com menos desconforto e sem conteúdo especial. ## O problema de estar deitado num mundo feito para estar sentado A Realidade Virtual para uso clínico mostra vídeo 360º real: uma praia, uma floresta, um lugar familiar. O centro da experiência é o horizonte: quando está direito, o cérebro relaxa e aceita o cenário. Quando está torto, surge desconforto e, muitas vezes, enjoo. O problema é que a maioria dos sistemas assume que a pessoa está sentada ou de pé. Num doente **acamado ou reclinado**, a cabeça está a 30º, 45º ou mesmo 90º da vertical. O horizonte aparece inclinado, o mundo fica torto, e a sessão torna-se incómoda precisamente para quem mais beneficiaria dela. ## O que o modo deitado faz O modo deitado do RVer alinha o horizonte da experiência com a **inclinação real da cabeça** do doente. A recentragem normal do headset limita-se à orientação frontal e é alinhada pela gravidade, não resolve isto. O RVer vai mais longe: inclina o mundo inteiro (vídeo, menus e painéis) para o ângulo em que a pessoa está. O resultado: a imagem aparece direita a qualquer inclinação, e **todos os cenários 360º funcionam** sem ser preciso filmar versões "deitadas". Cada ângulo é, na prática, uma variação nova do mesmo conteúdo. :::note O modo deitado ativa-se por sessão e desliga-se automaticamente no fim. Enquanto está ativo, oculta os módulos de movimento e cognição, porque um doente acamado não vai fazer exercício físico guiado, mantendo a interface simples para a equipa. ::: ## Onde faz diferença - **Cuidados paliativos:** evasão, conforto e reminiscência para quem já não sai da cama. - **Pós-operatório:** distração e relaxamento nas primeiras horas e dias, sem levantar o doente. - **Hemodiálise e tratamentos prolongados:** ocupar de forma calmante as horas em cadeira reclinada. - **Cadeira de dentista e procedimentos:** reduzir a ansiedade em posições que não são verticais. Em todos estes contextos, o objetivo é o mesmo: levar um momento de calma a pessoas que, pela sua posição, ficariam de fora da Realidade Virtual convencional. ## O papel do RVer O RVer é um Dispositivo Médico Classe I (produto base, registado no INFARMED e na EUDAMED, MDR 2017/745). Não substitui os cuidados clínicos, mas complementa-os, como alternativa não farmacológica e sob supervisão da equipa. O modo deitado é uma das formas de tornar essa terapia acessível ao maior número possível de doentes, seja qual for a posição em que se encontram. O modo deitado é uma peça de um quadro maior: [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Sobre chegar a quem não sai do quarto, ver [o plano de atividades de um lar](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). Q: A Realidade Virtual funciona com doentes acamados? A: Sim. O modo deitado do RVer alinha o horizonte da experiência com a inclinação da cabeça, por isso a imagem aparece direita mesmo com o doente a 30º, 45º ou 90º: na cama, em cadeira reclinada, em hemodiálise ou no pós-operatório. Aplica-se a todos os cenários 360º e ativa-se nas definições. Q: O modo deitado reduz o enjoo? A: Reduz uma das principais causas de desconforto em Realidade Virtual: um horizonte desalinhado. Ao acompanhar a inclinação da cabeça, mantém a imagem estável e natural. Como sempre, recomenda-se começar com sessões curtas e parar se surgirem tonturas ou desconforto. Q: É preciso conteúdo especial para usar o modo deitado? A: Não. O mesmo vídeo 360º funciona a qualquer ângulo: 0º, 30º, 45º ou 90º. Não é necessário filmar versões deitadas: cada inclinação é uma variação do conteúdo existente. Q: Em que contextos clínicos é mais útil? A: Cuidados paliativos, pós-operatório, hemodiálise, tratamentos prolongados em cadeira reclinada e procedimentos em posições não verticais. Em todos, o objetivo é levar conforto e distração a doentes que não se conseguem sentar. ### Delírium na UCI: pode a Realidade Virtual ajudar a prevenir? URL: https://rver.pt/blog/realidade-virtual-delirium-cuidados-intensivos/ Date: 20 July 2026 O delírium afeta uma parte significativa dos doentes internados em cuidados intensivos e associa-se a piores resultados. As melhores estratégias de prevenção são não farmacológicas, e é aí que a Realidade Virtual desperta interesse. ## O que é o delírium e porque importa na UCI O delírium é um estado agudo de confusão, com alteração da atenção e da consciência que oscila ao longo do dia. Na Unidade de Cuidados Intensivos (UCI) é frequente e está associado a internamentos mais longos, maior mortalidade e sequelas cognitivas a longo prazo. Várias condições da própria UCI contribuem para ele: **privação de sono**, ruído e luz constantes, imobilização, ausência de referências temporais e isolamento da família. Muitos destes fatores são ambientais, e, por isso, potencialmente modificáveis sem medicação. ## Porque é que a prevenção não farmacológica está no centro As abordagens farmacológicas ao delírium têm eficácia limitada e riscos próprios. Por isso, os pacotes de prevenção mais recomendados são **não farmacológicos**: reorientar o doente no tempo e no espaço, promover o sono, reduzir estímulos agressivos, mobilizar cedo e aproximar a família. É neste território que a Realidade Virtual para uso clínico encaixa como hipótese de investigação. A ideia não é tratar o delírium instalado, mas atuar sobre os fatores ambientais que o favorecem. ## Onde a Realidade Virtual pode contribuir - **Orientação e normalidade:** cenários calmos e reconhecíveis (um jardim, um dia de sol, um lugar familiar) devolvem referências a um ambiente desorientador. - **Redução da privação sensorial:** substituir, por períodos curtos, o tecto e os alarmes por um estímulo agradável e controlado. - **Relaxamento e sono:** experiências desenhadas para acalmar podem apoiar a preparação para o descanso. - **Presença da família:** a videochamada dentro da experiência aproxima quem está longe, um dos fatores protetores conhecidos. :::note A evidência nesta área ainda está a construir-se: há estudos promissores e muito interesse clínico, mas faltam ensaios grandes. A Realidade Virtual deve ser vista como um **complemento em investigação**, integrado no pacote de prevenção, nunca como substituto do protocolo da unidade. ::: ## Cautela e critério clínico O doente crítico exige critério redobrado. A utilização deve ser sempre supervisionada, com sessões curtas, higiene rigorosa entre doentes e atenção a sinais de desconforto. A decisão de usar, e em quem, cabe à equipa responsável. ## O papel do RVer O RVer é um Dispositivo Médico Classe I (produto base, registado no INFARMED e na EUDAMED, MDR 2017/745) e uma alternativa não farmacológica complementar. Em contextos como a UCI, o seu valor está em oferecer à equipa mais uma ferramenta segura e controlável para agir sobre o ambiente: um dos poucos aliados na prevenção do delírium que não passa por mais um fármaco. Q: A Realidade Virtual trata o delírium? A: Não. A Realidade Virtual não trata o delírium instalado. É estudada como estratégia não farmacológica de prevenção, atuando sobre fatores ambientais que favorecem o delírium: desorientação, privação sensorial, ansiedade e isolamento. Deve integrar-se no pacote de prevenção da unidade, sob supervisão clínica. Q: Há evidência de que funciona na UCI? A: A evidência ainda está a construir-se: existem estudos promissores e forte interesse clínico, mas faltam ensaios de grande dimensão. Por isso, a Realidade Virtual deve ser encarada como um complemento em investigação, não como uma intervenção comprovada nem um substituto do protocolo. Q: É seguro usar com doentes críticos? A: Deve ser usada com critério redobrado: sempre supervisionada, com sessões curtas, higiene rigorosa entre doentes e atenção a sinais de desconforto. A decisão de utilizar, e em que doentes, cabe sempre à equipa responsável. Q: Como é que a Realidade Virtual pode ajudar na prevenção? A: Ao reintroduzir referências de orientação, reduzir a privação sensorial, apoiar o relaxamento e o sono e aproximar a família através da videochamada: atuando sobre fatores ambientais modificáveis, sem recorrer a medicação adicional. ### Realidade Virtual em Cuidados Continuados (RNCCI) em Portugal URL: https://rver.pt/blog/realidade-virtual-cuidados-continuados-rncci/ Date: 20 July 2026 Nas unidades da Rede Nacional de Cuidados Continuados Integrados, o tempo é longo e o objetivo é duplo: recuperar função e manter a qualidade de vida. A Realidade Virtual para uso clínico serve exatamente estes dois lados. ## Um contexto diferente do hospital de agudos A Rede Nacional de Cuidados Continuados Integrados (RNCCI) cobre unidades de convalescença, de média duração e reabilitação, e de longa duração e manutenção. Ao contrário do hospital de agudos, aqui as estadias medem-se em **semanas ou meses**, e o doente tem frequentemente idade avançada, mobilidade reduzida e vários dias iguais pela frente. Este contexto muda o que se pede à tecnologia. Não se trata de uma intervenção pontual, mas de **acompanhar um percurso**: reabilitar, estimular e confortar, sessão após sessão, sem sobrecarregar uma equipa que já é reduzida. ## Os três eixos onde a Realidade Virtual encaixa **1. Reabilitação e adesão.** A recuperação motora nestas unidades depende da repetição, e a repetição depende da motivação. Transformar exercícios em cenários e jogos suaves ajuda o doente a manter a adesão ao longo de semanas, com registo objetivo do movimento para a equipa. **2. Estimulação cognitiva.** Em doentes com declínio cognitivo ou após AVC, a estimulação regular é parte do plano. Cenários de reminiscência (lugares familiares, épocas passadas) e exercícios cognitivos dão à equipa mais uma ferramenta estruturada. **3. Conforto e bem-estar.** Os dias longos pesam. Uma sessão calmante (uma praia, uma floresta, um pôr do sol) quebra a monotonia, reduz a ansiedade e melhora o humor, sem recorrer a mais medicação. :::note A RVer é uma alternativa **não farmacológica e complementar**. Não substitui o plano de reabilitação, a medicação nem o julgamento clínico: soma-se a eles, sob supervisão da equipa da unidade. ::: ## Simples para uma equipa reduzida O fator decisivo em cuidados continuados é operacional. O RVer foi pensado para equipas sem tempo para tecnologia complicada: arranca em modo quiosque com um toque, corre 100% offline (toda a biblioteca disponível, sem depender da internet), e a equipa controla tudo pela app Companion, no browser. A instalação e a formação estão incluídas. ## Custo e financiamento Um único equipamento serve muitos doentes ao longo do tempo, o que dilui o custo por sessão. Para instituições, vale a pena enquadrar o investimento nas linhas de financiamento e apoios disponíveis para inovação e qualidade em saúde: um tema que a nossa equipa ajuda a mapear caso a caso. Em suma: pela combinação de estadias longas, reabilitação e conforto, as unidades de cuidados continuados são um dos contextos onde a Realidade Virtual para uso clínico mostra melhor o seu valor. Q: A Realidade Virtual é adequada a unidades de cuidados continuados? A: Sim. As estadias longas e o objetivo duplo de reabilitar e confortar tornam estas unidades um contexto natural para a Realidade Virtual para uso clínico: apoia a adesão à reabilitação, a estimulação cognitiva e o bem-estar, sessão após sessão, como alternativa não farmacológica e complementar. Q: É preciso pessoal técnico para operar o equipamento? A: Não. O RVer arranca em modo quiosque com um toque, corre 100% offline e é controlado pela equipa através da app Companion, no browser. A instalação e a formação estão incluídas, sem necessidade de conhecimentos técnicos. Q: Funciona com doentes com mobilidade muito reduzida? A: Sim. Além de sessões sentadas, o modo deitado permite usar a Realidade Virtual com doentes acamados ou em cadeira reclinada, alinhando a imagem com a posição da pessoa. Q: Como se justifica o custo numa unidade? A: Um equipamento serve muitos doentes ao longo do tempo, o que reduz o custo por sessão. A nossa equipa ajuda a enquadrar o investimento nas linhas de financiamento e apoios à inovação em saúde disponíveis para a instituição. ### RVer Motion: movimento acompanhado em Realidade Virtual, com registo de cada sessão URL: https://rver.pt/blog/rver-motion-reabilitacao-com-realidade-virtual/ Date: 17 July 2026 O movimento acompanhado funciona quando o utente faz os exercícios, e continua a fazê-los. O RVer Motion é o módulo da RVer que torna esse movimento guiado, registado e, acima de tudo, motivador. O exercício acompanhado tem um problema conhecido: não falha por falta de exercícios, falha por falta de **repetição consistente**. O utente sabe o que tem de fazer, mas os exercícios em casa são aborrecidos, difíceis de registar e fáceis de abandonar. E quando não há registo objetivo, a equipa fica a depender do relato, nem sempre fiável, para saber o que aconteceu entre sessões. O **RVer Motion** foi desenhado para atacar exatamente esse ponto. ## Um treinador que demonstra, o utente que copia No centro do módulo está um treinador 3D calmo que demonstra cada exercício. O utente não precisa de ler instruções, interpretar menus ou lembrar-se da sequência: vê o movimento e acompanha. Essa simplicidade é deliberada: remove a barreira cognitiva e deixa o utente concentrado apenas no gesto. À medida que o utente se move, a aplicação **conta automaticamente as repetições** e regista o movimento. O que antes era "faça três séries de dez" passa a ser um número real, registado, sessão após sessão. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## Exercício que parece brincadeira Entre as sessões guiadas, o RVer Motion inclui um conjunto de **jogos suaves de mobilidade** e **ciclismo virtual sentado**. Cada jogo trabalha um tipo de movimento (amplitude, alcance, coordenação, equilíbrio) mas para o utente parece jogo. Essa diferença é o que sustenta a adesão. Alguém que quer voltar amanhã faz mais repetições do que alguém que sente que está a cumprir uma obrigação. E como tudo é ajustável, o mesmo módulo serve quem está a começar e quem já vai adiantado. ## Do movimento ao registo Cada movimento registado transforma-se em **registo objetivo para a equipa rever**. Em vez de perguntar "como correu?", a equipa abre o registo da sessão e vê o que aconteceu: repetições, amplitude, desempenho por sessão, consistência. É um registo da atividade: a leitura é sempre da equipa. O modo sentado alinha ainda a experiência com a inclinação da cabeça, o que torna o módulo utilizável por pessoas que não se conseguem levantar: na cama, em cadeira reclinada ou durante outros cuidados. ## Local, seguro e integrado O RVer Motion corre **localmente no equipamento**, sem depender de ligação à internet, e ativa-se por dispositivo. Faz parte da plataforma RVer, cujo **produto base** é um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED, com registo das sessões em conformidade com o RGPD. **O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos por esse registo.** O módulo regista a atividade da sessão: não avalia, não classifica, não diagnostica e não substitui qualquer avaliação clínica nem a decisão da equipa. Faz o que a tecnologia deve fazer numa instituição de saúde: **tirar trabalho de cima da equipa e devolver um registo útil**, enquanto mantém a pessoa a mexer-se. Q: O que é o RVer Motion? A: É o módulo de movimento acompanhado do sistema RVer. Um treinador 3D demonstra cada exercício enquanto o utente o acompanha, e a aplicação conta automaticamente as repetições e regista o movimento: repetições, amplitude e desempenho por sessão. Inclui jogos suaves de mobilidade e ciclismo virtual sentado, ajustáveis por utente. Funciona localmente e não substitui o critério clínico. Q: O RVer Motion está abrangido pelo registo de dispositivo médico? A: Não. O registo de Dispositivo Médico Classe I no INFARMED e na EUDAMED abrange o produto base: a biblioteca de vídeo RVer. O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos por esse registo. O produto base ostenta marcação CE ao abrigo do MDR 2017/745; os módulos não estão abrangidos por esse registo. Q: O RVer Motion avalia ou diagnostica? A: Não. O módulo regista a atividade da sessão: repetições, amplitude e desempenho, sem classificações, limiares ou normas. Não avalia, não classifica, não diagnostica e não substitui qualquer avaliação clínica. A leitura do registo é sempre da equipa. Q: Precisa de internet ou de instalação complexa? A: Não. O RVer Motion corre localmente no equipamento, sem depender de ligação à internet, e ativa-se por dispositivo nas definições. A instalação e a formação da equipa estão incluídas. ### Realidade virtual em hospitais: o que os estudos dizem sobre o tempo de internamento URL: https://rver.pt/blog/realidade-virtual-hospitais-mundo-tempo-internamento/ Date: 17 July 2026 Dos Estados Unidos à Coreia do Sul, há hospitais a usar realidade virtual no cuidado. O que os estudos publicados observaram, o que isso diz sobre o tempo de internamento, e o que ainda ninguém sabe. Nos últimos anos, hospitais de vários países (dos Estados Unidos ao Reino Unido, da Coreia do Sul ao Brasil) começaram a usar realidade virtual para uso clínico em alguns serviços. Há uma pergunta que aparece cedo em qualquer conversa com a gestão: **isto encurta o internamento?** A resposta honesta é que a evidência sobre o tempo de internamento é limitada e depende muito do contexto. Este artigo resume o que os estudos publicados analisaram, o que encontraram e o que ainda ninguém consegue afirmar. ## Onde a realidade virtual já é usada nos hospitais Os relatos publicados concentram-se em alguns serviços: pediatria (punções, pensos, exames de imagem), oncologia (sessões de tratamento longas), ortopedia e reabilitação, queimados, cuidados intensivos e preparação para cirurgia. Em quase todos, a realidade virtual entra como **abordagem complementar e não farmacológica**, ao lado do cuidado habitual e sob supervisão da equipa, e não como substituto de analgesia, sedação ou avaliação clínica. Há serviços que a usam com regularidade e outros onde ficou pelo projeto-piloto. As duas coisas acontecem, e as duas dizem alguma coisa. ## O que faz um internamento durar mais O tempo de internamento não depende só da doença. Pesam também: - **dor mal controlada e ansiedade**, antes e depois de procedimentos; - **imobilidade e perda de força**, sobretudo em estadias longas; - **delírio e sono perturbado**, frequentes em cuidados intensivos e em doentes mais frágeis; - **complicações e infeções** que surgem pelo caminho; - e fatores que nada têm de clínico: esperar por um exame, por transporte, por uma vaga na rede de cuidados continuados ou por apoio em casa. A realidade virtual pode, quando muito, tocar em parte dos primeiros. Nos últimos não toca de todo, e em muitos hospitais são eles que mais dias somam. ## O que os estudos observaram - **Dor e ansiedade em procedimentos.** É onde a evidência é mais abundante. Há ensaios aleatorizados e revisões sistemáticas que observaram menos dor e ansiedade referidas durante procedimentos, em crianças e em adultos, com distração imersiva. A realidade virtual pode ajudar a gerir a dor e a ansiedade, mas os efeitos variam com o procedimento, a idade e o conteúdo, e há estudos que não encontraram diferença. - **Sono e agitação.** Há estudos pequenos, sobretudo em cuidados intensivos, que exploraram ambientes calmos e imersivos para o sono e a agitação. Os resultados são preliminares e não permitem conclusões firmes. - **Mobilização.** Existem estudos de reabilitação com exercício em realidade virtual, com resultados mistos. No RVer, o exercício acompanhado corresponde ao **RVer Motion**, um módulo **em desenvolvimento e não abrangido pelo registo** de dispositivo médico Classe I, que cobre apenas o produto base. - **Tempo de internamento.** Poucos estudos o medem como resultado principal. Os que o medem vêm de contextos específicos, com amostras pequenas, e os resultados não são consistentes. Um procedimento mais tranquilo não se traduz automaticamente numa alta mais cedo. ## O que ainda não se sabe :::note Não se sabe se a realidade virtual reduz o tempo de internamento de forma geral, nem em quanto. Não há base para prometer camas libertadas, menos fármacos ou retorno financeiro num serviço concreto. Na nossa biblioteca pública, apenas **oito** estudos são sobre custos e retorno, todos de contextos muito específicos, e os números deles não se transferem para outro hospital: a população, o comparador e quem paga são diferentes. ::: Explicámos isto com mais detalhe em [«O ROI da realidade virtual que ninguém prova»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). A conclusão não é que não haja valor. É que o valor tem de ser medido no seu serviço, com métricas decididas antes de começar. ## O que um gestor pode medir Em vez de partir de um número de poupança, um piloto bem desenhado responde a perguntas de implementação: quantas sessões se fazem por semana, quanto tempo de equipa consomem (cronometrado, não estimado), quantos utentes recusam ou interrompem, e em que serviços a ferramenta entra mesmo na rotina. Um piloto não demonstra eficácia clínica e não deve ser apresentado como tal. Sobre isso, ver [como correr um piloto num serviço de saúde](/blog/piloto-realidade-virtual-hospital-como-correr/). ## Onde entra o RVer O RVer é um sistema de realidade virtual para uso clínico cujo produto base, a biblioteca de vídeo 360°, está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), com marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. O registo também não é um argumento de eficácia. Funciona offline, não depende dos sistemas informáticos do hospital e não recolhe dados clínicos do utente. É usado sempre com um profissional presente, com utentes dos 10 aos 100 anos. Não prescreve, não avalia, não diagnostica e não substitui o cuidado habitual. Os estudos estão na [biblioteca pública](/estudos/), incluindo os de resultados fracos ou neutros, e o que o registo abrange está em [Ciência e regulação](/ciencia/). :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: Q: A realidade virtual reduz o tempo de internamento? A: Não se sabe de forma geral. Poucos estudos medem o tempo de internamento como resultado principal, vêm de contextos específicos e os resultados não são consistentes. A evidência mais sólida é sobre dor e ansiedade durante procedimentos, e mesmo aí os efeitos variam. Q: Em que serviços hospitalares se usa realidade virtual? A: Os relatos publicados concentram-se em pediatria, oncologia, ortopedia e reabilitação, queimados, cuidados intensivos e preparação para cirurgia, sempre como abordagem complementar ao cuidado habitual e sob supervisão da equipa. Q: É possível saber de antemão quanto um hospital poupa? A: Não. Há poucos estudos económicos (oito na nossa biblioteca pública) e os números deles não se transferem para outro hospital, porque a população, o comparador e quem paga são diferentes. O que um piloto pode medir são sessões por semana, tempo de equipa e recusas. Q: O RVer substitui analgesia, sedação ou avaliação clínica? A: Não. O RVer é uma abordagem complementar e não farmacológica, usada sempre com um profissional presente. Não prescreve, não avalia e não diagnostica. O registo de dispositivo médico Classe I abrange o produto base, a biblioteca de vídeo 360°, e não é um argumento de eficácia. ### RVer Neuro: estimulação cognitiva em Realidade Virtual URL: https://rver.pt/blog/rver-neuro-cognicao-com-realidade-virtual/ Date: 16 July 2026 Exercícios em papel geram desinteresse e recusa. E se a atividade que estimula fosse também a que a pessoa quer repetir? As fichas de exercícios em papel funcionam, mas têm um custo conhecido: são monótonas, geram desinteresse e, muitas vezes, recusa. A pessoa sente que está a ser posta à prova, e desiste. A estimulação cognitiva acaba por acontecer menos vezes do que a equipa gostaria. O RVer Neuro parte de uma ideia simples: e se o exercício fosse algo que a pessoa quer repetir? ## Sete exercícios, numa sala virtual calma O módulo reúne sete atividades de Realidade Virtual que trabalham diferentes domínios cognitivos: - **Trilho de Números**: atenção e alternância - **Sequência de Blocos**: memória de trabalho - **Caça ao Foco**: atenção sustentada e autocontrolo - **Busca Visual**: atenção seletiva e varrimento visual - **Par de Formas**: raciocínio espacial em 3D - **Lista de Compras**: memória - **Memória Espacial**: memória espacial e orientação O utente controla cada tarefa com os dois comandos e o movimento da cabeça. A imersão remove as distrações do ambiente e torna a tarefa envolvente, o que ajuda sobretudo quem tem dificuldade em manter a atenção numa ficha de papel. Quase nada depende de saber ler: os itens são objetos 3D. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## Registo de atividade, decisão humana À medida que o utente executa, o registo da sessão segue em tempo real para o painel da equipa. Não há transcrição manual nem espera pelo fim da sessão. :::note **O que o registo é, e o que não é.** São contagens e tempos da atividade: quantos itens, em quanto tempo, com que erros. Não há classificações, limiares, normas nem comparação a valores de referência. O módulo **não avalia, não classifica e não diagnostica**, e não substitui qualquer avaliação clínica. É um auxiliar de estimulação e de registo de atividade, para fins de bem-estar. ::: ## Porque a Realidade Virtual ajuda aqui A diferença não está na tarefa em si: está em como ela é vivida. Numa sala virtual calma, sem os estímulos concorrentes de uma sala real, a pessoa concentra-se na atividade e não no seu próprio desempenho. A rotação mental em 3D, por exemplo, só é possível num ambiente tridimensional. A dificuldade é definida pela equipa. Só a Sequência de Blocos se adapta ao utente durante a atividade. ## Local, privado, integrado O RVer Neuro corre localmente no equipamento, sem nuvem, e ativa-se por dispositivo. Faz parte da plataforma RVer, cujo produto base é um Dispositivo Médico Classe I registado no INFARMED e na EUDAMED. O RVer Neuro é um módulo em desenvolvimento, não abrangido por esse registo. Nenhum dado do utente sai do equipamento, o que mantém tudo sob controlo da instituição e em conformidade com o RGPD. O módulo Neuro está **em desenvolvimento**, em parceria clínica. O RVer Neuro não pretende substituir nenhum profissional. Pretende dar à equipa uma atividade que as pessoas gostam de fazer, e um registo do que aconteceu na sessão, sem trabalho manual. Q: O que é o RVer Neuro? A: É o módulo de estimulação cognitiva do sistema RVer. Reúne sete atividades de Realidade Virtual (atenção, memória de trabalho, raciocínio espacial, pesquisa visual e memória) controladas com os dois comandos e o movimento da cabeça. O registo da atividade da sessão chega em tempo real ao painel da equipa. Q: O RVer Neuro avalia ou diagnostica? A: Não. O módulo regista a atividade da sessão: contagens e tempos, sem classificações, limiares, normas ou comparação a valores de referência. Não avalia, não classifica e não diagnostica, e não substitui qualquer avaliação clínica. É um auxiliar de estimulação e de registo de atividade, para fins de bem-estar. Q: Em que fase está o módulo Neuro? A: O registo de Dispositivo Médico Classe I no INFARMED e na EUDAMED abrange o produto base: a biblioteca de vídeo RVer. O RVer Neuro é um módulo em desenvolvimento, desenvolvido em parceria clínica, não abrangido por esse registo. O produto base ostenta marcação CE ao abrigo do MDR 2017/745; os módulos não estão abrangidos por esse registo. Q: Precisa de ligação à cloud? A: Não. O RVer Neuro corre localmente no equipamento, sem cloud, o que mantém os dados sob controlo da instituição e em conformidade com o RGPD. ### Porque é que um software modular é melhor para uma instituição de saúde URL: https://rver.pt/blog/software-modular-vantagens-saude/ Date: 15 July 2026 A pergunta não é 'que software tem mais funcionalidades?'. É 'que software me deixa usar só as que preciso, e adicionar as outras quando fizerem sentido?'. É aí que o modelo modular ganha. Comprar software para uma instituição de saúde costuma ser uma decisão desconfortável. As opções tradicionais pedem que se decida **hoje** aquilo que só se vai saber **amanhã**: de que funcionalidades vamos precisar, com que volume, para que serviços. Escolhe-se um pacote grande "por segurança", e paga-se por metade de coisas que nunca se usam. Ou escolhe-se um pacote pequeno, e daqui a um ano é preciso trocar tudo. Um **sistema modular** resolve este dilema de outra forma: começa-se com a base e adicionam-se capacidades quando a necessidade for real. ## Pagar pelo que se usa Num modelo modular, a plataforma base entrega o essencial e cada capacidade extra é um módulo que se ativa quando faz sentido. A instituição não financia funcionalidades paradas: o custo acompanha a utilização. No caso da RVer, a base cobre a experiência imersiva: ajuda a gerir a dor e a ansiedade, e dá conforto. Quem precisa de movimento acompanhado ativa o **RVer Motion**; quem precisa de atividades cognitivas ativa o **RVer Neuro**. Quem não precisa, não paga. O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos pelo registo de Dispositivo Médico Classe I, que abrange o produto base. ## Ativar por dispositivo, não por contrato inteiro A modularidade fina traz uma segunda vantagem: os módulos ativam-se **por dispositivo**. Um serviço de fisioterapia pode ter o Motion ativo nos seus equipamentos, enquanto o serviço de geriatria usa o Neuro nos dele: tudo na mesma plataforma, sem contratos paralelos. Isto permite testar uma capacidade nova numa ala antes de a estender a toda a instituição. Decisões pequenas, reversíveis, em vez de um compromisso único e caro. ## Crescer sem projetos de migração O maior custo escondido do software monolítico não é a licença: é a **migração**. Cada vez que se precisa de algo novo, há um projeto, uma paragem, formação repetida e risco. Num sistema modular, crescer é ativar o módulo seguinte. A base é a mesma, a equipa já a conhece, e a nova capacidade entra sem interromper o que já funciona. ## Melhorias contínuas, sem esforço da instituição Porque tudo assenta numa base comum, as **atualizações de software e de conteúdo chegam a todos os módulos ao mesmo tempo**, de forma automática. A instituição não gere versões nem contrata upgrades: o sistema melhora sozinho, e cada melhoria beneficia todos os módulos ativos. ## Uma base, muitas possibilidades Um bom sistema modular não é um conjunto de programas soltos. É **uma base registada e segura** sobre a qual assentam capacidades específicas. Na RVer, essa base é um Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED, que corre localmente e cumpre o RGPD, e essas garantias mantêm-se, quaisquer que sejam os módulos ativos. Para uma instituição de saúde, isto traduz-se numa vantagem simples: **começar pelo que precisa hoje, com a certeza de que o que precisar amanhã já está a um clique de distância**, sem recomeçar do zero. Do lado da infraestrutura, as perguntas que isto levanta estão em [«As oito perguntas da informática»](/blog/informatica-hospital-perguntas-realidade-virtual/). Q: O que significa um sistema ser modular? A: Significa que a plataforma base funciona por si e que capacidades adicionais (como reabilitação motora ou estimulação cognitiva) se ativam como módulos independentes, por dispositivo, quando a instituição precisa delas. Não é preciso comprar tudo de uma vez nem substituir o sistema para adicionar uma função. Q: Um sistema modular fica mais caro no total? A: Normalmente não. Paga-se pela base e adicionam-se módulos conforme a utilização real, o que evita pagar por funcionalidades que nunca se usam. Para volumes maiores existem preços adaptados, mas a lógica é sempre alinhar o custo com o uso. Q: E se precisarmos de uma capacidade nova mais tarde? A: Ativa-se o módulo correspondente, sem projeto de migração nem paragem. No caso da RVer, módulos como o Motion (reabilitação) e o Neuro (cognição) ativam-se por dispositivo nas definições. Q: A modularidade compromete a segurança ou a conformidade? A: Não. Numa boa arquitetura modular, todos os módulos partilham a mesma base registada e as mesmas regras de segurança e privacidade. Na RVer, a plataforma é um Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED, corre localmente e está em conformidade com o RGPD, independentemente dos módulos ativos. O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos pelo registo de Dispositivo Médico Classe I, que abrange o produto base. ### Onde está a poupança: as quatro alavancas de custo em hospitais e clínicas URL: https://rver.pt/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/ Date: 14 July 2026 A poupança não é uma propriedade da tecnologia: é do vosso serviço. Há quatro sítios onde pode estar, cada um com uma condição. Se nenhuma se aplicar, não está lá. *Atualizado a 16 de agosto de 2026.* «Onde está a poupança?» é a pergunta certa, e merece uma resposta que não seja um número inventado. A resposta honesta é que **a poupança não é uma propriedade da tecnologia: é uma propriedade do vosso serviço**. Há quatro sítios onde ela pode estar. Se nenhum deles se aplicar à vossa casa, não está lá, e mais vale sabê-lo antes de contratar. Esta página faz parte do [guia do ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/) e trata do lado do [hospital e da clínica](/solucoes/hospital/). Para um lar, a conta é outra e está em [quanto rende num lar](/blog/roi-realidade-virtual-lar-de-idosos/). ## Alavanca 1: Procedimentos que hoje exigem sedação É a alavanca com o custo unitário mais alto: um procedimento sedado consome fármaco, tempo de anestesia, vigilância na recuperação e, muitas vezes, um acompanhante que fica o dia todo. A literatura que estuda isto trabalha sobretudo em imagiologia pediátrica e em procedimentos curtos com distração. **A condição para haver poupança é simples: essas pessoas teriam mesmo sido sedadas.** Se no vosso serviço já se faz a maioria dos exames sem sedação, o custo evitado não existe: não porque a distração falhe, mas porque não havia despesa a evitar. ## Alavanca 2: Tempo de procedimento e interrupções Um doente calmo colabora, mexe-se menos, obriga a menos repetições. Onde isto conta é em salas cujo custo por minuto é alto e cuja agenda é o constrangimento: imagiologia, dentária, tratamento de feridas. A pergunta a fazer é: **quantos minutos por sessão, quantas sessões por dia, e o minuto de sala custa quanto?** Sem esses três valores, qualquer estimativa é conversa. ## Alavanca 3: Faltas, cancelamentos e desistências Esta é a mais subestimada. Uma consulta ou exame que não acontece porque a pessoa não apareceu, ou porque entrou em pânico à porta, custa o slot inteiro. Em ressonância magnética e em consultas de dentária, o medo é uma causa reconhecida de não comparência. Aqui a conta é fácil de fazer com dados que já têm: taxa de não comparência, custo do slot, e a fração dessa taxa que é atribuível a ansiedade ou claustrofobia. ## Alavanca 4: Adesão em programas longos Em reabilitação, o problema raramente é a primeira sessão: é a décima. Um programa abandonado a meio consome recursos e não produz o desfecho que justificava o gasto. O que a literatura de reabilitação em realidade virtual mais reporta é **adesão e envolvimento**: mais sessões completadas, não necessariamente melhor resultado clínico. ## A quinta, que não é poupança Experiência do doente, diferenciação, satisfação da família, atratividade para profissionais. É valor real e muitas vezes é o que decide a compra, mas não é uma linha de custo evitado, e apresentá-la como tal num caderno de encargos enfraquece o resto do argumento. ## Um modelo que se aguenta Para cada alavanca que se aplique ao vosso serviço: > **custo unitário evitado × frequência real × probabilidade de evitar** A terceira parcela é a que quase toda a gente esquece, e é a que separa uma estimativa defensável de um folheto. Se não souber estimar a probabilidade, meça-a: é exatamente para isso que serve um piloto. | Alavanca | Aplica-se se… | |---|---| | Sedação | os doentes em causa seriam sedados | | Tempo de sala | o minuto de sala é caro e a agenda é o constrangimento | | Faltas | a taxa de não comparência tem causa ansiosa identificável | | Adesão | há programas longos com abandono conhecido | ## Antes de usar qualquer número destes Os valores publicados noutros países e noutros sistemas **não transferem**: mudam a população, o comparador e quem paga o quê. Está explicado em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/), e é a leitura recomendada antes de escrever qualquer poupança num documento que alguém vai avaliar. Como medir o que é vosso está em [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/). :::note Nada nesta página é uma alegação de eficácia clínica nem uma promessa de poupança. São alavancas a verificar em cada serviço, com os dados desse serviço. O registo Classe I (INFARMED e EUDAMED) cobre o produto base e diz respeito a conformidade regulamentar, não a desempenho. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Q: A realidade virtual reduz mesmo a necessidade de medicação? A: A literatura de distração analgésica e de procedimentos com sedação estuda essa questão, mas a poupança só existe se essas pessoas fossem mesmo sedadas no vosso serviço. Se já se fazem os exames sem sedação, não havia custo a evitar. Não afirmamos redução de medicação com o nosso produto. Q: Como calculo o retorno para a minha instituição? A: Para cada alavanca que se aplique: custo unitário evitado × frequência real × probabilidade de evitar. A terceira parcela é a que quase toda a gente esquece e a que separa uma estimativa defensável de um folheto. Se não souber estimá-la, meça-a num piloto. Q: Que evidência existe sobre poupança? A: Pouca e muito específica: em outubro de 2026, dos 130 estudos da nossa biblioteca pública, oito são de custos e retorno, em contextos como imagiologia pediátrica sem sedação e dor pós-operatória. Os números deles não transferem diretamente para outro serviço, porque mudam a população, o comparador e quem paga o quê. Q: A experiência do doente conta como poupança? A: Não. Experiência, diferenciação e satisfação são valor real e muitas vezes decidem a compra, mas não são uma linha de custo evitado. Apresentá-las como poupança num caderno de encargos enfraquece o resto do argumento. ### Como escolher uma solução de realidade virtual para uso clínico: checklist para instituições de saúde URL: https://rver.pt/blog/como-escolher-realidade-virtual-terapeutica/ Date: 9 July 2026 Um guia de decisão para responsáveis clínicos e de gestão: os critérios que realmente importam ao escolher realidade virtual para uso clínico, e o que pedir por escrito antes de contratar. Escolher realidade virtual para uso clínico para uma instituição de saúde não é escolher um headset. É escolher **conteúdo, fluxo de trabalho, segurança de dados e suporte**: a tecnologia é apenas o suporte de tudo isso. Este guia reúne os critérios que realmente importam e mostra como testar antes de decidir. ## Comece pelo problema clínico, não pela tecnologia O erro mais comum é começar pela pergunta "que equipamento devo comprar?". A pergunta certa é **"que problema clínico quero resolver?"**: - Distração e gestão da dor em procedimentos? - Redução de ansiedade pré-operatória ou em contextos como hemodiálise e oncologia? - Estimulação cognitiva e reminiscência em pessoas mais velhas ou com demência? - Apoio à reabilitação motora e adesão à fisioterapia? - Relaxamento e bem-estar em cuidados continuados ou paliativos? Definido o objetivo, tudo o resto decorre daí. Uma solução excelente para gestão da dor pode ser irrelevante para estimulação cognitiva, porque o que muda não é o headset, é o **conteúdo e o enquadramento**. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## Critérios essenciais (checklist) Use esta lista como grelha de avaliação de qualquer fornecedor. Se ainda está a perceber o conceito, comece por [o que é a realidade virtual para uso clínico](/blog/o-que-e-realidade-virtual-terapeutica/); o enquadramento português está em [realidade virtual clínica em Portugal](/blog/realidade-virtual-terapeutica-portugal/). - **Conteúdo validado e adequado.** Existe uma biblioteca pensada para saúde, e não apenas jogos genéricos? O conteúdo é apropriado ao perfil dos utentes (geriatria, pediatria, saúde mental, cuidados paliativos)? - **Facilidade de uso pela equipa.** Um profissional de enfermagem consegue iniciar uma sessão em segundos, sem formação técnica? Se for complicado, não será usado. - **Funciona sem internet.** Em lares e domicílios, a rede falha. O conteúdo deve estar no equipamento e as sessões funcionar offline (é o critério que decidiu o [headset do RVer](/equipamento/)). - **Higiene e robustez.** O equipamento é fácil de limpar e desinfetar entre doentes? Aguenta uso intensivo em ambiente clínico? - **Segurança de dados e RGPD.** Que dados são recolhidos, onde ficam armazenados e como se cumpre o RGPD? Exija respostas claras. - **Acompanhamento clínico.** É possível registar sessões e acompanhar o uso ao longo do tempo, para integrar no plano de cuidados? - **Enquadramento regulamentar.** Qual é a finalidade declarada e o enquadramento (por exemplo, dispositivo médico classe I com marcação CE)? - **Suporte e formação.** Há formação inicial da equipa e suporte contínuo, ou o fornecedor desaparece após a venda? - **Custo total.** Qual é o custo real (equipamento, licenças, conteúdo, suporte, substituições), e não apenas o preço inicial? E como se paga: as vias de financiamento e contratação estão em [Como financiar e contratar](/aquisicao/). > A melhor solução não é a com mais funcionalidades. É a que a sua equipa vai efetivamente usar, todas as semanas, sem fricção. ## Perguntas a fazer ao fornecedor Leve estas perguntas à primeira reunião: 1. Que evidência apoia o uso deste conteúdo para o meu objetivo clínico? 2. Como funciona uma sessão típica, do início ao fim, na perspetiva da equipa? 3. O que acontece quando não há internet? 4. Como tratam os dados dos doentes e o cumprimento do RGPD? 5. Qual é o enquadramento regulamentar da solução? 6. Que formação e suporte estão incluídos? 7. Como é o arranque: quem configura, quem forma a equipa e em quanto tempo? ## Sinais de alerta Desconfie quando encontrar: - **Promessas de resultados garantidos.** A realidade virtual para uso clínico é uma ferramenta complementar, usada sob supervisão, e não um tratamento milagroso. - **Marketing acima de substância clínica.** Muito entusiasmo, pouca clareza sobre conteúdo, evidência e enquadramento. - **Dependência de internet** em contextos onde a rede não é fiável. - **Indefinição sobre dados e RGPD.** - **Ausência de formação e suporte** contínuos. ## Como testar antes de decidir: o piloto Não alargue a toda a instituição sem começar por um serviço. Um bom piloto é **curto, delimitado e medível**: - **Um serviço, um objetivo.** Escolha um contexto e um objetivo clínico concreto. - **Um período definido.** Por exemplo, 4 a 8 semanas. - **Critérios de sucesso à partida.** Adesão da equipa, facilidade de uso, feedback dos doentes, integração no fluxo de trabalho. - **Envolva quem vai usar.** A opinião da equipa de enfermagem no terreno vale mais do que qualquer demonstração comercial. No fim do piloto tem dados reais para decidir, e não uma impressão de vendedor. ## Em resumo Escolher realidade virtual para uso clínico é, acima de tudo, uma decisão sobre **conteúdo, pessoas e processo**, não sobre hardware. Comece pelo problema clínico, avalie com a checklist, faça as perguntas certas, reconheça os sinais de alerta e teste com um piloto. É assim que se adota tecnologia clínica que a equipa usa e que faz diferença para os doentes. Antes de comparar fornecedores, vale a pena saber que perguntas de segurança fazer: [a realidade virtual faz mal?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Se a escolha passar por concurso, o mesmo raciocínio em forma de especificação está em [como escrever um caderno de encargos](/blog/caderno-de-encargos-realidade-virtual-saude/). Q: O que devo avaliar primeiro ao escolher realidade virtual para uso clínico? A: Comece pelo problema clínico que quer resolver (gestão da dor, ansiedade, estimulação cognitiva, reabilitação), e não pela tecnologia. A solução certa é a que responde a esse objetivo com conteúdo adequado, é fácil de usar pela equipa e se integra no fluxo de trabalho existente. O headset é o último critério, não o primeiro. Q: A solução tem de funcionar sem internet? A: Em muitos contextos, sim. Lares, unidades de cuidados continuados e domicílios têm frequentemente ligação fraca ou inexistente. Uma solução em que o conteúdo está no próprio equipamento e as sessões funcionam offline é mais fiável nesses cenários. Confirme sempre este ponto com o fornecedor. Q: A realidade virtual para uso clínico é um dispositivo médico? A: Depende da finalidade prevista do produto. Soluções com finalidade terapêutica podem ser enquadradas como dispositivo médico (frequentemente classe I na UE), o que implica marcação CE e requisitos de conformidade. Peça ao fornecedor o enquadramento regulamentar por escrito. Q: Como começo sem envolver a instituição toda? A: Com um piloto curto e delimitado: um serviço, um objetivo clínico, um período definido (por exemplo 4 a 8 semanas), e critérios de sucesso acordados à partida: adesão da equipa, feedback dos doentes, facilidade de uso. Q: Que sinais de alerta devo procurar num fornecedor? A: Promessas de resultados clínicos garantidos, ausência de conteúdo clínico validado, indefinição sobre proteção de dados e RGPD, dependência de internet estável em contextos sem rede, e falta de formação ou suporte contínuo. Marketing acima de substância clínica é o principal sinal de alerta. ### Realidade virtual clínica em Portugal: onde já se usa, regras e como contratar (2026) URL: https://rver.pt/blog/realidade-virtual-terapeutica-portugal/ Date: 9 July 2026 O estado da realidade virtual para uso clínico em Portugal em 2026: onde já se aplica, o que diz a evidência, o enquadramento regulamentar e um caminho prático para começar. A realidade virtual para uso clínico deixou de ser uma promessa futura e passou a ser uma ferramenta em uso em contextos de saúde. Em **Portugal**, a adoção tem crescido de forma gradual e prática. Este guia resume onde já se usa, o que diz a evidência, o enquadramento regulamentar e como uma instituição portuguesa pode começar. A definição e o mecanismo estão em [o que é a realidade virtual para uso clínico](/blog/o-que-e-realidade-virtual-terapeutica/); os critérios para comparar fornecedores, na [checklist de escolha](/blog/como-escolher-realidade-virtual-terapeutica/). ## Onde já se usa em Portugal A adoção acontece sobretudo em contextos onde a **imersão** ajuda a captar atenção, reduzir ansiedade ou estimular a cognição: - **[Lares e estruturas residenciais para pessoas idosas (ERPI)](/solucoes/lar-residencial/).** Estimulação cognitiva, reminiscência de lugares familiares, bem-estar e combate ao isolamento. - **Hospitais e clínicas.** Distração e gestão da dor em procedimentos, ansiedade pré-operatória, apoio em oncologia e hemodiálise. - **Reabilitação e fisioterapia.** Apoio à adesão e ao envolvimento em programas motores. - **Cuidados ao domicílio e continuados.** Relaxamento, bem-estar e apoio a distância, incluindo em locais sem boa ligação à internet. Em todos estes casos, a realidade virtual é uma **ferramenta complementar**, aplicada sob supervisão de profissionais de saúde e integrada num plano de cuidados, nunca um substituto do tratamento. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## O que diz a evidência A investigação internacional tem mostrado resultados encorajadores no uso da realidade virtual como abordagem **não farmacológica**, sobretudo em: - **Gestão da dor** através de distração imersiva durante procedimentos. - **Redução da ansiedade** em contextos clínicos e pré-operatórios. - **Estimulação cognitiva e bem-estar** em lares e na demência. - **Apoio à reabilitação** motora e à adesão. Ao mesmo tempo, é importante manter honestidade: a evidência varia conforme a aplicação, e a realidade virtual funciona melhor como **complemento** de boas práticas clínicas, não isolada. Uma instituição séria comunica os benefícios sem os exagerar. > A pergunta útil não é "a realidade virtual funciona?", mas "para que objetivo, com que doentes e integrada em que cuidado?". ## Enquadramento: dispositivo médico e RGPD Duas questões regulamentares importam em Portugal, ambas alinhadas com o quadro europeu: - **Dispositivo médico.** Se a solução tem finalidade terapêutica declarada, pode ser enquadrada como dispositivo médico, frequentemente **classe I** na UE, com marcação CE. Em Portugal, a autoridade competente é o **INFARMED** ([o que significa a Classe I](/blog/dispositivo-medico-classe-1-realidade-virtual/)). Peça sempre ao fornecedor o enquadramento por escrito. - **RGPD.** Dados de saúde são dados sensíveis. É preciso base legal e finalidade claras, minimização de dados, segurança e transparência com doentes e famílias. Soluções em que os dados ficam controlados e o conteúdo funciona localmente simplificam a conformidade. ## Financiamento e custos Não existe uma comparticipação única e universal para realidade virtual para uso clínico; o financiamento depende do contexto, e as vias que existem hoje em Portugal (orçamento corrente, acordos de cooperação, mecenato, prémios de fundações, autarquias) estão em [Como financiar e contratar](/aquisicao/). Na prática, o mais relevante para decidir é: - O **custo total** (equipamento, conteúdo, licenças, formação e suporte) e não apenas o preço inicial. - O **retorno** em tempo de equipa poupado, bem-estar dos doentes e diferenciação do serviço. - Começar com um **piloto pequeno** para gerar dados reais antes de alargar a outros serviços. ## Como uma instituição portuguesa pode começar Um caminho prático, do mais simples ao mais amplo: 1. **Definir o objetivo clínico.** Um problema concreto: dor, ansiedade, estimulação cognitiva, reabilitação. 2. **Escolher um serviço.** Um contexto onde o objetivo é claro e a equipa está motivada. 3. **Correr um piloto.** Algumas semanas, com critérios de sucesso definidos à partida. 4. **Confirmar enquadramento.** Regulamentar (dispositivo médico) e de dados (RGPD). 5. **Envolver a equipa.** Quem usa no terreno decide a adoção real. 6. **Avaliar e decidir.** Só então escalar, com base em dados e não em impressões. ## Em resumo Em Portugal, a realidade virtual para uso clínico está em adoção crescente e prática: em lares, hospitais, clínicas e cuidados ao domicílio. Feita bem, é uma ferramenta complementar, sob supervisão, com enquadramento regulamentar e de dados claro. O caminho recomendado é sempre o mesmo: **começar pequeno, medir e só depois escalar**. Q: A realidade virtual para uso clínico já se usa em Portugal? A: Sim. Instituições portuguesas (lares, hospitais, clínicas e serviços de cuidados ao domicílio) têm vindo a adotar realidade virtual para uso clínico como ferramenta complementar, sobretudo em gestão da dor e ansiedade, estimulação cognitiva, bem-estar e apoio à reabilitação. O uso é sempre sob supervisão de profissionais de saúde. Q: A realidade virtual para uso clínico é considerada dispositivo médico em Portugal? A: Pode ser, consoante a finalidade prevista do produto. Em Portugal aplica-se o enquadramento europeu de dispositivos médicos: uma solução com finalidade terapêutica pode ser enquadrada como dispositivo médico (frequentemente classe I), com marcação CE e requisitos de conformidade. O INFARMED é a autoridade competente nacional. Q: Como se cumpre o RGPD ao usar realidade virtual na saúde? A: Dados de saúde são dados sensíveis ao abrigo do RGPD. Na prática, isto significa recolher apenas o necessário, definir base legal e finalidade, garantir segurança e controlo de acessos, e ser transparente com doentes e famílias. Soluções em que os dados ficam controlados e o conteúdo funciona localmente facilitam a conformidade. Q: Quanto custa adotar realidade virtual para uso clínico numa instituição portuguesa? A: O custo depende do modelo: equipamento, conteúdo, licenças, formação e suporte. Mais importante do que o preço inicial é o custo total e o retorno em tempo de equipa, bem-estar dos doentes e diferenciação do serviço. Recomenda-se começar por um piloto pequeno para avaliar antes de escalar. Q: Como pode uma instituição em Portugal começar a usar realidade virtual para uso clínico? A: Começando pequeno: escolher um objetivo clínico concreto, um serviço, e correr um piloto de algumas semanas com critérios de sucesso definidos. Envolver a equipa que vai usar, confirmar o enquadramento regulamentar e de dados, e só depois decidir sobre uma adoção mais alargada. ### Ciclismo virtual sentado: pedalar em realidade virtual, também para utentes frágeis URL: https://rver.pt/blog/realidade-virtual-ciclismo-sentado-reabilitacao/ Date: 4 July 2026 Ciclismo em realidade virtual sem bicicleta, sem pedais e sem sair da cadeira: cardio suave para utentes de todas as idades, com dados de movimento para a equipa. Pedir a um utente frágil que faça cardio é, muitas vezes, pedir o impossível: falta mobilidade, falta equilíbrio, falta motivação. O **RVer Pedalar Sentado** resolve a equação de outra forma: um passeio de bicicleta imersivo, feito **sempre sentado**, que trabalha as pernas e dá cardio suave sem bicicleta e sem pedais, sem nunca sair da cadeira. O Pedalar Sentado faz parte do **RVer Motion**, um módulo em desenvolvimento, não abrangido pelo registo de Dispositivo Médico Classe I, que abrange o produto base. ## Um passeio pelo campo, a partir da cadeira O utente pousa ou prende um comando de realidade virtual em cada perna e começa a pedalar. Esse movimento conduz um passeio na primeira pessoa por um **campo 3D luminoso**: estrada sinuosa, alameda de árvores, colinas ao sol. O mundo nunca o desloca fisicamente: o horizonte fica nivelado, sem solavancos, o que reduz o risco de enjoo que costuma afastar os mais frágeis da realidade virtual. No ecrã surgem, em tempo real, a **velocidade, a distância e a cadência (RPM)**. Um cartão de instruções e um botão GO permitem que qualquer pessoa comece sozinha, sem menus nem leitura complicada. ## A equipa vê dados de movimento. O utente vê um passeio É aqui que o Pedalar Sentado se distingue de uma app de fitness. Enquanto o utente se diverte a pedalar pelo campo, a **app companheira do fisioterapeuta** recebe ao vivo, pela rede local: - distância percorrida; - velocidade média e máxima; - cadência (RPM); - duração da sessão; - **simetria entre a perna esquerda e direita**: o equilíbrio bilateral do esforço. Transforma um passeio agradável em informação objetiva que a equipa pode acompanhar ao longo do tempo. ## Feito para utentes, não para ciclistas O ciclismo em realidade virtual não é novo, mas as soluções habituais exigem uma bicicleta e um *smart trainer* reais e foram pensadas para ciclistas em forma. O **RVer Pedalar Sentado** é o oposto: - **sentado** e confortável, com o horizonte nivelado; - movido apenas pelos **comandos nas pernas**, sem equipamento de ginásio; - **simples**: sem contas, sem menus, com um botão para começar; - **local e privado**: corre no próprio equipamento, sem nuvem; - pensado para **doentes frágeis, descondicionados ou com défice cognitivo**. ## Parte do RVer Motion O Pedalar Sentado junta-se às restantes atividades do **RVer Motion**: o treinador 3D guiado (Ginásio) e os jogos de mobilidade (Corta-Frutas, Toca e Rebenta, Rebenta Balões, Ritmo). Todas partilham a mesma filosofia: movimento que o utente quer fazer, registado para a equipa rever. O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos pelo registo de Dispositivo Médico Classe I, que abrange o produto base. :::note **Nota importante:** o RVer Pedalar Sentado é um **auxiliar de exercício e de registo de movimento para fins de bem-estar**, usado sob supervisão de profissionais de saúde. Não é um dispositivo de diagnóstico e não substitui a avaliação clínica. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Corre em headsets autónomos acessíveis, é simples de operar pela equipa e não recolhe dados clínicos do paciente. Pedalar pelo campo, sentado, com o esforço a transformar-se em dados: é assim que o Pedalar Sentado torna o cardio possível, e desejável, para quem mais precisa dele. Q: O que é o RVer Pedalar Sentado? A: É uma atividade de ciclismo indoor em realidade virtual, sentada, que faz parte do módulo de movimento RVer Motion. O utente pousa ou prende um comando em cada perna e pedala; esse movimento conduz um passeio na primeira pessoa por um campo 3D. Foi desenhado para utentes de todas as idades, incluindo os mais frágeis, com conforto e segurança em primeiro lugar. Q: Como funciona o ciclismo virtual sentado sem bicicleta? A: Não é preciso bicicleta nem pedais. O utente fica sentado e usa um comando de realidade virtual em cada perna; o movimento de pedalar é detetado e move o passeio virtual para a frente. Velocidade, distância e cadência (RPM) aparecem no ecrã, e um botão GO permite começar sem ajuda. Q: O que é que o fisioterapeuta vê? A: A app companheira do fisioterapeuta recebe ao vivo, pela rede local, a distância percorrida, a velocidade média e máxima, a cadência, a duração e a simetria entre a perna esquerda e direita. O utente vê um passeio de bicicleta; o clínico vê dados de movimento para acompanhar a evolução. Q: É seguro para utentes mais velhos ou frágeis? A: Sim. A atividade é sempre feita sentada, com o horizonte nivelado e sem movimento forçado da imagem, o que reduz o risco de enjoo. É adequada para pessoas frágeis, descondicionadas ou com défice cognitivo, sempre sob supervisão da equipa. É um auxiliar de exercício e de bem-estar, não um dispositivo de diagnóstico. ### O que é a realidade virtual para uso clínico? Guia completo para profissionais de saúde URL: https://rver.pt/blog/o-que-e-realidade-virtual-terapeutica/ Date: 3 July 2026 Realidade virtual para uso clínico: o que é, como funciona e onde se aplica em saúde, um guia claro para quem pondera adotá-la. O termo "realidade virtual" faz muita gente pensar em videojogos ou entretenimento. Em saúde, o conceito é diferente, e é importante começar por aí. A **realidade virtual para uso clínico** é uma ferramenta clínica, não um passatempo. Este guia explica o que é, como funciona e onde se aplica. ## O que é, afinal Realidade virtual para uso clínico é o **uso de ambientes imersivos em realidade virtual como ferramenta complementar em cuidados de saúde**. O doente usa um headset que o transporta para um ambiente virtual (uma praia calma, uma floresta, um cenário guiado) com um objetivo clínico concreto: ajudar a gerir a dor e a ansiedade, estimular a cognição, apoiar a reabilitação ou induzir relaxamento. O que a distingue do entretenimento não é a tecnologia, é o **propósito e o enquadramento**: aplicada com objetivo terapêutico, sob supervisão de profissionais de saúde, integrada num plano de cuidados. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## Como funciona O mecanismo assenta na forma como o cérebro responde a uma experiência sensorial envolvente: - **Captação de atenção**: a imersão ocupa os sentidos e desvia o foco da dor ou do medo. É o princípio da distração terapêutica. - **Regulação emocional**: ambientes calmos e técnicas guiadas de respiração ajudam a baixar a ativação e a ansiedade. - **Estímulo ativo**: tarefas e movimentos guiados podem apoiar funções cognitivas e motoras na reabilitação (no RVer, são módulos em desenvolvimento, fora do registo Classe I). > A imersão não "engana" o doente: cria uma experiência suficientemente envolvente para mudar aquilo em que o cérebro se concentra. ## Onde se aplica em saúde O leque é amplo e cresce à medida que a [evidência](/estudos/) se acumula: - **[Gestão da dor](/blog/realidade-virtual-gestao-da-dor/)** em procedimentos (pensos, punções, tratamento de feridas). - **Ansiedade** pré-operatória, em oncologia, em hemodiálise, em imagiologia. - **Pediatria**: distração do medo e da dor em crianças (no RVer, a partir dos 10 anos). - **[Geriatria e demência](/blog/realidade-virtual-demencia-alzheimer/)**: estimulação cognitiva, reminiscência, calma. - **Reabilitação** motora e neurológica. - **Saúde mental**: relaxamento, gestão de stress, fobias. - **Cuidados paliativos**: conforto e evasão. ## O que NÃO é Vale ser explícito para evitar mal-entendidos: - **Não é um videojogo**: o objetivo é clínico, não recreativo. - **Não substitui o tratamento**: é complementar, nunca alternativa ao cuidado médico. - **Não decide nada sozinha**: qualquer uso e qualquer decisão clínica cabem à equipa de saúde. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e **não farmacológica**, usada sob supervisão de profissionais de saúde e integrada no plano de cuidados. Não substitui diagnóstico, medicação nem decisão clínica. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Reúne uma biblioteca de conteúdos pensada para uso clínico, é simples de operar pelas equipas, funciona com os conteúdos guardados no próprio equipamento, sem depender de internet, e não recolhe dados clínicos do paciente. Compreender o que é a realidade virtual para uso clínico é o primeiro passo para a usar bem: como ferramenta clínica ao serviço da equipa, não como gadget. O passo seguinte depende de onde está: o retrato português em [realidade virtual clínica em Portugal](/blog/realidade-virtual-terapeutica-portugal/), a [checklist para escolher](/blog/como-escolher-realidade-virtual-terapeutica/) uma solução, e o uso em cada contexto em [Soluções](/solucoes/). Q: O que é a realidade virtual para uso clínico? A: É o uso de ambientes imersivos em realidade virtual como ferramenta complementar em cuidados de saúde: para distração da dor, gestão da ansiedade, estimulação cognitiva, reabilitação ou relaxamento. Distingue-se do entretenimento por ser aplicada com objetivo clínico, sob supervisão de profissionais de saúde e integrada num plano de cuidados. Q: Como funciona a realidade virtual para uso clínico? A: O doente usa um headset que o coloca num ambiente virtual imersivo. Esse envolvimento capta a atenção e altera a perceção: por exemplo, desviando o foco da dor ou do medo, induzindo relaxamento, ou estimulando funções cognitivas e motoras através de tarefas guiadas. O efeito assenta na forma como o cérebro responde a uma experiência sensorial envolvente. Q: A realidade virtual para uso clínico substitui o tratamento médico? A: Não. É uma abordagem complementar e não farmacológica, usada em acréscimo ao cuidado clínico e sempre sob supervisão da equipa de saúde. Não substitui diagnóstico, medicação nem qualquer decisão clínica. Q: Onde se usa a realidade virtual em saúde? A: Em contextos variados: gestão da dor em procedimentos, ansiedade pré-operatória, oncologia, hemodiálise, pediatria, geriatria e demência, reabilitação motora, saúde mental e cuidados paliativos, entre outros. O uso concreto depende sempre da avaliação da equipa clínica. ### Medo da ressonância magnética: como a realidade virtual ajuda com a claustrofobia no exame URL: https://rver.pt/blog/realidade-virtual-ressonancia-magnetica-claustrofobia/ Date: 3 July 2026 A claustrofobia faz adiar, interromper ou repetir ressonâncias magnéticas. A realidade virtual ajuda a preparar o doente antes de entrar no aparelho. Uma parte significativa das ressonâncias magnéticas é adiada, interrompida ou repetida por uma razão que não tem nada a ver com a máquina: **o doente não aguenta lá dentro**. O tubo estreito, o ruído intenso, a obrigação de ficar imóvel durante minutos: para quem tem tendência claustrofóbica, é um cenário difícil de suportar. ## Porque a ressonância assusta tanto A ressonância junta, ao mesmo tempo, vários gatilhos clássicos de ansiedade: - **Espaço fechado e estreito**: o gatilho direto da claustrofobia. - **Imobilidade obrigatória**: qualquer movimento estraga a imagem, o que aumenta a tensão. - **Ruído alto**: o aparelho é barulhento e imprevisível. - **Perda de controlo**: estar preso e à espera, sem poder sair à vontade. O resultado, em doentes mais sensíveis, pode ser um ataque de pânico que obriga a parar o exame, com custos de tempo, de repetição e de atraso no diagnóstico. ## Onde entra a realidade virtual A realidade virtual para uso clínico atua sobretudo **antes** do exame, na preparação: - **Relaxamento prévio**: ambientes calmos e técnicas de respiração ajudam o doente a chegar menos ativado. - **Familiarização**: reduzir o efeito surpresa do que vai acontecer torna a experiência mais previsível e menos ameaçadora. - **Distração e foco**: desviar a atenção do medo antecipado para um estímulo agradável. > O objetivo não é enganar o doente: é dar-lhe ferramentas para tolerar melhor um exame necessário, evitando interrupções e repetições. ## O valor para o serviço de imagiologia Cada exame interrompido é tempo de máquina perdido, uma marcação a repetir e um diagnóstico adiado. Ajudar o doente a completar o exame à primeira tem valor clínico e operacional direto. Um doente mais calmo é também um doente mais imóvel, e imagens de melhor qualidade. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar**, usada sob supervisão de profissionais de saúde. Não substitui a avaliação clínica nem qualquer decisão sobre sedação, que cabe sempre à equipa de saúde. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Simples de operar entre exames, confortável para o doente e com conteúdos guardados no próprio equipamento, funciona sem depender de internet, apoia a preparação de doentes ansiosos sem recolher dados clínicos do paciente. Preparar o doente antes de entrar no aparelho é, muitas vezes, a diferença entre um exame concluído e um exame perdido. Q: Porque é que tantas pessoas têm medo da ressonância magnética? A: A ressonância combina vários gatilhos de ansiedade: um espaço estreito e fechado, a imobilidade obrigatória durante longos minutos, o ruído alto do aparelho e a sensação de perda de controlo. Em pessoas com tendência claustrofóbica, isto pode causar ataques de pânico que levam a interromper o exame. Q: Como pode a realidade virtual ajudar num exame de ressonância magnética? A: A realidade virtual para uso clínico é usada sobretudo na preparação: ambientes calmos e técnicas de relaxamento ajudam o doente a chegar ao exame menos ansioso, e a familiarização prévia reduz o efeito surpresa. O objetivo é que o doente tolere melhor o exame e evite interrupções, sempre sob supervisão da equipa. Q: A realidade virtual substitui a sedação na ressonância? A: Não substitui nem é uma decisão da tecnologia. É uma abordagem complementar não farmacológica que, em alguns doentes, pode reduzir a necessidade de recorrer a sedação. Qualquer decisão clínica cabe sempre à equipa de saúde. ### Fisioterapia com realidade virtual: transformar o exercício em algo que o utente quer fazer URL: https://rver.pt/blog/realidade-virtual-fisioterapia-idosos-adesao/ Date: 3 July 2026 Na fisioterapia com idosos, o difícil não é prescrever o exercício: é fazer com que ele seja feito. A realidade virtual muda essa equação. Qualquer fisioterapeuta que trabalhe com idosos conhece o verdadeiro obstáculo. Não é desenhar o plano de exercícios: é conseguir que ele seja feito, com regularidade e com a técnica certa. **A adesão é o problema mais difícil da fisioterapia geriátrica.** Exercícios repetitivos, sem retorno imediato e feitos sozinhos em casa são fáceis de abandonar. O treinador 3D, a contagem de repetições e os jogos descritos abaixo são do **RVer Motion**, um módulo em desenvolvimento, não abrangido pelo registo de Dispositivo Médico Classe I, que abrange o produto base. ## Porque a adesão falha O exercício de reabilitação tende a ser tudo aquilo que desmotiva: - **Repetitivo**: as mesmas séries, sem variação nem estímulo. - **Sem retorno**: o utente não vê progresso de forma tangível. - **Solitário**: feito em casa, sem acompanhamento nem contagem fiável. - **Aborrecido**: nada convida a repetir amanhã. O resultado é conhecido: repetições a menos, técnica a mais desleixar, e um progresso que o terapeuta não consegue medir com objetividade. ## O que a realidade virtual muda A realidade virtual ataca o problema pela motivação. Em vez de contar repetições sozinho, o utente entra num ambiente onde o movimento tem propósito e retorno imediato: - **Treinador 3D guiado**: um instrutor virtual demonstra cada exercício; o utente apenas acompanha. A app conta as repetições automaticamente. - **Jogos de movimento**: cortar esferas no ar, rebentar balões, alcançar alvos. Simples, sem instruções, desenhados para tornar o movimento uma brincadeira. - **Progresso visível**: pontuação e métricas em tempo real dão ao utente a sensação de avanço que o mantém a repetir. > O utente vê um jogo. O terapeuta vê reabilitação. É essa a chave da adesão. ## Movimento que também é dado A diferença face a um simples videojogo está na medição. Enquanto o utente se diverte, o sistema regista **alcance, amplitude de movimento, velocidade e consistência**: transformando o exercício em informação que o clínico pode rever. Menos trabalho manual de contagem para a equipa, progresso objetivo para o fisioterapeuta. E porque é pensado para utentes de todas as idades, incluindo os mais frágeis, funciona **seguro sentado por defeito**, sem menus nem leitura, com o conforto em primeiro lugar: utilizável por doentes frágeis e com défice cognitivo. :::note **Nota importante:** trata-se de um auxiliar de exercício e de registo de movimento para fins de bem-estar e motivação: **não é um dispositivo de diagnóstico**. O plano, a prescrição e a supervisão cabem sempre ao fisioterapeuta. ::: ## O papel do RVer Motion O **RVer Motion** é o módulo de movimento acompanhado do RVer, concebido para clínicas, centros de reabilitação e lares. Junta um treinador 3D com contagem automática de repetições a um conjunto de jogos de mobilidade: tudo seguro sentado, simples e ajustável pela equipa (metas de repetições, dificuldade, zonas de alcance). Funciona totalmente no equipamento, sem contas nem nuvem. O RVer Motion e o RVer Neuro são módulos em desenvolvimento, não abrangidos pelo registo de Dispositivo Médico Classe I, que abrange o produto base. A melhor reabilitação é a que o utente realmente faz. Tornar o exercício desejável é o caminho mais curto para a adesão. Numa população em que o equilíbrio e o medo de cair são o problema central, ver [realidade virtual e doença de Parkinson](/blog/realidade-virtual-doenca-de-parkinson/). Q: Como pode a realidade virtual ajudar na fisioterapia de idosos? A: A realidade virtual transforma o exercício prescrito em movimento guiado e divertido. Um treinador 3D demonstra cada exercício e o utente acompanha; jogos simples de mobilidade tornam o movimento agradável. Ao mesmo tempo, o sistema mede alcance, amplitude e velocidade, dando ao terapeuta um registo objetivo do progresso. O efeito principal é na adesão: as pessoas querem repetir. Q: É seguro para doentes frágeis ou com défice cognitivo? A: Sim, quando desenhado para isso. Uma solução adequada a utentes frágeis deve ser segura sentado por defeito, sem menus nem leitura, com foco no conforto. Assim é utilizável por doentes frágeis e com défice cognitivo, sempre sob supervisão da equipa de fisioterapia. Q: A realidade virtual substitui o fisioterapeuta? A: Não. É uma ferramenta de apoio ao exercício e de registo de movimento, para fins de bem-estar e motivação. O plano, a prescrição e a supervisão continuam a cargo do fisioterapeuta. A tecnologia mede e motiva; o clínico decide. ### Que headset de realidade virtual escolher para saúde? Quest 3, Pico 4 e Apple Vision Pro comparados URL: https://rver.pt/blog/comparar-headsets-realidade-virtual-saude/ Date: 2 July 2026 Quest 3, Pico 4 ou Apple Vision Pro? Para um contexto de saúde, a escolha decide-se menos pela ficha técnica e mais pela operação diária. Quando uma equipa de saúde decide adotar realidade virtual para uso clínico, a pergunta técnica surge cedo: **"que headset usar?"**. As três respostas mais comuns são o Meta Quest 3, o Pico 4 e o Apple Vision Pro. Mas a comparação certa não é a que se faz nas lojas de tecnologia. Num contexto clínico, os critérios são outros. :::note Atualização de outubro de 2026: no RVer, o primeiro critério passou a ser o espaço. A biblioteca já vai perto dos 300 GB, e o Pico 4 Ultra só existe com 256 GB. A comparação completa, com onze headsets ficha contra ficha, está em [Porquê o Meta Quest 3](/equipamento/). E no RVer os headsets são nossos: a instituição não os compra. ::: ## O que realmente importa em saúde Numa clínica, lar ou domicílio, o headset não é usado por um entusiasta durante horas: é usado por vários doentes, por vários profissionais, muitas vezes ao dia. O que pesa é a **operação repetida**: - **Higiene**: quão rápido se limpa e desinfeta entre doentes. - **Peso e conforto**: tolerável para pessoas mais velhas, crianças ou doentes fragilizados. - **Tempo de preparação**: segundos, não minutos, entre utilizações. - **Autonomia**: funciona sem cabos e sem PC ao lado. - **Robustez**: aguenta o uso intensivo e a circulação entre salas. A ficha técnica que impressiona numa demonstração conta pouco se o equipamento for pesado, complicado de limpar ou lento a preparar. ## Comparação rápida | Critério | Meta Quest 3 | Pico 4 | Apple Vision Pro | |---|---|---|---| | Tipo | Autónomo | Autónomo | Autónomo | | Preço | Acessível | Acessível | Elevado | | Peso | Leve | Leve | Mais pesado | | Qualidade visual | Muito boa | Muito boa | Excelente | | Facilidade de higiene | Alta | Alta | Média | | Adequação a uso repetido em saúde | Alta | Alta | Menor | > Para a maioria dos contextos de saúde, um headset autónomo acessível vence não por ser o mais potente, mas por ser o que a equipa consegue usar em minutos, doente após doente. ## Porque o autónomo (standalone) vence Os três equipamentos são autónomos: têm o computador integrado, sem cabos nem PC. Isto é meio caminho andado para saúde: menos montagem, mais mobilidade entre camas, salas e domicílios. O **Apple Vision Pro** oferece qualidade de imagem superior, mas o preço e o peso tornam-no menos prático para o uso repetido junto à cabeceira que a saúde exige. O **Quest 3** e o **Pico 4** acertam no equilíbrio: leves, acessíveis, fáceis de higienizar e de preparar. ## O headset é só metade da decisão O equipamento é apenas o corpo. O que decide a experiência clínica é o **software** que corre nele: conteúdos pensados para saúde, simples de lançar, confortáveis, e disponíveis **sem depender de internet**. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar**, usada sob supervisão de profissionais de saúde e integrada no plano de cuidados. Não substitui o cuidado médico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para correr em headsets autónomos acessíveis, com conteúdos guardados no próprio equipamento: funciona sem internet, é simples de operar pela equipa e não recolhe dados clínicos do paciente. Escolha o headset pela operação diária, não pela ficha técnica. O melhor equipamento é o que a equipa usa todos os dias. Sobre porque é que pedir resolução e campo de visão num concurso não distingue ninguém, ver [como escrever um caderno de encargos](/blog/caderno-de-encargos-realidade-virtual-saude/). E antes de comparar headsets entre si, há a comparação anterior: [realidade virtual ou um tablet?](/blog/realidade-virtual-ou-tablet-qual-a-diferenca/). Q: Qual é o melhor headset de realidade virtual para uso clínico? A: Não existe um vencedor absoluto: depende do contexto. Para a maioria das clínicas, lares e uso ao domicílio, um headset autónomo (standalone) de gama acessível como o Meta Quest 3 ou o Pico 4 é o mais adequado: leve, sem cabos, fácil de higienizar e de preparar entre doentes. O Apple Vision Pro oferece qualidade superior mas é bastante mais caro e pesado, o que dificulta o uso repetido junto à cabeceira. Q: É preciso um computador potente para usar realidade virtual em saúde? A: Não. Os headsets autónomos (Quest 3, Pico 4) têm o computador integrado e funcionam sem PC nem cabos. Isto é decisivo em saúde: menos equipamento, menos montagem e maior mobilidade entre camas, salas ou domicílios. Q: O headset precisa de internet para funcionar? A: Depende do software. Uma solução bem desenhada para saúde deve ter os conteúdos guardados no próprio equipamento, para funcionar mesmo sem ligação: essencial em enfermarias, lares e visitas ao domicílio onde o Wi-Fi é fraco ou inexistente. ### Como financiar realidade virtual: orçamento, apoios e alternativas à compra URL: https://rver.pt/blog/financiamento-comparticipacao-realidade-virtual-saude/ Date: 2 July 2026 O problema costuma não ser o preço: é a rubrica. Investimento ou despesa corrente é a pergunta que decide se o projeto arranca este trimestre ou daqui a um ano. *Atualizado a 16 de agosto de 2026.* Quando uma instituição reconhece o valor da realidade virtual para uso clínico, o travão que aparece a seguir raramente é técnico. É financeiro, mas não do modo que se pensa. **O problema costuma não ser o preço; é a rubrica.** E aí há mais portas do que a compra direta. Esta página faz parte do [guia do ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/); aqui trata-se de como pagar, não de quanto rende. ## Primeiro: não há comparticipação ao doente Convém ser claro, porque é a primeira pergunta. A realidade virtual para uso clínico **não tem comparticipação direta ao doente**, como teria um medicamento prescrito. É adquirida pela instituição (hospital, clínica, lar, IPSS) enquanto equipamento e ferramenta de trabalho. Isto não é má notícia: significa apenas que a via certa não é a receita, é a decisão de aquisição da organização. [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## Segundo, e igualmente importante **O registo de dispositivo médico não confere elegibilidade a apoios públicos.** São coisas separadas: o registo diz respeito a conformidade regulamentar; a elegibilidade depende do programa de financiamento concreto, das suas regras e do momento em que está aberto. Desconfie de quem apresentar o registo como passaporte para um apoio: nós não o fazemos. ## A pergunta que decide tudo: investimento ou despesa corrente? É aqui que a maioria dos processos encalha, e é uma pergunta de contabilidade, não de tecnologia: - **Investimento (capital).** Compra de equipamento. Tem de entrar no plano de investimentos, tem limiares de aprovação e, muitas vezes, um ciclo anual. Se o plano deste ano já fechou, o projeto espera doze meses. - **Despesa corrente.** Um serviço pago por ano ou por mês. Sai da rubrica de funcionamento, com limiares de aprovação mais baixos e sem esperar pelo ciclo. O RVer é sempre a segunda: um serviço anual, com os equipamentos a continuarem nossos. A instituição usa, nunca compra, e por isso não fica à espera do plano de investimentos. Vale a pena confirmar com a direção financeira, **antes** de pedir uma proposta, em que rubrica entra. ## As vias, por ordem de rapidez 1. **Orçamento de funcionamento**: a via mais rápida quando o valor mensal cabe nos limiares de quem decide localmente. 2. **Contratação pública**: quando o valor ou as regras da entidade pedem um procedimento, com os prazos que ele traz. 3. **Mecenato, doações e fundações**: comum em IPSS e misericórdias, e particularmente adequado a algo que se mostra a quem doa. 4. **Apoios e programas de financiamento**: existem, mudam, e têm de ser verificados caso a caso, no momento, para o seu tipo de entidade. Não assumimos elegibilidade por si. 5. **Projetos com parceiros clínicos ou académicos**: quando o RVer entra num protocolo ou numa co-validação. Estas são as principais. A lista completa, por tipo de instituição (hospital e ULS, IPSS e misericórdias), com o estado de cada programa, está em [Como financiar e contratar](/aquisicao/). ## O argumento interno, escrito para quem assina Quem aprova raramente é quem vai usar. O documento que costuma passar tem quatro linhas e nenhuma delas é entusiasmo: - **o que resolve**, em uma frase, com o problema que já é conhecido lá dentro; - **o custo total anual**, incluindo o tempo de equipa (a linha que ninguém soma: está no [guia do ROI](/blog/custo-roi-realidade-virtual-instituicao-saude/)); - **o que se compromete a medir** nos primeiros três meses; - **como se para**, se não resultar. Essa última é a que dá confiança a quem assina. Uma proposta que não prevê como terminar parece um risco maior do que é. ## Testar antes de decidir Um piloto de três meses resolve a maior parte da discussão orçamental, porque troca uma promessa por dados vossos. O que medir (e o que não vale a pena tentar medir) está em [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/) e em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). Num lar, a conta que costuma abrir a porta ao orçamento é outra, e está em [quanto rende num lar](/blog/roi-realidade-virtual-lar-de-idosos/). :::note Nada nesta página é aconselhamento financeiro ou jurídico, nem uma garantia de elegibilidade a qualquer apoio. As regras dos programas mudam e dependem do tipo de entidade; confirme junto da entidade gestora do programa. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Q: A realidade virtual para uso clínico é comparticipada? A: Não ao nível do doente, como seria um medicamento prescrito. É contratada pela instituição como serviço e ferramenta de trabalho, portanto o financiamento faz-se do lado da organização. Q: O registo de dispositivo médico dá acesso a apoios públicos? A: Não. São coisas separadas: o registo diz respeito a conformidade regulamentar, e a elegibilidade depende das regras do programa de financiamento concreto e do tipo de entidade. Deve ser confirmada junto da entidade gestora do programa, caso a caso. Q: Que vias existem para financiar? A: As principais, por ordem de rapidez: orçamento de funcionamento, contratação pública, mecenato e fundações, programas de apoio (a verificar caso a caso) e projetos com parceiros clínicos ou académicos. A lista completa, por tipo de instituição, está em Como financiar e contratar (rver.pt/aquisicao/). Q: Porque é que a diferença entre investimento e despesa corrente é tão importante? A: Porque muda o caminho de aprovação. Uma compra entra no plano de investimentos, com limiares mais altos e um ciclo anual; um serviço sai da rubrica de funcionamento, com limiares mais baixos. O RVer é um serviço anual: a instituição usa, nunca compra, e por isso não espera pelo ciclo de investimento. Q: É possível testar antes de investir? A: Sim, e é o que resolve a maior parte da discussão orçamental: um piloto de três meses troca uma promessa por dados da própria instituição. Convém decidir antes o que se vai medir: sessões realizadas, quem passou a participar, tempo real da equipa e recusas. ### Realidade virtual em casa: até onde a terapia pode sair da instituição URL: https://rver.pt/blog/realidade-virtual-domicilio-telereabilitacao/ Date: 29 June 2026 A terapia mais eficaz é a que tem continuidade. Levar a realidade virtual para o domicílio promete preencher o intervalo entre sessões, mas só funciona quando a decisão de quem, como e com que supervisão é levada a sério. Há uma pergunta incómoda que qualquer terapia enfrenta: **o que acontece entre as sessões?** Um doente é visto uma ou duas vezes por semana na instituição, faz progressos, e depois passa dias sem nada estruturado até voltar. Para muitas pessoas, é nesse intervalo que os ganhos se diluem. A realidade virtual para uso clínico tem aqui uma oportunidade clara: sair das paredes da instituição e dar continuidade ao cuidado no domicílio. É uma ideia entusiasmante e, esta semana, foi precisamente sobre isto que estivemos a falar com um cliente. Mas é também uma ideia que exige honestidade sobre os seus limites. ## O argumento a favor: continuidade A reabilitação, a estimulação cognitiva, a gestão da ansiedade: quase tudo o que a realidade virtual para uso clínico faz beneficia da **repetição**. Não é a sessão isolada que muda a trajetória de um doente; é a soma de muitas, com regularidade. O problema é que a instituição só consegue oferecer um número limitado de sessões presenciais. O tempo de equipa é escasso, as deslocações são pesadas, sobretudo para pessoas mais velhas ou doentes com mobilidade reduzida, e as listas são longas. Resultado: muito do potencial terapêutico fica por usar, não por falta de eficácia, mas por falta de oportunidades. Levar a realidade virtual para casa muda essa aritmética. Entre as sessões presenciais, o doente pode manter um ritmo de prática orientado, no seu próprio ambiente, sem depender de uma deslocação. Para quem vive longe, tem dificuldade em sair de casa ou simplesmente precisa de mais frequência do que a instituição consegue dar, a diferença é enorme. ## A condição que torna isto possível: conteúdo sem internet Há um detalhe técnico que decide se a realidade virtual domiciliária é viável ou uma fonte de frustração: **a dependência de ligação à internet.** Muitas casas, sobretudo de doentes mais velhos, têm internet fraca, intermitente ou inexistente. Uma solução que precise de streaming para funcionar vai falhar exatamente onde é mais necessária. Por isso, na RVer, o conteúdo terapêutico fica guardado no próprio equipamento e funciona offline. A sessão corre sempre, independentemente da rede. A ligação, quando existe, serve apenas para o que faz sentido fazer em segundo plano: sincronizar o registo das sessões e atualizar a biblioteca de conteúdos. Nunca para a experiência acontecer. É uma distinção que parece técnica mas é, na verdade, clínica: porque determina se o doente certo, na casa certa, consegue mesmo usar a ferramenta. ## O argumento de cautela: nem tudo deve sair da instituição Aqui é onde temos de ser claros, porque é fácil deixar o entusiasmo ultrapassar o bom senso. **Levar a terapia para casa não é o mesmo que deixar o doente sozinho com ela.** A realidade virtual domiciliária só é responsável se mantiver três coisas: - **Triagem de quem pode.** Há doentes que precisam de supervisão presencial direta: pela complexidade do quadro, pelo risco de queda, por agitação, por fragilidade. Esses não são candidatos a uso autónomo em casa, e dizê-lo é parte do trabalho clínico, não uma limitação a contornar. - **Um plano definido pelo profissional.** O que está disponível em casa, com que objetivos, durante quanto tempo e com que conteúdo é uma decisão clínica tomada antes, e não algo deixado ao acaso do doente. - **Acompanhamento, não abandono.** O profissional continua a olhar para o que foi feito, através do registo das sessões, e ajusta o plano. A distância muda a forma da supervisão; não a elimina. :::note Já escrevemos sobre por que razão, na RVer, cada sessão tem um profissional por perto e por que a inteligência artificial não deve substituir o juízo clínico. O domicílio não é uma exceção a esse princípio: é um teste a ele. A pergunta não é "como tiramos o profissional da equação?", mas "como mantemos o profissional presente mesmo à distância?". ::: ## Telereabilitação: o profissional presente, mesmo à distância A palavra "telereabilitação" assusta quando se interpreta como "reabilitação sem terapeuta". Não é isso. Bem feita, é o terapeuta a estender o seu alcance: a definir o trabalho, a ver o que o doente fez entre consultas e a usar o tempo presencial, que é precioso, para o que só pode acontecer cara a cara. A realidade virtual encaixa bem nesse modelo porque torna o que se faz em casa **estruturado e registável**. Em vez de "faça os exercícios e depois conte-me", o doente faz uma sessão desenhada para si, e o profissional vê o que aconteceu. A continuidade deixa de depender da memória e da boa vontade, e passa a ter dados. ## Onde isto vai Estamos a explorar o uso domiciliário com clientes que sentem, no dia a dia, o custo do intervalo entre sessões. Não como forma de fazer mais barato à custa de menos cuidado, mas como forma de dar **mais terapia** a quem dela beneficia, sem multiplicar deslocações nem esgotar a equipa. A regra que nos orienta é simples: a realidade virtual pode sair da instituição, mas o cuidado clínico não pode ficar para trás. Quando essas duas coisas viajam juntas, levar a terapia para casa deixa de ser um risco e passa a ser exatamente o que devia ser: uma forma de estar mais perto do doente, mesmo quando ele está longe. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: Q: A realidade virtual em casa substitui as sessões na instituição? A: Não é essa a ideia. O domicílio serve para dar continuidade entre sessões presenciais, não para as substituir. A avaliação clínica, a definição do plano e os momentos-chave continuam a acontecer com o profissional. O uso em casa é uma extensão supervisionada à distância, não um substituto do cuidado presencial. Q: Como é que a supervisão funciona se o profissional não está presente? A: A continuidade não significa deixar o doente entregue a si próprio. O profissional define previamente que conteúdo está disponível, com que objetivos e durante quanto tempo, e acompanha o que foi feito através do registo das sessões. Doentes que precisam de supervisão presencial direta não são candidatos a uso domiciliário: essa triagem é parte do trabalho clínico. Q: É preciso internet em casa do doente para isto funcionar? A: Não para a sessão em si. O conteúdo terapêutico fica guardado no próprio equipamento e funciona sem ligação, o que é essencial em casas onde a internet é fraca ou inexistente. A ligação só é útil, quando existe, para sincronizar registos e atualizar conteúdos, nunca para a experiência correr. ### Quatro horas na cadeira: como a realidade virtual ajuda na hemodiálise URL: https://rver.pt/blog/realidade-virtual-hemodialise/ Date: 28 June 2026 Poucos tratamentos pedem tanto tempo ao doente como a hemodiálise. A realidade virtual não acelera a máquina, mas pode mudar por completo a forma como essas horas são vividas. A hemodiálise tem uma característica que a distingue de quase todos os outros tratamentos: a sua exigência principal não é a dor, é o **tempo**. Três sessões por semana, três a quatro horas em cada uma, durante anos. Para muitos doentes renais, é a estrutura à volta da qual a vida toda se organiza. E esse tempo, na prática, é quase sempre tempo parado. O doente está ligado à máquina, com um braço imóvel por causa do acesso vascular, sem grande margem de movimento. O que sobra são horas para encher, e o tédio, a ansiedade e a sensação de aprisionamento são queixas tão reais como qualquer sintoma físico. É exatamente aqui que a realidade virtual para uso clínico encontra um dos seus encaixes mais naturais. ## O problema não é só clínico: é vivencial Quando se fala em melhorar a experiência da diálise, pensa-se logo em parâmetros: tensão, cãibras, tolerância à sessão. São importantes. Mas há uma dimensão que raramente entra nos indicadores e que pesa enormemente para quem está na cadeira: **o que fazer com a cabeça durante todas aquelas horas**. Olhar para um teto. Ver televisão que não se escolheu. Pensar na doença. Contar o tempo que falta. A monotonia das sessões longas alimenta ansiedade, irritabilidade e, ao longo dos meses, desânimo. E um doente desanimado adere pior, tolera pior e sofre mais. A realidade virtual ataca precisamente esse vazio. Em vez de quatro horas a olhar para a unidade, o doente pode estar numa praia calma, a caminhar por uma floresta, a assistir a um concerto ou a viajar por um lugar que nunca visitou. Não é entretenimento de luxo: é uma forma de **reduzir o tempo subjetivo** e devolver alguma escolha a quem tem tão pouca durante o tratamento. ## Porque a diálise é um bom cenário para a RV Nem todos os contextos clínicos se prestam igualmente à realidade virtual. A diálise tem várias características que a tornam particularmente favorável: - **A sessão é longa e previsível.** Há tempo de sobra para colocar o headset com calma, escolher conteúdo e fazer uma experiência completa, sem pressa. - **O doente está sentado e estável.** Ao contrário de cenários agudos, aqui a pessoa está numa posição confortável e monitorizada: condições ideais para uma experiência imersiva segura. - **Repete-se no tempo.** Como o doente volta várias vezes por semana, é possível variar o conteúdo, construir preferências e ajustar a experiência sessão após sessão. - **A equipa já está presente.** Numa unidade de diálise há sempre enfermagem a acompanhar: o que significa que a supervisão necessária à RV já faz parte do fluxo. :::note O acesso vascular impõe um limite claro: o braço da fístula tem de ficar imóvel. Por isso o conteúdo é escolhido para ser contemplativo e de baixo movimento (paisagens, viagens lentas, ambientes calmos) e não experiências que convidem a gesticular. A RV adapta-se à restrição do tratamento, não o contrário. ::: ## Segurança primeiro: o que tem de ser garantido Levar realidade virtual para uma unidade de diálise exige cuidado. Alguns princípios são inegociáveis: O equipamento é **autónomo e sem fios ligados ao doente**: ocupa a visão e a audição, nada mais. O acesso vascular permanece visível e acessível à equipa a todo o momento. O conteúdo é selecionado para minimizar qualquer risco de enjoo, especialmente importante numa população que já pode ter alterações de tensão durante a sessão. E o headset sai em segundos: se for preciso medir tensão, ajustar a máquina ou intervir, nada disso é dificultado. Há ainda a **triagem do doente**. Nem toda a gente é candidata: quem tem tendência marcada a náuseas, certas condições oftalmológicas ou vestibulares, ou agitação significativa, pode não beneficiar. Essa decisão é clínica e cabe ao profissional, que conhece o doente e o seu histórico. ## O que estamos a aprender, com honestidade Estamos neste momento a correr um **testbed da RVer numa unidade de diálise**, e preferimos ser claros: não vendemos promessas que ainda não verificámos. O objetivo é perceber, no terreno real, o que funciona e o que não funciona. As perguntas que nos interessam são concretas. Os doentes querem repetir? Que tipo de conteúdo prende mais: paisagens, viagens, música? A higienização entre utentes encaixa no ritmo da unidade sem atrasar nada? A experiência reduz, de facto, a ansiedade e a sensação de tempo? E, sobretudo: a equipa de enfermagem sente que isto a ajuda, ou que lhe acrescenta trabalho? São estas respostas, e não folhetos, que vão dizer-nos como a realidade virtual deve ser usada na diálise. Quando tivermos dados que valha a pena partilhar, partilhamo-los, incluindo o que correr menos bem. ## Uma camada de humanidade sobre um tratamento difícil A hemodiálise mantém pessoas vivas, mas cobra um preço pesado em tempo e em qualidade de vida. Não vamos fingir que um headset resolve isso. O que a realidade virtual pode fazer é mais modesto e, ainda assim, importante: transformar horas vazias em algo mais suportável, dar alguma escolha a quem tem pouca, e mostrar ao doente que a equipa se preocupa não só com os seus rins, mas com a sua experiência. Numa cadeira onde se passam tantas horas, isso não é pouco. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: Q: A realidade virtual interfere com a máquina de diálise ou com o acesso vascular? A: Não. O headset é um equipamento autónomo, sem fios ligados ao doente, que ocupa apenas a visão e a audição. O braço da fístula permanece imóvel e visível para a equipa, e o conteúdo é escolhido para não exigir movimentos amplos. A sessão de RV adapta-se ao tratamento, nunca o contrário. Q: O doente fica isolado da equipa durante a sessão? A: Não deve ficar. Na RVer, a realidade virtual é usada com o enfermeiro por perto, que continua a monitorizar tensão, sintomas e o decorrer da diálise. O headset pode ser retirado em segundos se for preciso intervir. É uma camada de conforto sobre o cuidado, não uma forma de deixar o doente sozinho. Q: Serve para todos os doentes em diálise? A: Não necessariamente. Doentes com tendência a enjoo, alterações vestibulares, certas condições oftalmológicas ou agitação importante podem não ser candidatos, e é o profissional que faz essa triagem. Para muitos outros, sobretudo quem enfrenta o tédio e a ansiedade das sessões longas, pode ser um apoio valioso. ### Porque a inteligência artificial ainda não está pronta para ser o clínico URL: https://rver.pt/blog/ia-nao-esta-pronta-para-ser-o-clinico/ Date: 16 June 2026 A inteligência artificial já faz coisas extraordinárias. Mas há uma pergunta que importa separar do entusiasmo: estará pronta para ser, sozinha, o profissional que decide o que acontece a um doente? Hoje, a resposta honesta é não. Há uma frase que se repete em conferências e apresentações: "a IA vai substituir o médico". Costuma vir acompanhada de um número impressionante e de um gráfico a subir. É uma boa frase para vender, e uma má forma de pensar em saúde. Não porque a inteligência artificial seja má. Pelo contrário: já é, em muitas tarefas, melhor do que qualquer um de nós. A questão é outra, mais cirúrgica: **estará pronta para ocupar, sozinha, o lugar de quem decide o que acontece a um doente?** Olhando para o que a IA é hoje, a resposta é não, e vale a pena perceber exatamente porquê. ## 1. Não percebe o doente. Processa dados sobre ele. Um profissional de saúde, à beira de uma pessoa, está a ler muito mais do que aquilo que mede. Lê a expressão, a respiração, a hesitação, o "não é nada" que quer dizer o contrário. Capta o sinal que não cabe em nenhum formulário. A IA não vê a pessoa: vê os dados que lhe damos sobre ela. E nas populações que mais nos importam, isso é um problema sério: um utente com demência, um doente em sofrimento, alguém que não consegue descrever o que sente. É precisamente onde o relato falha que o olhar humano se torna insubstituível. A máquina não estava na sala. ## 2. Está, por vezes, confiantemente errada Esta é talvez a característica mais perigosa da IA atual: erra com a mesma fluência com que acerta. Produz uma resposta articulada, plausível, segura de si, e por vezes simplesmente falsa. Sem hesitar, sem assinalar a dúvida. Num motor de busca, uma resposta errada é um inconveniente. Junto de um doente, é outra coisa. Um profissional sabe dizer "não tenho a certeza, vamos verificar". A IA tende a não saber que não sabe, e essa falsa segurança, em saúde, é um risco real. ## 3. Não pode ser responsável Quando um clínico decide, há alguém responsável por essa decisão: uma pessoa com formação, sujeita a regras, a deontologia, a prestação de contas. Se algo corre mal, há quem responda e quem aprenda. Um algoritmo não tem essa responsabilidade: não a pode ter. "O modelo decidiu" não é uma resposta aceitável diante de um doente ou de uma família. E uma decisão clínica sem ninguém que a assuma não é autonomia: é um vazio de responsabilidade disfarçado de eficiência. ## 4. Falha no caso raro, e a medicina vive de casos raros A inteligência artificial é brilhante na média. Aprende dos padrões mais comuns e responde-lhes muito bem. O problema é que a saúde está cheia de exceções, e a exceção, muitas vezes, **é** o doente vulnerável: o que reage de forma atípica, o que tem várias condições ao mesmo tempo, o que não se enquadra. É exatamente aí, na cauda longa dos casos invulgares, que a IA é mais fraca, e onde um profissional experiente faz a diferença. Apostar a segurança de quem mais precisa precisamente no ponto fraco da tecnologia é uma troca difícil de justificar. ## 5. Aprendeu de dados que não representam toda a gente Um modelo é tão bom quanto os dados com que aprendeu. E esses dados costumam sub-representar precisamente algumas das populações que servimos: as pessoas mais velhas, os multi-doentes, determinados grupos. O resultado são pontos cegos, e os pontos cegos de um sistema de IA tendem a cair em cima de quem já está em desvantagem. ## 6. Conhece padrões, não significados Por fim, há algo que a IA não faz: compreender o que está em jogo. Não pesa a dignidade de uma pessoa assustada, a vontade de uma família, a diferença entre tratar para curar e acompanhar para confortar. Reconhece correlações; não atribui sentido. E grande parte do que um profissional faz, sobretudo em cuidados a pessoas frágeis, é exatamente isso: dar sentido, decidir com valores, cuidar. ## "Ainda não" é uma porta aberta Dizemos "ainda não" de propósito. Isto não é tecnofobia nem uma rejeição da IA: é um juízo sobre o seu estado atual. À medida que a fiabilidade melhorar, a evidência se acumular, a regulação amadurecer e a responsabilização ficar clara, o papel da inteligência artificial vai crescer, e ainda bem. Até lá, a forma responsável de usar IA em saúde é simples de enunciar: **ao serviço do profissional, não no lugar dele.** É essa a fronteira. E é por respeitá-la que continuamos a construir a RVer à volta de uma ideia antiga e ainda insubstituível: a de que, por trás de cada sessão, há uma pessoa a cuidar de outra. Q: A RVer é contra a inteligência artificial? A: De forma alguma. A IA tem um papel real e crescente na saúde: organizar informação, sugerir opções, apoiar a equipa. A nossa posição é outra e mais específica: a IA, no estado atual, não está pronta para substituir o juízo de um profissional junto de um doente vulnerável. É a diferença entre uma ferramenta de apoio e um decisor autónomo. Q: O que é que um profissional faz que a IA ainda não faz? A: Percebe a pessoa à sua frente: o desconforto que não é dito, a reação subtil, o sinal que escapa a qualquer formulário. Pondera contexto, valores e o caso raro. E, sobretudo, é responsável pela decisão. A IA processa dados; o clínico cuida de uma pessoa. Não é a mesma coisa. Q: Então quando é que a IA estará pronta? A: Dizemos «ainda não» de propósito: é uma porta aberta, não uma rejeição. À medida que a evidência, a fiabilidade, a regulação e a responsabilização amadurecerem, o papel da IA crescerá. Até lá, o caminho responsável é a IA ao serviço do profissional, nunca no lugar dele. ### Sem buffering, sem depender da Wi-Fi: porque o conteúdo da RVer vive no equipamento URL: https://rver.pt/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/ Date: 15 June 2026 A melhor tecnologia em saúde é a que funciona sempre, e não só quando a rede está boa. É por isso que, na RVer, os vídeos não são transmitidos pela internet: vivem dentro do próprio equipamento. Imagine a cena: uma sala tranquila num lar, um residente pronto para uma sessão, e o Wi-Fi a oscilar como costuma oscilar em edifícios antigos com paredes grossas. Se a experiência dependesse de streaming, seria aqui que tudo se complicaria: imagem a parar, qualidade a cair, a pessoa a tirar o headset por frustração. Foi a pensar exatamente nesta sala que tomámos uma decisão técnica de fundo: **o conteúdo da RVer não é transmitido pela internet. Vive no equipamento.** ## O problema do streaming em vídeo 360 Vídeo 360 de alta qualidade é pesado. Para envolver a visão em todas as direções com nitidez, é preciso muito mais informação do que num vídeo normal. Transmitir isso em tempo real exige uma ligação rápida **e estável**, e é precisamente a estabilidade que falta em muitos lares, hospitais e centros de dia. O resultado de fazer streaming nesses ambientes é previsível: pausas para carregar, perda de definição nos momentos de pico, atrasos. Numa experiência cujo objetivo é acalmar, nada disto é aceitável. Uma sessão terapêutica não pode ficar refém da qualidade da rede naquele instante. ## A nossa escolha: o conteúdo já está lá Na RVer, os vídeos são colocados no próprio equipamento. Quando a sessão começa, não há nada a descarregar, nada a aguardar: o conteúdo já está presente, pronto a reproduzir. A imagem corre de forma fluida porque não está a chegar pela rede: está a sair da memória do aparelho. Isto traz três benefícios concretos: - **Fluidez garantida.** Sem buffering, sem quebras de qualidade. A experiência é igualmente suave numa sala com excelente Wi-Fi ou sem qualquer ligação. - **Fiabilidade.** A sessão acontece sempre. Não depende de a rede estar boa àquela hora, naquele canto do edifício. - **Simplicidade.** A equipa coloca o headset e começa. Não há diagnóstico de ligação, não há "está a carregar". ## E as atualizações? A pergunta natural é: se o conteúdo está no equipamento, como é que cresce e se renova? Aqui a internet entra, mas no momento certo. A biblioteca é atualizada de forma pontual, quando há ligação disponível, sincronizando novos ambientes terapêuticos. A diferença é que isso acontece **fora da sessão**, em segundo plano, e não enquanto a pessoa está a viver a experiência. Separar as duas coisas (reproduzir localmente, atualizar quando dá) é o que permite ter o melhor dos dois mundos: conteúdo sempre fresco e reprodução sempre fluida. ## Equipamento autónomo, instalação simples Esta arquitetura encaixa na geração atual de headsets autónomos: aparelhos que não precisam de computador, nem de cabos, nem de uma instalação complexa. Tudo o que é necessário para a sessão está contido no próprio equipamento. Para quem trabalha no terreno, isto significa levar a experiência a qualquer sala, a qualquer quarto, sem montar nada. ## A tecnologia certa é a que desaparece No fim, o objetivo de uma boa decisão técnica é que ninguém tenha de pensar nela. A pessoa que coloca o headset não devia saber, nem se preocupar, se há rede. Devia apenas ver-se, num instante, num lugar calmo. Guardar o conteúdo no equipamento é, no fundo, isso: tirar a tecnologia da frente para que fique só a experiência. É menos visível do que uma funcionalidade nova e brilhante, mas é o tipo de decisão que faz a diferença entre uma demonstração que impressiona e uma ferramenta em que se pode confiar, todos os dias. É uma das razões pelas quais a informática costuma aprovar isto depressa: [as oito perguntas da informática](/blog/informatica-hospital-perguntas-realidade-virtual/). Q: A RVer precisa de internet para funcionar? A: Para reproduzir as experiências, não. Os vídeos estão guardados no próprio equipamento, por isso a reprodução é fluida e fiável mesmo em locais com Wi-Fi fraco ou sem ligação. A ligação à internet é usada apenas para tarefas pontuais, como atualizar a biblioteca de conteúdos, nunca durante a sessão. Q: Porque é que isso é melhor do que fazer streaming? A: O streaming de vídeo 360 em alta qualidade exige muita largura de banda e uma ligação estável, algo que muitos lares e hospitais não têm de forma consistente. Ao guardar o conteúdo localmente, eliminam-se as paragens, o buffering e a perda de qualidade. A experiência é sempre suave, independentemente da rede. Q: E em termos de privacidade? A: Ter o conteúdo no equipamento significa que a experiência não depende de transmitir dados pela rede durante a sessão. É uma arquitetura mais simples e mais robusta, alinhada com uma utilização cuidadosa em contexto de saúde. As questões de proteção de dados são tratadas com o rigor que o setor exige. ### Porque há sempre um profissional ao lado: realidade virtual não é uma app deixada na mão do doente URL: https://rver.pt/blog/acompanhamento-clinico-sessoes-realidade-virtual/ Date: 14 June 2026 A tecnologia em saúde só vale alguma coisa quando há alguém a olhar para o doente. Na RVer, a realidade virtual nunca substitui o profissional: está nas mãos dele. E essa decisão não é um pormenor: é o princípio. Há uma tentação recorrente em saúde digital: a de transformar uma ferramenta clínica num produto que se entrega ao doente e se deixa funcionar sozinho. É compreensível: promete escala, reduz custos, soa a futuro. Mas em populações vulneráveis, essa tentação tem um preço que raramente aparece na apresentação. Na RVer, fizemos a escolha contrária, e fizemo-la de propósito: **cada sessão é acompanhada por um profissional de saúde**. Não é uma limitação que ainda não resolvemos. É uma decisão de princípio. ## A tecnologia não observa o doente, o profissional sim Uma sessão de realidade virtual para uso clínico parece simples vista de fora: a pessoa coloca o headset e relaxa. Mas o que torna essa sessão segura e útil acontece à volta dela. É o profissional que sabe que **aquela** pessoa tem tendência a vertigens e por isso escolhe um conteúdo estável. É o profissional que repara que o utente está mais agitado do que o habitual e decide encurtar. É quem nota palidez, desconforto, uma reação emocional inesperada, e age. Nada disto está no conteúdo. Está no olhar de quem acompanha. A realidade virtual oferece a experiência. O juízo clínico (o que é adequado, para quem, quando e até onde) continua a ser humano. E é esse juízo que separa uma ferramenta terapêutica de um simples ecrã. ## O caso recente que devíamos discutir Surgiu há pouco a notícia de que um sistema de saúde iria disponibilizar uma solução de inteligência artificial para guiar, sem terapeuta, a reabilitação física de doentes. A intenção (alargar o acesso, reduzir listas de espera) é boa. A execução, tirar o profissional da equação, merece ser olhada com cuidado. A reabilitação física não é executar movimentos. É **ler o corpo enquanto se move**: perceber se a dor é a dor que faz parte ou a dor que avisa, se a pessoa está a compensar com o lado errado, se há um sinal de alarme escondido num gesto. Um algoritmo pode contar repetições e medir ângulos. O que ele não faz (porque não está lá, e porque não é responsável por ninguém) é a parte clínica. E há o problema da equidade, que costuma ser esquecido. Quem fica sozinho com uma aplicação é, quase sempre, quem mais precisaria de acompanhamento: a pessoa mais velha, o doente complexo, quem tem menos literacia digital ou menos rede de apoio. Chamar autonomia a deixar estas pessoas entregues a si mesmas é, no mínimo, otimista. Nada disto é um argumento contra a inteligência artificial. É um argumento contra **retirar o humano** de onde o humano é insubstituível. ## Onde a IA ajuda, e onde não deve mandar Vale a pena ser justo. A inteligência artificial tem lugar na saúde: pode ajudar a organizar conteúdos, a registar o que aconteceu numa sessão, a sugerir opções à equipa, a dar apoio entre consultas. São tarefas em que acrescenta valor real. O que não deve fazer é assumir o lugar do clínico perante um doente frágil, sem ninguém a validar a decisão. A diferença é simples: a IA como **copiloto** da equipa é uma boa ideia; a IA como **substituto** do profissional, em cuidados a pessoas vulneráveis, é transferir responsabilidade para uma máquina que não a pode ter. ## O que isto significa na RVer A RVer foi construída a partir deste princípio. Por isso o sistema é desenhado para a equipa: é a equipa que escolhe o conteúdo certo para cada pessoa, que conhece as contraindicações, que conduz e supervisiona a sessão. A tecnologia faz o que a tecnologia faz bem: entregar uma experiência imersiva, calma e segura. As decisões continuam com quem é responsável pelo doente. Não vendemos cuidados sem cuidadores. Damos aos cuidadores uma ferramenta melhor. É uma distinção pequena na frase e enorme na prática, e é, no fundo, o que separa uma promessa tecnológica de uma boa prática clínica. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: Sobre o utilizador previsto, a formação e quem decide na instituição: [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Antes do registo vem a explicação e o direito a parar: [é preciso consentimento?](/blog/consentimento-informado-realidade-virtual-saude/). Q: Posso usar a RVer sem um profissional de saúde presente? A: Não é assim que a RVer foi pensada. Cada sessão é acompanhada por um profissional (médico, enfermeiro, terapeuta ou cuidador formado) que escolhe o conteúdo adequado, observa a reação do utente e decide quando começar, continuar ou parar. A tecnologia é uma ferramenta nas mãos da equipa, não um substituto dela. Q: Mas a inteligência artificial não pode guiar sozinha a terapia? A: A IA pode ajudar em tarefas concretas: sugerir, registar, dar apoio entre sessões. O que não pode é assumir o juízo clínico: avaliar dor, detetar uma reação adversa, perceber que algo não está bem num doente frágil. Em populações vulneráveis, retirar o profissional da equação não é eficiência: é transferir o risco para quem menos se pode defender. Q: Isso não torna a solução mais cara e menos escalável? A: Acompanhar não significa ocupar um profissional a tempo inteiro. Significa integrar a sessão no fluxo de cuidados existente, com supervisão e critério. O objetivo da RVer é potenciar a equipa, dar-lhe uma ferramenta segura e eficaz, não prometer cuidados sem cuidadores. ### Conforto e enjoo na realidade virtual: porque o vídeo 360 é mais suave URL: https://rver.pt/blog/conforto-e-enjoo-realidade-virtual/ Date: 14 June 2026 «E se me der tonturas?» É uma das primeiras perguntas de quem nunca usou realidade virtual. A resposta depende menos da tecnologia e mais de como o conteúdo é feito, e aqui o vídeo 360 parte com vantagem. Quem nunca experimentou realidade virtual costuma trazer uma imagem na cabeça: a do jogo que dá tonturas, do simulador que deixa alguém pálido ao fim de dois minutos. É uma preocupação legítima, e também um mal-entendido. O enjoo na realidade virtual existe, mas depende muito mais de **como o conteúdo é feito** do que da tecnologia em si. ## O que é o enjoo da realidade virtual O termo técnico é *cybersickness*. Os sintomas são conhecidos de quem já enjoou num carro ou num barco: náusea, tonturas, suores frios, desorientação. A causa também é a mesma: um **conflito sensorial**. O nosso sentido de equilíbrio vive no ouvido interno e funciona em permanente diálogo com a visão. Quando os dois concordam, sentimo-nos estáveis. Quando discordam, os olhos veem movimento que o corpo não sente, o cérebro recebe sinais contraditórios e responde com mal-estar. No enjoo de viagem, o corpo move-se e os olhos (a ler um livro) não veem esse movimento. Na realidade virtual, acontece muitas vezes o inverso: os olhos veem movimento e o corpo está parado. ## Porque alguns conteúdos enjoam e outros não A chave está no **movimento da câmara**. Em jogos e experiências sintéticas, a câmara desloca-se artificialmente: anda, corre, voa, sobe escadas: tudo sem que o corpo da pessoa se mexa. É essa locomoção artificial, intensa e prolongada, a principal responsável pelo enjoo. Quanto mais agressivo o movimento, e quanto menor a fluidez da imagem, maior o desconforto. O **vídeo 360 estacionário** funciona de outra forma. A câmara está fixa num ponto e a pessoa simplesmente olha em redor, como olharia numa sala real. O que vê acompanha exatamente o movimento da sua cabeça: não há deslocação imposta, não há conflito. Por isso o vídeo 360 é, por natureza, muito mais suave, e particularmente adequado a utentes mais frágeis, de qualquer idade. Não é acaso: é uma escolha de desenho. Para um uso terapêutico e tranquilo, a câmara parada não é uma limitação, mas é uma vantagem. ## A exceção: nem todo o 360 é igual Vale a pena ser honesto. Mesmo em vídeo 360, certas filmagens podem causar algum desconforto: imagens aéreas (de drone), panorâmicas rápidas, planos captados em movimento dentro de um veículo. Aí volta a existir movimento visual sem movimento do corpo. A solução é simples: **escolher conteúdo estável e calmo**, sobretudo para quem é mais sensível. Uma paisagem serena, uma praça, o mar (filmados a partir de um ponto fixo) são tão imersivos quanto confortáveis. ## Quem deve ter cuidado A realidade virtual é segura para a grande maioria das pessoas, mas há situações que pedem precaução ou que a desaconselham: - **Tendência para vertigens** ou perturbações do equilíbrio. - **Enjoo de movimento acentuado** ou náusea já presente. - **Epilepsia fotossensível**: evitar conteúdos com flashes ou luzes intensas. - **Infeções recentes do ouvido** ou quadros agudos que afetem o equilíbrio. Sinalizar estas situações à partida, e associá-las ao conteúdo certo, é parte de uma utilização responsável. Por isso faz sentido que cada vídeo traga indicações claras sobre a sua intensidade e eventuais contraindicações, que no RVer [retiram o conteúdo da lista](/rver-ai/) em vez de o assinalar. ## Como conduzir uma sessão confortável Pequenos cuidados fazem toda a diferença: - **Sentado e estável.** A maioria das sessões terapêuticas é feita sentado, num lugar seguro. - **Começar curto e calmo.** Poucos minutos, com conteúdo estável, para a pessoa se habituar. Aumenta-se depois, se houver conforto. - **A pessoa controla o ritmo.** Pode tirar o headset a qualquer momento. Saber isso, só por si, tranquiliza. - **Boa nitidez.** Um headset bem ajustado e lentes limpas reduzem o esforço visual e o cansaço ([porque o RVer usa lentes pancake](/equipamento/)). - **Atenção aos primeiros sinais.** Palidez, suor, "sinto-me estranho": parar é sempre a decisão certa. O desconforto passa rapidamente em repouso. ## Em resumo O enjoo na realidade virtual é real, mas evitável. A maior parte do problema vem de conteúdos que movem a câmara de forma artificial: exatamente o que o vídeo 360 estacionário não faz. Com conteúdo estável, sessões curtas e atenção à pessoa, a esmagadora maioria dos utentes, de todas as idades, vive a experiência com conforto. A tecnologia não tem de causar desconforto. Bem escolhida e bem usada, faz precisamente o contrário: traz calma. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: O enjoo é uma parte da pergunta maior. O resto (vista, epilepsia fotossensível, pessoas idosas e limites de idade) está reunido em [«A realidade virtual faz mal?»](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Q: O que é o enjoo da realidade virtual? A: É um mal-estar (náusea, tonturas, desorientação) que pode surgir quando os olhos veem movimento que o corpo não sente. Chama-se cybersickness e resulta de um conflito sensorial entre a visão e o ouvido interno, semelhante ao enjoo de viagem, mas ao contrário. É mais frequente em experiências que movem a câmara artificialmente do que no vídeo 360 estacionário. Q: O vídeo 360 também provoca enjoo? A: Muito menos. No vídeo 360, a câmara está parada e a pessoa apenas olha em redor a partir de um ponto fixo: o que vê acompanha o movimento da sua cabeça. Sem locomoção artificial, o conflito sensorial é mínimo. A exceção são filmagens com muito movimento de câmara (aéreas, panorâmicas rápidas, dentro de veículos), que convém evitar com utilizadores sensíveis. Q: Quem deve ter cuidado ou evitar? A: Pessoas com tendência para vertigens, perturbações do equilíbrio, náusea ativa ou enjoo de movimento acentuado devem usar com precaução. Conteúdos com flashes ou luzes intensas devem ser evitados por quem tem epilepsia fotossensível. Como sempre, a utilização é supervisionada, individualizada e integrada no plano de cuidados. ### Voltar a um lugar familiar: realidade virtual e terapia de reminiscência URL: https://rver.pt/blog/reminiscencia-lugares-familiares-realidade-virtual/ Date: 14 June 2026 Uma pessoa com demência pode não se lembrar do que comeu ao almoço, mas reconhecer, num instante, a praça da sua infância. A terapia de reminiscência trabalha precisamente com essa memória, e a realidade virtual leva-a mais longe. Há uma característica da demência que surpreende quem lida com ela pela primeira vez: a memória mais recente desaparece primeiro, enquanto a mais antiga muitas vezes permanece. Uma pessoa pode não reconhecer o quarto onde dormiu esta noite, mas descrever com detalhe a casa onde cresceu há setenta anos. É sobre essa memória resistente, a **memória autobiográfica**, que trabalha a terapia de reminiscência. ## O que é a terapia de reminiscência A reminiscência é uma das abordagens não farmacológicas mais estabelecidas no acompanhamento de pessoas mais velhas e com demência. A ideia é simples: usar estímulos do passado (uma canção, uma fotografia, um cheiro, um lugar) para evocar recordações e, com elas, emoção, conversa e ligação. O objetivo nunca é "testar" se a pessoa se lembra. É o oposto: oferecer-lhe um terreno onde a memória ainda é firme, onde se sente competente e reconhecida. Os benefícios [documentados na literatura](/estudos/tema/qualidade-de-vida/) incluem melhoria do humor, redução da agitação e um maior sentido de identidade e de pertença. ## Porque a realidade virtual leva a reminiscência mais longe Tradicionalmente, a reminiscência apoia-se em fotografias, álbuns e objetos. São ferramentas valiosas, mas estáticas. A realidade virtual acrescenta a dimensão que falta: a de **estar lá**. Voltar a um lugar é diferente de o ver numa imagem. Quando alguém com mobilidade reduzida, há anos sem sair de um lar, volta a "passear" pela praça da sua aldeia, pela igreja onde casou ou junto ao mar da sua terra, a recordação ativa-se de forma mais completa. A imersão envolve a atenção por inteiro e dá ao cérebro pistas sensoriais ricas: exatamente o tipo de gatilho que a memória antiga reconhece. Para muitas pessoas, é também o reencontro com lugares que já não conseguem visitar fisicamente. A realidade virtual devolve-lhes esse acesso. ## O lugar tem de ser o lugar certo Aqui está um ponto que faz toda a diferença e que é fácil de subestimar: **o conteúdo tem de ser culturalmente próximo**. Uma paisagem genérica e bonita pode relaxar, mas não evoca memória. O que evoca é o reconhecimento: "isto é a minha terra", "eu conheço este sítio". Para uma pessoa portuguesa, voltar a um lugar familiar do seu país (uma cidade que conhece, um [santuário onde foi em peregrinação](/blog/dia-mundial-do-turismo-o-destino-mais-pedido-e-fatima/), uma praia onde passou verões) tem um peso afetivo que nenhuma imagem de outro continente consegue ter. A relevância cultural e geográfica não é um detalhe: é o que separa uma experiência agradável de um verdadeiro reencontro. É por isso que faz sentido construir bibliotecas de conteúdo enraizadas na realidade de quem as vai ver. ## Como usar bem A realidade virtual na reminiscência funciona melhor quando é **acompanhada**, não solitária. Alguns princípios práticos: - **Escolher o lugar com a pessoa (ou com a família; a [ficha de história de vida](/ferramentas/historia-de-vida/) ajuda).** Saber que sítios marcaram a vida de alguém é o primeiro passo. Um lugar com história pessoal vale mais do que o mais espetacular dos cenários. - **Estar presente.** O maior valor surge na conversa que a experiência desencadeia. A reminiscência é um momento de relação, não um ecrã para entreter. - **Sessões curtas e calmas.** O objetivo é o conforto e a evocação positiva, sem cansaço nem sobre-estimulação. - **Observar a reação.** Nem todas as memórias são felizes. Escolhem-se lugares ligados a recordações positivas e está-se atento a sinais de desconforto, terminando se necessário. ## Uma ferramenta de dignidade No fundo, a terapia de reminiscência com realidade virtual não é sobre tecnologia. É sobre reconhecer que, mesmo quando a doença avança, a pessoa continua lá, com a sua história, os seus lugares, a sua identidade. Levá-la de volta a um sítio que ama, ainda que por alguns minutos, é uma forma de lhe dizer que essa história continua a importar. É um lembrete simples e poderoso: por trás de um diagnóstico há sempre uma vida inteira, e essa vida tem endereço. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: O quadro geral (calma, agitação e cuidado na demência) está em [realidade virtual na demência](/blog/realidade-virtual-demencia-alzheimer/). Sobre onde encaixar estas sessões na semana, ver [o plano de atividades de um lar](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). Q: O que é a terapia de reminiscência? A: É uma abordagem que usa estímulos (fotografias, música, objetos ou lugares) para evocar memórias do passado, sobretudo em pessoas mais velhas ou com demência. O objetivo não é testar a memória, mas despertar recordações positivas, estimular a conversa e reforçar o sentido de identidade e de continuidade da pessoa. Q: Porque é que a realidade virtual ajuda na reminiscência? A: Porque permite voltar a lugares que a pessoa já não consegue visitar fisicamente: a sua terra, uma igreja, o mar. A imersão num ambiente reconhecível ativa a memória de forma mais rica do que uma fotografia, e o conteúdo local e culturalmente próximo torna o reencontro muito mais significativo. Q: É adequado para todas as pessoas com demência? A: Deve ser sempre individualizado e supervisionado. Escolhem-se lugares associados a memórias positivas, evitando os que possam causar tristeza ou confusão, e observa-se a reação da pessoa. É uma ferramenta complementar, integrada no plano de cuidados, e nunca um substituto do acompanhamento humano. ### Não é entretenimento: a biblioteca validada que a equipa clínica escolhe para cada pessoa URL: https://rver.pt/blog/biblioteca-validada-equipa-clinica-realidade-virtual/ Date: 14 June 2026 Há um abismo entre «pôr um vídeo bonito» e «escolher o ambiente certo para aquela pessoa, naquele dia». É nesse abismo que vive a diferença entre entretenimento e terapia. Faça-se a experiência mental: dois utentes, o mesmo equipamento, dois resultados opostos. A um, mostra-se uma paisagem serena e ele acalma. A outro, mostra-se a mesma paisagem e nada acontece, ou pior, fica desconfortável. O equipamento é igual. O que mudou foi a **adequação do conteúdo à pessoa**. É por isso que, na RVer, a biblioteca de conteúdos não é um detalhe do produto. É o produto. ## Bonito não é o mesmo que terapêutico A internet está cheia de vídeos 360. Muitos são belíssimos. Quase nenhum foi pensado para uma pessoa frágil, num lar ou num hospital, com um objetivo clínico em mente. Conteúdo terapêutico é outra coisa. É um ambiente escolhido **para um fim**: acalmar quem está ansioso, ativar quem precisa de estimulação, evocar memória em quem vive com demência, dar um momento de conforto a quem está em cuidados paliativos. E é um ambiente avaliado quanto a segurança (ritmo, estabilidade de imagem, ausência de gatilhos) porque o que para a maioria é inofensivo pode não o ser para todos. A biblioteca da RVer é construída assim: selecionada com profissionais de saúde, não apenas recolhida. ## A equipa escolhe, e essa é a parte que importa Ter bom conteúdo não chega. É preciso escolher **o conteúdo certo para a pessoa certa**, e essa decisão é clínica. A equipa que acompanha o utente escolhe com base em três coisas: - **A intenção.** O objetivo daquela sessão (acalmar, estimular, recordar) orienta a escolha. Um ambiente sereno e um ambiente estimulante servem propósitos diferentes. - **O estado da pessoa, naquele momento.** Não é só quem a pessoa é, mas como está hoje. O conteúdo adequado numa tarde tranquila pode não ser o melhor num dia de maior agitação. - **O perfil e as contraindicações.** Tendência a vertigens, sensibilidade a luzes intensas, fragilidades específicas. Saber o que evitar é tão importante como saber o que oferecer. Por isso a RVer organiza a biblioteca de forma a que esta escolha seja simples e segura: cada ambiente traz consigo a indicação da sua intensidade e das suas contraindicações, para que a equipa decida com informação, e não por tentativa e erro. ## O conteúdo familiar tem um valor próprio Há ainda uma dimensão que faz toda a diferença: a **proximidade**. Para muitas pessoas, sobretudo as mais velhas, voltar a um lugar reconhecível tem um peso afetivo que uma paisagem genérica nunca terá. Um sítio que se conhece, uma cidade onde se viveu, um lugar com história pessoal. Uma biblioteca enraizada na realidade de quem a vê não é só mais agradável: é mais eficaz. ## Uma biblioteca que cresce As necessidades clínicas são variadas e as pessoas cansam-se da repetição. Por isso a biblioteca é atualizada regularmente, com novos ambientes terapêuticos. O objetivo é que a equipa tenha sempre a opção certa à mão (para acalmar, para ativar, para recordar) e que a experiência se mantenha viva ao longo do tempo. ## Em resumo A tecnologia entrega a imersão. Mas é o conteúdo (escolhido, validado, adequado) que a transforma em cuidado. Na RVer, a biblioteca não é uma coleção de vídeos: é um conjunto de ferramentas clínicas, nas mãos de quem sabe qual usar, com quem e quando. Porque, no fim, a pergunta nunca é «que vídeo vamos pôr?». É «de que precisa esta pessoa, agora?». :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: Q: O que torna a biblioteca da RVer diferente de vídeos 360 disponíveis online? A: A curadoria e a validação. Cada ambiente é selecionado para um propósito terapêutico (acalmar, estimular, evocar memória, dar conforto) e avaliado quanto a adequação e segurança. Não é uma coleção de paisagens bonitas; é uma biblioteca pensada para uso clínico, com indicações claras de intensidade e contraindicações. Q: Como é escolhido o conteúdo para cada utente? A: É a equipa clínica que escolhe, com base no objetivo (acalmar, ativar, reminiscência), no estado da pessoa nesse momento e no seu perfil: incluindo eventuais contraindicações, como tendência a vertigens ou sensibilidade a luzes intensas. O mesmo ambiente que ajuda uma pessoa pode não ser indicado para outra. Q: A biblioteca é fixa ou cresce? A: Cresce. A biblioteca é atualizada regularmente com novos ambientes terapêuticos, para que a experiência se mantenha rica e relevante ao longo do tempo, evitando a repetição e respondendo a diferentes necessidades clínicas. ### Para onde vai a realidade virtual na saúde: tendências para 2026 URL: https://rver.pt/blog/tendencias-realidade-virtual-saude-2026/ Date: 12 June 2026 Durante anos, a pergunta sobre realidade virtual na saúde foi «será que funciona?». Em 2026, a conversa mudou: passou a ser «como integramos isto no dia a dia?». Essa mudança diz tudo. Durante anos, falar de realidade virtual na saúde era falar de potencial. De estudos promissores, de pilotos isolados, de "um dia". Em 2026, esse tom mudou. A realidade virtual para uso clínico deixou de ser uma curiosidade tecnológica para se tornar uma ferramenta que as instituições procuram integrar, com método, com critério e com expectativas realistas. Reunimos as tendências que melhor traduzem este momento. Sem hype, sem promessas de revolução: apenas o que está, de facto, a mudar. ## 1. Da pergunta "funciona?" para "como integrar?" A mudança mais importante de 2026 não é tecnológica: é de mentalidade. A base de evidência cresceu o suficiente para que a conversa nas instituições deixasse de girar em torno de "será que isto resulta?" e passasse a ser sobre **integração**: em que momentos do percurso do utente faz sentido, quem opera, como se documenta, como se mede o resultado. É a transição típica de uma tecnologia que amadurece: de projeto experimental para parte do fluxo de cuidados. E é uma boa notícia, porque significa que o foco se desloca da novidade para aquilo que realmente importa: o benefício para a pessoa. ## 2. A saúde mental e o conforto lideram De todas as aplicações, a área que mais cresce não é a cirurgia nem a formação: é a do **bem-estar emocional**: ansiedade, stress, conforto. A lógica é simples. A distração imersiva é uma forma não farmacológica de mudar o foco da atenção, e isso tem valor em inúmeros momentos do quotidiano clínico: uma espera, um procedimento desconfortável, uma tarde longa num lar. Para populações mais frágeis, como residentes de lares ou pessoas em cuidados paliativos, este é talvez o contributo mais imediato da realidade virtual: oferecer um momento de calma, de evasão, de dignidade, sem adicionar medicação. ## 3. A dor continua a ser o caso mais bem documentado Se há uma aplicação com evidência robusta, é a **distração para a dor**. Vários ensaios clínicos mostram reduções significativas na intensidade da dor com realidade virtual imersiva durante procedimentos, e algumas soluções demonstram efeitos que se mantêm ao longo do tempo, não apenas no momento. O mecanismo é conhecido: a atenção é um recurso limitado. Ao envolver a visão e a audição num ambiente cativante, sobra menos capacidade para processar o sinal de dor. Não substitui o tratamento, complementa-o, e sem os efeitos secundários associados à medicação. ## 4. Os headsets autónomos tornaram tudo prático Nada disto teria saído do laboratório sem uma mudança de equipamento. Os headsets de realidade virtual **autónomos** (sem computador, sem cabos, sem instalação) transformaram a viabilidade prática. Ligam-se, colocam-se e estão prontos. Esta acessibilidade mudou o jogo para quem trabalha no terreno: é possível levar a experiência à beira do leito, ao quarto de um lar ou à casa de uma pessoa, com higienização simples entre utilizações e a um custo incomparavelmente menor do que há poucos anos. A barreira deixou de ser técnica. ## 5. A personalização é a próxima fronteira A geração atual de realidade virtual para uso clínico entrega, na maioria dos casos, o mesmo conteúdo a toda a gente. A próxima adapta-se: ajusta o ambiente, o ritmo e a intensidade ao perfil e ao estado da pessoa. Na prática, isto começa por algo simples e poderoso: **escolher o conteúdo certo para cada utilizador**. Uma paisagem serena para quem precisa de acalmar; um ambiente estimulante para quem beneficia de ativação cognitiva; um lugar familiar para quem vive com demência. Associar cada conteúdo a uma intenção e a um perfil clínico é o primeiro passo para uma realidade virtual que responde à pessoa, e não a uma média. ## 6. Evidência, normas e proteção de dados deixam de ser opcionais À medida que a utilização se generaliza, sobe a fasquia. As instituições já não aceitam "parece resultar": pedem evidência, protocolos claros e garantias de **proteção de dados** e governação clínica. Em contexto europeu, o RGPD não é um detalhe: é uma condição. Esta exigência é saudável. Separa as soluções sérias das modas passageiras e protege quem mais importa: o utente. A tendência de 2026 é a profissionalização: menos demonstração tecnológica, mais rigor clínico. ## O que isto significa, na prática A realidade virtual na saúde está a entrar na sua fase adulta. Não é uma solução para tudo, e qualquer afirmação nesse sentido deve ser olhada com ceticismo. Mas, nas aplicações certas (conforto, ansiedade, dor, estimulação, acompanhamento de pessoas frágeis), é hoje uma ferramenta concreta, acessível e cada vez mais sustentada por evidência. O desafio de 2026 já não é provar que a tecnologia tem valor. É usá-la bem: com critério clínico, com o conteúdo certo para cada pessoa e com o respeito que o contexto de saúde exige. Q: A realidade virtual na saúde já é uma prática estabelecida ou ainda é experimental? A: Depende da aplicação. A distração imersiva para dor e ansiedade tem hoje uma base de evidência sólida e está a passar de projetos-piloto para utilização estruturada em muitas instituições. Outras áreas continuam em investigação. A tendência geral de 2026 é clara: a discussão deixou de ser sobre se funciona e passou a ser sobre como integrar de forma segura no fluxo clínico. Q: O que muda com a personalização da realidade virtual? A: A geração atual oferece, em geral, o mesmo conteúdo a toda a gente. A próxima adapta-se à pessoa: ajustando o ambiente ao perfil, ao estado emocional e ao objetivo terapêutico. Na prática, isto significa escolher o conteúdo certo para cada utilizador, em vez de uma solução única para todos. Q: Preciso de equipamento complexo para usar realidade virtual para uso clínico? A: Já não. Os headsets autónomos atuais dispensam computador e cabos: ligam-se e estão prontos a usar. Foi essa acessibilidade que tornou a realidade virtual prática à beira do leito, num lar ou em casa, e é uma das razões pelas quais a adoção acelerou. ### Realidade virtual na dor de queimaduras durante o tratamento de feridas: o que mostra a evidência URL: https://rver.pt/blog/realidade-virtual-queimaduras-tratamento-feridas/ Date: 10 June 2026 Poucos procedimentos são tão dolorosos como a mudança de penso de uma queimadura, repetida dia após dia. Entre as abordagens não farmacológicas, a realidade virtual de distração é das mais estudadas, e a evidência é consistente. Mudar os pensos de uma queimadura é um dos procedimentos mais dolorosos de toda a medicina, e não é feito uma vez, mas repetido diariamente através de lavagem, desbridamento e novo penso. A medicação para a dor ajuda, mas raramente a elimina por completo. Entre as abordagens não farmacológicas estudadas para fechar essa lacuna, a **realidade virtual de distração** é das mais investigadas. Vale a pena ver a evidência. ## O mecanismo: a atenção é um recurso limitado A lógica assenta num facto simples sobre a mente: **a dor exige atenção**, e a atenção é finita. Um ambiente imersivo absorvente compete por essa mesma atenção limitada. Quanto mais a experiência puxa a mente para dentro, menos recursos cognitivos sobram para processar o sinal doloroso. Não se trata de "ignorar" a dor pela força de vontade: é redirecionar a atenção de que a dor depende para ser sentida na sua intensidade plena. ## O que dizem as revisões sistemáticas Aqui a base de evidência é invulgarmente sólida para uma intervenção não farmacológica: - Uma **revisão sistemática e meta-análise** que reuniu cerca de **1 293 doentes queimados em 30 estudos** concluiu que a realidade virtual **reduziu de forma significativa a intensidade da dor** durante o tratamento de feridas, em comparação com o cuidado padrão isolado (efeito moderado a grande). - Para além de uma única pontuação de dor, os dados agregados mostram reduções na **intensidade da dor máxima**, no **desconforto da dor** e no **tempo passado a pensar na dor**, aumentando, ao mesmo tempo, o "divertimento" relatado pelos doentes num procedimento de outra forma temido. - Revisões focadas em **doentes pediátricos queimados** registam o mesmo sentido de efeito tanto na **dor** como na **ansiedade**, duas coisas que se alimentam mutuamente em crianças perante procedimentos repetidos. > Que a distração imersiva baixa a dor do procedimento em queimaduras é das afirmações mais sustentadas na gestão não farmacológica da dor: apoiada por meta-análises, não por estudos isolados. ## Os limites que é honesto referir - Os efeitos são medidos **durante e em torno do procedimento**; a RV é uma ferramenta para a dor aguda do procedimento, não um tratamento da lesão de base. - Os estudos são **heterogéneos** (diferentes equipamentos, conteúdos, gravidades de queimadura e faixas etárias), o que alarga o intervalo de efeitos relatados. - É um **adjuvante**: funciona ao lado da analgesia e de um tratamento de feridas competente, não em vez deles. :::note **Nota importante:** a realidade virtual para a dor de procedimentos é uma abordagem **complementar** usada sob supervisão clínica. Não substitui a analgesia, a sedação quando indicada, ou o juízo da equipa de tratamento de queimaduras. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para oferecer uma imersão calma e absorvente que a equipa clínica inicia em segundos durante um procedimento: simples de usar junto ao leito, higiénico entre doentes e sem recolha de dados clínicos do paciente. Quando um procedimento é inevitável mas a dor à sua volta não está fixada, a distração imersiva oferece uma forma de baixo risco de o tornar mais suportável: sempre como complemento de uma analgesia e de um cuidado adequados. ## Referências Estudos independentes sobre realidade virtual e dor em queimaduras (investigação geral, não específica de qualquer produto): - [Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9676699/) - [Impact of Virtual Reality Technology on Pain and Anxiety in Pediatric Burn Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9563984/) - [Virtual reality as a pain reduction method in burn and wound healing: a systematic review and meta-analysis, *Burns & Trauma* (Oxford Academic)](https://academic.oup.com/burnstrauma/article/doi/10.1093/burnst/tkaf061/8245060) Q: A realidade virtual reduz a dor durante o tratamento de feridas de queimaduras? A: A evidência aponta claramente nesse sentido. Revisões sistemáticas e meta-análises que reúnem mais de mil doentes queimados concluem que a realidade virtual, usada em conjunto com a analgesia padrão, reduz de forma significativa a intensidade da dor durante o tratamento de feridas e a mudança de pensos: um dos procedimentos mais dolorosos da medicina. Q: Como é que a RV reduz a dor do procedimento? A: Através da distração imersiva. A dor exige atenção; um ambiente virtual absorvente compete por essa mesma atenção limitada, deixando menos recursos cognitivos para processar o sinal doloroso. Os doentes relatam menor intensidade de dor máxima, menor desconforto e menos tempo a pensar na dor. Q: Substitui a medicação para a dor? A: Não. A realidade virtual é estudada e usada como complemento da analgesia padrão, não como substituto. É um adjuvante que pode baixar a dor sentida durante o procedimento, sempre sob o cuidado da equipa clínica. ### Realidade virtual na ansiedade pré-operatória: o que mostra a investigação URL: https://rver.pt/blog/realidade-virtual-ansiedade-pre-operatoria/ Date: 10 June 2026 Poucos momentos no cuidado são tão ansiogénicos como a espera antes de uma cirurgia. Entre as abordagens estudadas para a aliviar, a realidade virtual reúne já evidência consistente de ensaios aleatorizados, em adultos e, sobretudo, crianças. As horas antes de uma operação são, para muitas pessoas, a parte mais ansiogénica de toda a experiência: a espera, o desconhecido, o próprio bloco operatório. Essa ansiedade não é apenas desagradável: nas crianças, em particular, está associada a uma recuperação mais difícil. Entre as abordagens não farmacológicas estudadas para a aliviar, a **realidade virtual** tem já uma base consistente de evidência vinda de ensaios aleatorizados. Vale a pena ver o que mostram. ## O mecanismo: distração e preparação A realidade virtual é usada aqui de duas formas distintas, e a diferença importa: - **Distração**: imergir o doente num ambiente calmo e absorvente que afasta a atenção da espera e do contexto clínico. A atenção é finita; um mundo virtual envolvente deixa menos atenção disponível para a antecipação ansiosa. - **Preparação (exposição)**: percorrer com o doente, antecipadamente, o que vai realmente acontecer: as salas, os passos, os sons. O desconhecido é grande parte do medo pré-operatório, e torná-lo familiar reduz esse medo. As revisões que comparam as duas abordagens sugerem que a **distração tende a mostrar o efeito mais forte**, embora ambas sejam usadas. ## O que dizem os ensaios aleatorizados Aqui a evidência vem de ensaios controlados, e não apenas de observação: - Uma **meta-análise de 10 ensaios clínicos aleatorizados** com cerca de **813 doentes** encontrou ansiedade pré-operatória **significativamente menor** nos grupos com realidade virtual do que nos controlos. - Numa revisão mais ampla de **29 estudos**, **25 (86%)** mostraram reduções estatisticamente significativas da ansiedade pré-operatória após uma intervenção de RV, com um tamanho de efeito agregado **moderado** e consistente. - Revisões focadas em **doentes cirúrgicos pediátricos** registam o mesmo benefício significativo: importante porque a ansiedade antes da anestesia é, nas crianças, comum e com consequências. > Que a realidade virtual baixa a ansiedade pré-operatória é apoiado por várias meta-análises de ensaios aleatorizados (tanto em adultos como em crianças), uma base mais sólida do que a de estudos isolados. ## Os limites que é honesto referir - Os efeitos são medidos **em torno do período perioperatório**; trata-se de aliviar uma ansiedade específica e limitada no tempo, não de tratar uma perturbação de ansiedade. - Os estudos variam no **equipamento, no conteúdo e em distrair ou preparar**, o que alarga o intervalo de efeitos relatados. - É um **complemento** de uma boa comunicação e cuidado clínicos, não um substituto de nenhum deles. :::note **Nota importante:** a realidade virtual para a ansiedade pré-operatória é uma abordagem **complementar** usada sob supervisão clínica. Não substitui a avaliação anestésica, a pré-medicação quando indicada, ou o apoio da equipa cirúrgica. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para oferecer uma imersão calma que as equipas iniciam em segundos numa sala de pré-operatório ou unidade de cirurgia de ambulatório: simples de usar, higiénico entre doentes e sem recolha de dados clínicos do paciente. Quando a espera antes da cirurgia é inevitável mas a ansiedade à sua volta não está fixada, a realidade virtual imersiva oferece uma forma de baixo risco e sem medicação de a tornar mais calma, sempre como complemento de um cuidado clínico atento. ## Referências Estudos independentes sobre realidade virtual e ansiedade pré-operatória (investigação geral, não específica de qualquer produto): - [The Effect of Virtual Reality on Preoperative Anxiety: A Meta-Analysis of Randomized Controlled Trials](https://pmc.ncbi.nlm.nih.gov/articles/PMC7600416/) - [The Role of Preoperative Virtual Reality for Anxiety Reduction in Pediatric Surgical Patients: A Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC11801400/) - [Effects of Virtual Reality–Based Interventions on Preoperative Anxiety in Patients Undergoing Elective Surgery: Systematic Review and Meta-Analysis](https://pmc.ncbi.nlm.nih.gov/articles/PMC12079079/) Q: A realidade virtual reduz a ansiedade antes da cirurgia? A: Os ensaios aleatorizados indicam que sim. Meta-análises que reúnem centenas de doentes encontram ansiedade pré-operatória significativamente menor nos grupos com realidade virtual do que com o cuidado habitual, com efeito moderado. O benefício aparece tanto em adultos como em crianças a aguardar cirurgia. Q: Como é que a RV baixa a ansiedade pré-operatória? A: Sobretudo de duas formas. A distração imerge o doente num ambiente calmo que afasta a atenção da espera e do bloco operatório. A preparação, ou 'exposição', leva o doente a percorrer antecipadamente o que vai acontecer, tornando familiar o desconhecido. As revisões sugerem que a abordagem de distração tende a mostrar o efeito mais forte. Q: É útil especificamente para crianças? A: Sim: é uma das aplicações mais promissoras. A ansiedade antes da anestesia é comum e penosa nas crianças e está associada a uma recuperação mais difícil. Meta-análises focadas em doentes cirúrgicos pediátricos registam reduções significativas da ansiedade pré-operatória com realidade virtual. ### Medo do dentista: como a realidade virtual ajuda a vencer a ansiedade dental URL: https://rver.pt/blog/realidade-virtual-medo-do-dentista/ Date: 9 June 2026 A broca, o cheiro, a cadeira: para milhões de pessoas, a ida ao dentista é fonte de ansiedade real. A realidade virtual transporta a atenção para outro lugar, e muda a experiência. Poucos medos são tão comuns, e tão silenciosos, como o **medo do dentista**. Estima-se que uma parte significativa da população adie tratamentos dentários por ansiedade, por vezes durante anos, agravando problemas que seriam simples de resolver. A broca, o som, o cheiro, a sensação de não ter controlo: tudo contribui para uma experiência que muita gente prefere evitar. A realidade virtual oferece uma abordagem simples para este problema: **mudar o foco da atenção**. ## O mecanismo: distração imersiva A ansiedade alimenta-se de antecipação. Na cadeira do dentista, a atenção concentra-se em cada som e cada movimento, e essa vigilância amplifica o desconforto. A realidade virtual imersiva ocupa simultaneamente a visão e a audição, transportando a pessoa para um ambiente calmo e afastando-a mentalmente da sala de tratamento. Com menos "largura de banda" disponível para processar o medo e a dor, a consulta torna-se mais tolerável. É o mesmo mecanismo, a **analgesia e ansiólise por distração**, que torna a RV eficaz noutros procedimentos de saúde. ## O que diz a evidência A ansiedade dental é uma das áreas onde a distração por RV tem sido testada com resultados encorajadores: - Estudos em **medicina dentária pediátrica** mostram redução da ansiedade e do comportamento de medo durante tratamentos com recurso a distração por realidade virtual. - Em **adultos com ansiedade dental**, ensaios indicam menor perceção de dor e desconforto quando a consulta decorre com distração imersiva. - O efeito é particularmente relevante porque a ansiedade dental é **autoperpetuante**: o medo leva ao adiamento, o adiamento agrava os problemas, e os problemas confirmam o medo. Quebrar este ciclo tem valor a longo prazo. > Tornar a primeira consulta tolerável pode ser a diferença entre alguém que volta a cuidar dos dentes e alguém que desaparece durante anos. ## Porque importa, para além da consulta - **Menos tratamentos adiados**: reduzir o medo significa pessoas a procurar cuidados mais cedo, quando os problemas ainda são pequenos. - **Consultas mais fáceis**: um paciente calmo facilita o trabalho do profissional e reduz a necessidade de interrupções. - **Alternativa não farmacológica**: útil quando se quer evitar ou reduzir o recurso a sedação. :::note **Nota importante:** a realidade virtual é uma abordagem **complementar** e não farmacológica. Não substitui a anestesia, a sedação, a avaliação ou as decisões dos profissionais de saúde, e é sempre utilizada sob a sua supervisão e integrada no plano de cuidados. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de iniciar pela equipa, confortável para o paciente e sem recolha de dados clínicos do paciente: exatamente o que um consultório precisa para tornar uma consulta difícil mais tranquila. Quando o medo é a barreira, baixá-lo é o tratamento que torna todos os outros possíveis. ## Referências Estudos independentes sobre realidade virtual e ansiedade dental (investigação geral, não específica de qualquer produto): - [Nezhad et al. (2024). Realidade virtual na ansiedade e na dor em medicina dentária: revisão sistemática e meta-análise (*Community Dental Health*)](https://doi.org/10.1922/CDH_00160Nezhad08) - [Zaidman et al. (2023). Headset de RV como distração no tratamento dentário pediátrico: ensaio controlado aleatorizado (*International Dental Journal*)](https://doi.org/10.1016/j.identj.2022.06.003) Q: A realidade virtual ajuda mesmo com o medo do dentista? A: Sim. Vários estudos mostram que a distração por realidade virtual durante consultas dentárias reduz a ansiedade e a perceção de dor, tanto em crianças como em adultos. Ao ocupar a visão e a audição num ambiente calmo, sobra menos atenção para o medo e para o desconforto. Q: Como funciona a realidade virtual na cadeira do dentista? A: O paciente coloca um headset imersivo e é transportado para um ambiente relaxante (uma praia, uma floresta, uma paisagem calma) enquanto o profissional realiza o tratamento. A distração imersiva reduz a ansiedade antecipatória e a atenção dada aos estímulos da consulta. Q: Serve para crianças com medo do dentista? A: Sim, e é uma das aplicações mais estudadas. Em crianças, a distração por RV pode tornar a consulta mais calma e reduzir o medo que, de outra forma, se prolongaria para a vida adulta. É sempre usada sob supervisão da equipa clínica. ### Realidade virtual na quimioterapia: distração e conforto durante o tratamento oncológico URL: https://rver.pt/blog/realidade-virtual-quimioterapia-oncologia/ Date: 9 June 2026 A quimioterapia trata o corpo, mas desgasta a mente: a espera, a ansiedade, as náuseas. A realidade virtual transporta o doente para outro lugar durante a sessão. A **quimioterapia** trata o corpo, mas tem um custo que vai além do físico. As sessões são longas (por vezes várias horas ligado a um soro), atravessadas por ansiedade, antecipação e sintomas como náuseas e fadiga. Para muitos doentes, o desgaste psicológico da espera é uma parte real da experiência. A realidade virtual oferece algo simples mas valioso nesse contexto: **uma forma de sair mentalmente da sala de tratamento** sem sair da cadeira. ## O mecanismo: ocupar a atenção, aliviar a espera Durante uma infusão prolongada, a atenção tende a fixar-se na sala, no soro e em cada sensação corporal, e essa concentração amplifica a ansiedade e o desconforto. A realidade virtual imersiva ocupa a visão e a audição, transportando o doente para um ambiente calmo ou para uma experiência envolvente. Com a atenção noutro lugar, há menos espaço mental para a ansiedade antecipatória e para a vigilância dos sintomas. O tempo de tratamento passa de forma diferente: menos como uma espera, mais como uma pausa. ## O que diz a evidência A oncologia é uma das áreas onde a distração por RV tem ganho atenção crescente, com resultados encorajadores (ver o tema [ansiedade](/estudos/tema/ansiedade/) da biblioteca): - Ensaios com doentes em **quimioterapia** mostram redução da ansiedade e melhoria do estado de espírito durante as sessões com recurso a realidade virtual. - Vários estudos apontam para **menor perceção de náuseas e fadiga** quando a sessão decorre com distração imersiva. - A RV é particularmente adequada porque a experiência da quimioterapia combina **tempo de espera longo** com **carga emocional alta**: exatamente o terreno onde a distração imersiva é mais útil. > Não muda o tratamento, mas pode mudar a forma como o doente o vive, e, ao longo de muitos ciclos, isso conta. ## Porque importa, para além da sessão - **Melhor experiência ao longo de muitos ciclos**: quem faz quimioterapia repete sessões durante semanas ou meses; tornar cada uma mais tolerável tem efeito cumulativo. - **Menos ansiedade antecipatória**: uma experiência menos pesada pode reduzir o receio das sessões seguintes. - **Abordagem não farmacológica**: útil como complemento, sem adicionar medicação. :::note **Nota importante:** a realidade virtual é uma abordagem **complementar** e não farmacológica. Não substitui a quimioterapia, a medicação antiemética, a avaliação ou as decisões dos profissionais de saúde, e é sempre utilizada sob a sua supervisão e integrada no plano de cuidados. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de iniciar pela equipa, confortável para o doente e sem recolha de dados clínicos do paciente: adequado a uma sala de tratamento, num [hospital ou hospital de dia](/solucoes/hospital/), onde o tempo e o conforto contam. Quando o tratamento é longo e difícil, dar ao doente um lugar melhor para onde olhar tem valor próprio. ## Referências Estudos independentes sobre realidade virtual em oncologia e quimioterapia (investigação geral, não específica de qualquer produto): - [Czech et al. (2024). Terapia imersiva em RV no bem-estar psicológico e físico de mulheres com cancro da mama: ensaio controlado aleatorizado (*Current Oncology*)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11505915/) - [Erdős e Horváth (2023). RV e variáveis psicológicas e fisiológicas em crianças durante a quimioterapia: estudo-piloto cruzado (*Integrative Cancer Therapies*)](https://doi.org/10.1177/15347354231168984) Q: A realidade virtual ajuda durante a quimioterapia? A: Os estudos em oncologia apontam nesse sentido: ensaios com distração por realidade virtual durante a quimioterapia registaram menos ansiedade e melhor estado de espírito durante as sessões, e alguns referem menor perceção de náuseas e fadiga. São estudos de investigadores independentes, não do RVer, e a realidade virtual não substitui o tratamento. Q: Como é usada a realidade virtual nas sessões de quimioterapia? A: Durante a infusão, que pode durar horas, o doente coloca um headset imersivo e é transportado para um ambiente relaxante ou para uma experiência envolvente. A distração afasta a atenção da sala, do soro e dos sintomas, tornando a espera menos pesada. Q: É seguro para doentes oncológicos? A: A realidade virtual é uma abordagem não invasiva e complementar, usada sob supervisão da equipa de saúde e integrada no plano de cuidados. Não substitui qualquer tratamento médico. As sessões são adaptadas à condição e ao conforto de cada doente. ### Realidade Virtual na gestão da dor: como funciona a distração imersiva URL: https://rver.pt/blog/realidade-virtual-gestao-da-dor/ Date: 4 June 2026 A dor é uma experiência tanto física como atencional. Quando a mente está totalmente envolvida noutro lugar, sobra menos capacidade para processar o sinal doloroso: é aqui que a realidade virtual para uso clínico entra. A gestão da dor em ambiente hospitalar depende, há muito, de abordagens farmacológicas. São eficazes, mas trazem limitações conhecidas: efeitos secundários, risco de tolerância e situações em que a medicação adicional não é desejável. Por isso cresce o interesse em **alternativas não farmacológicas** que possam complementar o plano clínico, e a realidade virtual (RV) é uma das mais promissoras. ## O mecanismo: atenção é um recurso limitado A perceção da dor não é um processo puramente mecânico. O cérebro tem de *atender* ao sinal de dor para que este se traduza em sofrimento consciente. A atenção, porém, é finita. A realidade virtual imersiva ocupa simultaneamente vários sentidos: visão, audição e, frequentemente, a sensação de presença num espaço diferente. Ao envolver o doente num ambiente cativante, reduz a capacidade atencional disponível para processar o estímulo doloroso. É o que a [literatura](/estudos/tema/dor/) descreve como **analgesia por distração**. > Quanto mais imersiva a experiência, maior tende a ser o efeito de distração, porque o cérebro tem menos "largura de banda" livre para a dor. ## Porque é que a RV é diferente de outras distrações Ver televisão ou ouvir música também distraem, mas de forma passiva e parcial. A RV distingue-se por três fatores: - **Imersão multissensorial**: o campo de visão é totalmente substituído, eliminando os estímulos da sala clínica. - **Interatividade**: o doente pode olhar à volta e, por vezes, interagir, o que aprofunda o envolvimento. - **Sensação de presença**: a perceção de "estar noutro lugar" mobiliza recursos cognitivos de forma mais completa. ## Contextos clínicos relevantes A RV para uso clínico tem aplicação em vários momentos do percurso do doente: - Procedimentos dolorosos de curta duração (pensos, punções, pequenas intervenções), em [hospitais e clínicas](/solucoes/hospital/). - Reabilitação, onde a imersão pode tornar exercícios repetitivos mais toleráveis. - [Cuidados paliativos](/solucoes/cuidados-paliativos/) e gestão do desconforto e da ansiedade associada. - Períodos de espera, em que o conforto do doente influencia a experiência global. :::note **Nota importante:** a RV para uso clínico é uma abordagem **complementar**. Não substitui a avaliação, o diagnóstico ou a prescrição de profissionais de saúde, e é sempre utilizada sob a sua supervisão e integrada no plano clínico definido. ::: Em cuidados paliativos, a dor física é só uma das quatro componentes da [dor total](/blog/dia-mundial-cuidados-paliativos-2026-a-dor-total/). ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de usar pelas equipas clínicas e confortável para o doente, sem recolha de dados clínicos do paciente. O objetivo não é prometer milagres, mas oferecer uma ferramenta registada como dispositivo médico que ajude a tornar a experiência de cuidados mais humana, calma e tolerável. Q: Como é que a realidade virtual ajuda a gerir a dor? A: A realidade virtual capta a atenção do doente num ambiente imersivo, reduzindo a atenção disponível para processar o estímulo doloroso. Este efeito de distração analgésica pode ajudar a diminuir o desconforto percebido durante procedimentos ou estados de dor. Q: A RV substitui a medicação para a dor? A: Não. A RV para uso clínico é uma abordagem complementar e não farmacológica. É usada em conjunto com o plano clínico definido pelos profissionais de saúde, nunca como substituto da avaliação ou prescrição médica. Q: Em que contextos clínicos pode ser usada? A: É aplicável em contextos como procedimentos dolorosos de curta duração, reabilitação, cuidados paliativos e gestão do desconforto durante a espera, sempre sob supervisão de profissionais de saúde. ### Medo de agulhas e dor em procedimentos: a aplicação mais provada da realidade virtual URL: https://rver.pt/blog/realidade-virtual-medo-de-agulhas-procedimentos/ Date: 4 June 2026 Picas, pensos, queimaduras: momentos curtos mas intensos, sobretudo para quem tem medo de agulhas. É aqui que a realidade virtual mostra alguns dos seus resultados mais sólidos. De todas as aplicações da realidade virtual em saúde, há uma que reúne evidência particularmente forte: a **distração durante procedimentos dolorosos**. Picas, colocação de cateteres, mudança de pensos, cuidados a queimaduras: momentos curtos mas intensos, frequentemente agravados pelo **medo de agulhas**. É exatamente o terreno onde a realidade virtual mostra alguns dos seus melhores resultados. ## O mecanismo: atenção é um recurso limitado A dor precisa de atenção para se tornar sofrimento consciente. E a atenção é finita. A realidade virtual imersiva ocupa simultaneamente a visão e a audição, transportando a pessoa para um ambiente cativante e afastando-a por completo da sala de procedimentos. Com menos "largura de banda" disponível, sobra menos atenção para a dor e para o medo. É a chamada **analgesia por distração**. No caso específico do medo de agulhas, a distração atua em dois momentos: durante a picada *e* na ansiedade antecipatória, que muitas vezes é a parte mais difícil. ## O que dizem os ensaios clínicos Esta é uma das áreas mais estudadas da RV em saúde, com evidência consistente: - Uma **meta-análise** que reuniu 21 ensaios concluiu que o grupo com realidade virtual teve uma redução significativa na intensidade da pior dor, no desconforto e no tempo passado a pensar na dor, com aumento da componente de "diversão" da experiência. - Ensaios controlados e aleatorizados em **crianças com queimaduras**, dos procedimentos mais dolorosos que existem, mostraram reduções da dor durante os cuidados com recurso a distração por RV. - A distração imersiva é particularmente valiosa porque a dor procedimental é frequentemente **intensa e subtratada**, e os analgésicos nem sempre são suficientes ou desejáveis. > Poucas aplicações da realidade virtual em saúde têm uma base de evidência tão consistente como a distração durante procedimentos dolorosos. ## Porque importa, para além da dor - **Menos trauma associado**: experiências dolorosas repetidas, sobretudo em crianças, podem criar medo duradouro de cuidados de saúde. Tornar o momento mais tolerável tem valor a longo prazo. - **Procedimentos mais fáceis**: uma pessoa mais calma e quieta facilita o trabalho da equipa. - **Alternativa não farmacológica**: útil quando se quer reduzir o recurso a medicação adicional. :::note **Nota importante:** a realidade virtual é uma abordagem **complementar** e não farmacológica. Não substitui a analgesia, a avaliação ou as decisões dos profissionais de saúde, e é sempre utilizada sob a sua supervisão e integrada no plano de cuidados. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado precisamente para este tipo de momento: simples de iniciar pela equipa, confortável para o doente e sem recolha de dados clínicos do paciente. Quando a evidência é forte e o uso é simples, o valor é direto: tornar um momento difícil (uma pica, um penso) mais tolerável para quem o vive. ## Referências Estudos independentes sobre realidade virtual e dor em procedimentos (investigação geral, não específica de qualquer produto): - [Eficácia da RV na dor de crianças com queimaduras: revisão sistemática e meta-análise (*Frontiers*, 2025)](https://www.frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2025.1651695/full) - [RV na modulação da dor em crianças com queimaduras agudas: ensaio aleatorizado](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC554986/) Sobre porque é que ocupar o campo de visão não é o mesmo que ver um ecrã ao lado, ver [realidade virtual ou um tablet?](/blog/realidade-virtual-ou-tablet-qual-a-diferenca/). Q: A realidade virtual ajuda mesmo com o medo de agulhas e a dor das picas? A: Sim: é uma das aplicações da RV em saúde com evidência mais forte. Vários ensaios clínicos e meta-análises mostram que a distração imersiva durante procedimentos reduz significativamente a intensidade da dor, o desconforto e o tempo a pensar na dor, especialmente em crianças. O efeito é robusto e bem documentado. Q: Como é que a realidade virtual reduz a dor de um procedimento? A: Por distração imersiva. A atenção é um recurso limitado: ao envolver totalmente a visão e a audição num ambiente cativante, sobra menos capacidade para processar o sinal de dor e o medo. É o mecanismo conhecido como analgesia por distração. Q: Serve para adultos ou só para crianças? A: A evidência mais forte está em crianças, mas o mecanismo aplica-se a qualquer idade. Em adultos com medo de agulhas ou ansiedade perante procedimentos, a distração imersiva pode igualmente ajudar a tornar o momento mais tolerável. ### Realidade virtual na pediatria: tornar os procedimentos menos assustadores URL: https://rver.pt/blog/realidade-virtual-pediatria-criancas/ Date: 4 June 2026 Para uma criança, o hospital é um lugar estranho e muitas vezes assustador. A realidade virtual para uso clínico fala a linguagem que as crianças melhor compreendem: a do brincar e da imaginação. Uma criança não processa um internamento como um adulto. Não consegue racionalizar a necessidade de um procedimento nem relativizar o desconforto. O que sente é mais direto: medo do desconhecido, ansiedade perante o que aí vem. Acompanhar uma criança em contexto hospitalar exige ferramentas que falem a sua linguagem, e a realidade virtual para uso clínico fala-a particularmente bem. ## Porque a RV funciona tão bem com crianças A realidade virtual combina dois elementos a que as crianças respondem naturalmente: **imersão** e **brincadeira**. Em vez de pedir a uma criança que "fique quieta e não pense no que vai acontecer", oferece-lhe um lugar para onde ir com a imaginação. - **A imersão é total**: o campo de visão é substituído, afastando os estímulos clínicos que assustam. - **O envolvimento é ativo**: olhar à volta, explorar e reagir mantém a criança ocupada de forma genuína. - **A linguagem é familiar**: o registo do jogo e da fantasia é aquele em que a criança já vive. > Para uma criança, não estar a "ser tratada" mas a "estar noutro lugar" muda completamente a forma como o momento é vivido. ## O mecanismo: distração que reduz o medo Tal como na gestão da dor, a atenção é um recurso limitado. Quando a criança está totalmente envolvida num ambiente imersivo, sobra menos atenção para o medo e para o desconforto do procedimento. Esta distração não engana a criança, apenas lhe dá um lugar melhor onde focar a atenção enquanto a equipa faz o seu trabalho. ## Contextos pediátricos relevantes - Procedimentos de curta duração, como punções, pensos ou pequenas intervenções. - Períodos de espera, frequentemente carregados de ansiedade antecipatória. - Momentos de desconforto durante o internamento, em que distrair ajuda a acalmar. :::note **Nota importante:** a realidade virtual para uso clínico em pediatria é uma abordagem **complementar**, usada com conteúdos e tempos adequados à idade e sempre sob supervisão de profissionais de saúde. Não substitui o acompanhamento dos pais, a avaliação clínica nem a presença da equipa. ::: ## O que dizem os estudos A distração por realidade virtual em procedimentos pediátricos é das áreas mais estudadas da realidade virtual em saúde. Alguns exemplos da nossa [biblioteca de estudos](/estudos/tema/criancas-e-jovens/): - **Três meta-análises** ([Eijlers et al., 2019](/estudos/eijlers-2019-systematic-review-meta-analysis-virtual-reality-a75363/); [Nordgård e Låg, 2021](/estudos/nordgard-2021-effects-virtual-reality-procedural-pain-anxiety-329973/); [Tas et al., 2022](/estudos/tas-2022-virtual-reality-pediatrics-effects-pain-anxiety-290064/)) reúnem dezenas de estudos em crianças e jovens e reportam menos dor e menos ansiedade durante procedimentos com realidade virtual. Nordgård e Låg observaram efeitos maiores com realidade virtual não interativa, como o vídeo imersivo. - **Picadas e cateteres:** dois ensaios aleatorizados em hospitais australianos ([Chan et al., 2019](/estudos/chan-2019-virtual-reality-pediatric-needle-procedural-pain-2e603b/)) e dois ensaios com jovens dos 10 aos 21 anos, em colheitas de sangue ([Gold e Mahrer, 2018](/estudos/gold-2018-virtual-reality-ready-prime-time-medical-107e51/)) e na colocação de cateteres ([Gold et al., 2021](/estudos/gold-2021-effect-immersive-virtual-reality-intervention-pain-902b4d/)). - **Antes da cirurgia:** uma visita virtual ao bloco operatório antes da anestesia ([Ryu et al., 2017](/estudos/ryu-2017-randomized-clinical-trial-immersive-virtual-reality-e9871d/)). São estudos sobre realidade virtual em geral, com equipamentos e conteúdos próprios de cada equipa de investigação. Não são estudos do RVer, e os resultados são dos autores. ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de usar pelas equipas clínicas e confortável para o doente, incluindo os mais novos, sem recolha de dados clínicos do paciente. Em pediatria, o objetivo é tornar momentos difíceis um pouco mais leves: dar à criança um lugar para onde ir enquanto recebe os cuidados de que precisa. O RVer usa-se a partir dos 10 anos. Sobre as restantes precauções, ver [a realidade virtual faz mal?](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Q: A realidade virtual é segura para crianças em contexto hospitalar? A: Quando utilizada sob supervisão de profissionais de saúde, com conteúdos e tempos adequados à idade, a realidade virtual para uso clínico é uma abordagem não invasiva e não farmacológica. É sempre integrada no plano clínico e usada apenas quando apropriado para cada criança. Q: Em que situações pediátricas pode ajudar? A: Pode ajudar a reduzir o medo e a ansiedade associados a procedimentos de curta duração (como punções ou pensos), períodos de espera e momentos de desconforto, captando a atenção da criança num ambiente imersivo e envolvente. Q: A realidade virtual substitui a presença dos pais ou da equipa? A: Não. É uma ferramenta complementar. O acompanhamento dos pais e da equipa clínica continua a ser essencial; a realidade virtual apenas acrescenta uma forma de distração e conforto durante momentos difíceis. ### Cuidados paliativos: conforto e dignidade com Realidade Virtual URL: https://rver.pt/blog/cuidados-paliativos-conforto-realidade-virtual/ Date: 4 June 2026 Em cuidados paliativos, o objetivo muda: não se trata de curar, mas de cuidar: de garantir conforto, dignidade e qualidade de vida. A realidade virtual oferece algo precioso nesse contexto: a possibilidade de estar, por instantes, noutro lugar. Os cuidados paliativos têm um objetivo diferente do resto da medicina. Não procuram curar, procuram **cuidar**: aliviar o sofrimento, preservar a dignidade e melhorar a qualidade dos dias que restam. Nesse contexto, cada momento de conforto conta. A realidade virtual para uso clínico encontra aqui um dos seus papéis mais humanos, e um dos que a investigação já estuda: a biblioteca reúne esses estudos no tema [cuidados paliativos](/estudos/tema/paliativos/). ## Evasão: estar noutro lugar Um doente em cuidados paliativos passa muito tempo no mesmo espaço, frequentemente com dor, cansaço ou ansiedade. A realidade virtual oferece **evasão**: a possibilidade de, durante alguns minutos, estar numa praia, num jardim, na sua terra natal ou num lugar que sempre quis visitar. Não é fuga à realidade. É um descanso dela. E esse descanso tem valor: pode desviar o foco do desconforto e abrir espaço para a calma. > Quando o corpo já não pode viajar, a mente ainda pode. A RV devolve essa possibilidade. ## Conforto e bem-estar emocional Para além da evasão, a RV pode apoiar: - **Relaxamento**: cenários calmos e ritmo suave ajudam a baixar a ansiedade. - **Distração do desconforto**: a imersão desvia a atenção da dor e do mal-estar. - **Momentos significativos**: revisitar lugares com valor pessoal e emocional. - **Sentido de controlo**: escolher para onde ir, num momento da vida em que tanto escapa ao controlo. ## A família, mais perto Um dos aspetos mais difíceis do fim de vida é a distância da família. O **RVer** inclui **[videochamada com a família em tempo real](/blog/videochamadas-familia-realidade-virtual/)**: o doente vê e ouve os seus enquanto partilham o mesmo cenário imersivo, mesmo que estejam longe. É uma forma de manter ligação e presença quando a proximidade física nem sempre é possível. :::note **Nota importante:** a RV para uso clínico em cuidados paliativos é um apoio **complementar e não farmacológico** ao conforto e ao bem-estar. É usada com sessões curtas, cenários adequados e sempre sob supervisão da equipa de saúde, adaptada à condição e à vontade do doente. Não substitui os cuidados clínicos. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual para uso clínico, **Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED** (MDR 2017/745). Foi desenhado para ser simples, confortável e respeitador: fácil de usar pelas [equipas de cuidados paliativos](/solucoes/cuidados-paliativos/) e **sem recolha de dados clínicos do paciente**. Num momento em que o tempo é precioso, o objetivo do RVer é simples: ajudar a tornar cada dia um pouco mais confortável, mais calmo e mais ligado a quem importa. Q: Como é que a realidade virtual ajuda em cuidados paliativos? A: A RV oferece evasão e momentos de bem-estar: permite ao doente visitar lugares significativos, relaxar em ambientes calmos e distrair-se do desconforto. É usada como apoio não farmacológico ao conforto, sob supervisão da equipa de cuidados paliativos. Q: A RV é apropriada para doentes em fim de vida? A: Quando usada com sessões curtas, cenários calmos e sob supervisão da equipa de saúde, a RV pode trazer momentos de conforto e ligação. O uso é sempre adaptado à condição e à vontade do doente. Q: A família pode participar? A: Sim. O RVer inclui videochamada com a família em tempo real, permitindo momentos de proximidade mesmo à distância: o doente vê e ouve a família enquanto partilham a mesma experiência imersiva. ### Dispositivo Médico Classe I: o que significa para a RV em saúde URL: https://rver.pt/blog/dispositivo-medico-classe-1-realidade-virtual/ Date: 4 June 2026 Há uma diferença enorme entre uma aplicação de bem-estar e um dispositivo médico registado. Para um hospital, essa diferença é tudo. Eis o que o registo Classe I representa, e porque deve pesar na decisão. Existem hoje muitas aplicações de realidade virtual que prometem relaxamento ou distração. Mas usar tecnologia num ambiente clínico levanta uma questão diferente: **esta solução cumpre os requisitos de um dispositivo médico?** A resposta separa um produto de consumo de uma ferramenta apta a integrar o cuidado de saúde. ## O que é a Classe I no MDR 2017/745 O **MDR 2017/745** é o Regulamento de Dispositivos Médicos da União Europeia. Classifica os dispositivos por nível de risco, da Classe I (mais baixo) à Classe III (mais alto). A Classe I cobre dispositivos com risco reduzido para o utilizador, mas **"risco reduzido" não significa "sem requisitos"**. Mesmo na Classe I, o fabricante tem de: - Manter **documentação técnica** completa do dispositivo. - Implementar um sistema de **gestão de risco**. - Garantir **vigilância pós-comercialização** e rastreabilidade. - **Registar** o dispositivo junto da autoridade competente. [Image: As três bandas do regime de software em dispositivos médicos, e onde está o produto base da RVer. RVer Motion, RVer Neuro e RVer Exposure são módulos em desenvolvimento, não abrangidos pelo registo. Fonte: MDCG 2019-11 e Regra 11 do Anexo VIII do MDR.] ## O papel do Infarmed Em Portugal, o **Infarmed** é a autoridade nacional para os dispositivos médicos. O registo junto do Infarmed significa que o dispositivo e o fabricante estão identificados perante a autoridade portuguesa, dentro do enquadramento europeu. Não é uma aprovação nem uma certificação. > O registo não é um selo decorativo. É a prova de que existe responsabilidade, processo e rastreabilidade por trás do produto. ## A EUDAMED A EUDAMED é a base de dados europeia de dispositivos médicos, prevista no MDR 2017/745. O registo na EUDAMED não é uma aprovação: torna a identificação do dispositivo e do fabricante consultável em toda a União Europeia. Desde outubro de 2026, o produto base do RVer está registado na EUDAMED, com o Basic UDI-DI 56006195127RVERTZ. ## Porque é que isto importa para um hospital Ao escolher tecnologia para um serviço de saúde, a [equipa de aquisição](/aquisicao/) e os profissionais clínicos precisam de garantias que uma app de loja não oferece: - **Segurança:** o dispositivo foi avaliado quanto aos riscos para o doente. - **Responsabilidade:** há um fabricante identificado e responsável pela conformidade. - **Rastreabilidade:** existe processo para reportar e resolver incidentes. - **Confiança institucional:** facilita a integração em contextos regulados. ## O RVer e a conformidade desde o desenho O **RVer** é um sistema de realidade virtual para uso clínico registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi construído para o contexto de saúde desde o início, incluindo uma decisão importante de privacidade: **não recolhe dados clínicos do paciente**. No caso da RVer, o [registo abrange o produto base](/ciencia/): a biblioteca de vídeo. Os módulos [RVer Motion, RVer Neuro e RVer Exposure](/modulos/) estão em desenvolvimento e não estão abrangidos por esse registo, e o produto base ostenta marcação CE ao abrigo do MDR 2017/745. Para um hospital ou clínica, isto traduz-se numa ferramenta que pode ser adotada com a confiança de que cumpre o enquadramento regulamentar aplicável. Q: O que é um Dispositivo Médico Classe I? A: É a classe de risco mais baixa de dispositivos médicos no regulamento europeu MDR 2017/745. Abrange dispositivos com baixo risco para o utilizador, mas que, ainda assim, têm de cumprir requisitos de segurança, qualidade e conformidade e ser registados junto da autoridade competente. Q: O que significa o registo no Infarmed? A: Significa que o dispositivo e o fabricante estão registados junto da autoridade portuguesa e que o fabricante cumpre os requisitos do MDR: mantém documentação técnica, gestão de risco e vigilância pós-comercialização, e que o dispositivo está registado para uso em Portugal. O registo aplica-se ao dispositivo tal como registado: no caso da RVer, ao produto base. Q: Porque é que isto importa ao escolher tecnologia de RV para saúde? A: O registo como dispositivo médico identifica o fabricante e o dispositivo e obriga a cumprir requisitos de segurança, rastreabilidade e responsabilidade que uma aplicação de consumo não tem, o que é essencial em contexto clínico. ### Realidade virtual para gerir o stress: o que mostra a investigação URL: https://rver.pt/blog/reduzir-stress-com-realidade-virtual/ Date: 4 June 2026 O stress é universal, e procurar formas de o aliviar também. Entre as abordagens estudadas, a realidade virtual de relaxamento reúne já evidência consistente, incluindo efeitos fisiológicos mensuráveis. O stress é uma das experiências mais universais, e "como reduzir o stress" é uma das pesquisas de saúde mais frequentes. Entre as abordagens não farmacológicas estudadas, a **realidade virtual de relaxamento** destaca-se por já ter um corpo de evidência relativamente consistente. Vale a pena ver o que a investigação mostra. ## O mecanismo: imersão que acalma A lógica é direta. Ambientes imersivos calmos (tipicamente paisagens naturais) captam a atenção e afastam os estímulos do ambiente real. Combinados, por vezes, com respiração guiada ou *biofeedback*, ajudam a baixar a **ativação fisiológica** associada ao stress. O resultado procurado é um estado de relaxamento, induzido pela experiência. ## O que dizem as revisões sistemáticas Aqui a evidência é mais robusta do que em muitas outras aplicações de RV (a biblioteca reúne-a no tema [relaxamento, stress e ansiedade](/estudos/tema/ansiedade/)): - Uma **revisão sistemática** (2024) reuniu **50 estudos** e cerca de **2 885 participantes**, concluindo que a realidade virtual é "uma intervenção geralmente de baixo risco e viável" para quem lida com stress, com forte potencial e sem danos documentados. - Revisões anteriores, com dezenas de estudos e mais de mil participantes, descrevem a RV de relaxamento como **viável, aceitável e eficaz a curto prazo** para aumentar o relaxamento e reduzir o stress. - Vários estudos vão além do relato subjetivo e medem **marcadores fisiológicos**: frequência cardíaca, atividade eletrodérmica e **cortisol salivar** (a "hormona do stress"), registando reduções após sessões de relaxamento em RV. > Que a imersão de relaxamento reduz o stress no imediato é dos pontos mais sustentados, incluindo por marcadores fisiológicos objetivos, não apenas pela sensação relatada. ## Os limites que é honesto referir - A maior parte da evidência diz respeito a efeitos de **curto prazo**; sabe-se menos sobre o benefício sustentado ao longo do tempo. - Os resultados são **heterogéneos** entre estudos, com desenhos e populações variados. - A RV é uma ferramenta entre várias; não anula outras estratégias de gestão do stress. :::note **Nota importante:** a realidade virtual de relaxamento é uma abordagem **complementar** de bem-estar. Não substitui o acompanhamento de profissionais de saúde quando o stress é intenso, persistente ou associado a sofrimento clínico. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para promover relaxamento e conforto através da imersão: simples de usar pelas equipas e sem recolha de dados clínicos do paciente. Fora do contexto clínico, o mesmo relaxamento é o que se usa em [SPAs e espaços de bem-estar](/solucoes/spa/). Quando a evidência é sólida, o discurso pode ser direto: a realidade virtual de relaxamento é uma forma viável e de baixo risco de apoiar a redução do stress, sempre como complemento e nunca como substituto do cuidado adequado. ## Referências Estudos independentes sobre realidade virtual e stress (investigação geral, não específica de qualquer produto): - [Virtual Reality and Stress Management: A Systematic Review (2024)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323791/) - [Virtual reality relaxation for the general population: a systematic review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197783/) - [Physiological Responses to VR-Based Stress Regulation and Relaxation: A Systematic Review, *Stress and Health* (2026)](https://onlinelibrary.wiley.com/doi/10.1002/smi.70164) Q: A realidade virtual ajuda a reduzir o stress? A: A investigação aponta nesse sentido. Revisões sistemáticas com milhares de participantes descrevem a realidade virtual de relaxamento como uma abordagem viável e de baixo risco para reduzir o stress e aumentar o relaxamento, com efeitos de curto prazo demonstrados. Alguns estudos medem ainda reduções em marcadores fisiológicos como o cortisol. Q: Como é que a RV reduz o stress? A: Através da imersão em ambientes calmos (frequentemente paisagens naturais) por vezes combinada com respiração guiada ou biofeedback. A imersão capta a atenção e ajuda a baixar a ativação fisiológica associada ao stress, promovendo um estado de relaxamento. Q: É um efeito real ou apenas subjetivo? A: Ambos. Para além da sensação de relaxamento relatada pelos participantes, vários estudos documentam alterações em marcadores fisiológicos objetivos: frequência cardíaca, atividade eletrodérmica e cortisol salivar. Ainda assim, a evidência é sobretudo de curto prazo e os resultados variam entre estudos. ### Quanto custa e o que rende: o guia do ROI da realidade virtual em saúde URL: https://rver.pt/blog/custo-roi-realidade-virtual-instituicao-saude/ Date: 4 June 2026 O preço do serviço é a parte fácil da conta. Esta página é o ponto de partida: as três contas diferentes, o custo que ninguém soma, e o que não se consegue provar. *Atualizado a 16 de agosto de 2026.* Quando uma instituição avalia adotar realidade virtual para uso clínico, a primeira pergunta costuma ser «quanto custa?». É a pergunta errada para começar, ou, pelo menos, é meia pergunta. O preço do serviço é a parte mais fácil e mais visível da conta. Esta página é o ponto de partida do tema: **o que entra no custo, onde está o retorno em cada contexto, e o que não se consegue provar**. Cada secção aponta para o artigo que a desenvolve. O custo anual comparado com o nível de evidência publicada está em [Custo anual vs evidência](/custo-e-evidencia/). ## Primeiro: não há uma conta, há três O erro mais comum é aplicar a aritmética de um hospital a uma casa que não é um hospital. As alavancas são diferentes, e algumas simplesmente não existem: | Contexto | O que domina a conta | Onde aprofundar | |---|---|---| | Hospital e clínica | tempo de procedimento, sedação, faltas e cancelamentos | [onde está a poupança](/blog/poupanca-custos-realidade-virtual-hospitais-clinicas/) | | Lar residencial | ocupação, tempo de equipa por atividade | [quanto rende num lar](/blog/roi-realidade-virtual-lar-de-idosos/) | | Qualquer um | o que a evidência económica sustenta | [o ROI que não se consegue provar](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/) | Num lar não há bloco operatório nem sedação para evitar. Num hospital, a taxa de ocupação de camas não se resolve com uma atividade. Começar pela conta certa poupa meia reunião. [Image: A divisão de responsabilidades entre a RVer e a instituição, do equipamento à decisão clínica.] ## O custo total, linha a linha O preço do serviço, com os equipamentos incluídos, é a linha que toda a gente vê. As outras quatro são as que decidem se o serviço se paga: - **Tempo de equipa.** É a maior de todas e a mais esquecida. Uma sessão são cerca de cinco minutos para escolher e colocar o equipamento, mais o tempo de sessão. Multiplicado pelo custo-hora real da vossa equipa, é o custo recorrente que conta. - **Higiene entre utilizações.** Rotina curta, mas existe e consome minutos. Está descrita em [higiene e segurança do equipamento](/blog/higiene-seguranca-equipamento-realidade-virtual/). - **Formação inicial.** Quanto tempo até a equipa estar operacional sem supervisão. Se for muito, o equipamento fica na arrecadação. - **Espaço e logística.** Onde fica, quem o prepara, como circula entre pisos ou serviços. Quanto maior o atrito em cada um destes pontos, maior o custo real, independentemente do preço na fatura. ## O retorno mede-se no uso, não no contrato Um serviço contratado e pouco usado tem retorno zero, por muito boa que seja a tecnologia. É por isso que a métrica que melhor prevê o valor de uma instalação é a mais simples: **sessões realizadas por semana**. Tudo o que aumenta o atrito (um cabo que falta, uma senha que ninguém sabe, uma rotina de higiene demasiado longa, depender da Wi-Fi do hospital) reduz o uso e, com ele, o retorno. Foi por isso que o conteúdo [fica no equipamento e não depende da rede](/blog/conteudo-no-equipamento-sem-internet-realidade-virtual/). ## O que não entra na conta Não conte com redução de medicação, menos quedas ou melhoria clínica. Não há ensaios que sustentem essas linhas para o nosso produto, e apresentá-las num caderno de encargos constrói um caso que não sobrevive à primeira pergunta difícil de quem avalia. A literatura económica sobre realidade virtual em saúde é escassa: dos **130 estudos** da nossa biblioteca pública (outubro de 2026), **oito** são de [custos e retorno](/estudos/tema/custos-e-roi/), e todos de contextos muito específicos. Porque é que os números deles não são os vossos está explicado em [«O ROI que não se consegue provar»](/blog/roi-realidade-virtual-o-que-nao-se-consegue-provar/). ## Como provar no primeiro serviço Um piloto de três meses responde melhor do que qualquer folheto, desde que se decida **antes** o que se vai contar. Quatro métricas chegam: sessões realizadas, quem participou que antes não participava, tempo real da equipa por sessão, e recusas ou interrupções. Nenhuma é clínica, de propósito. Um piloto responde a perguntas de implementação e não responde a eficácia. Como o desenhar está em [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/), e como escrever os requisitos sem pedir coisas que não existem está em [«O caderno de encargos»](/blog/caderno-de-encargos-realidade-virtual-saude/). ## E se o orçamento não chega este ano O RVer é um serviço anual: entra no orçamento de funcionamento e não exige investimento inicial. As vias (acordos de cooperação, mecenato, prémios de fundações, autarquias) estão em [Como financiar e contratar](/aquisicao/), e as opções ( orçamento corrente, apoios, alternativas ao investimento) estão em [como financiar](/blog/financiamento-comparticipacao-realidade-virtual-saude/). ## Em resumo | Se é… | Comece por | |---|---| | Hospital ou clínica | as quatro alavancas de poupança | | Lar residencial | a conta da ocupação | | Quem vai a concurso | o caderno de encargos | | Quem tem de justificar à direção | o piloto de três meses | :::note Nada nesta página é uma alegação de eficácia. O registo de dispositivo médico Classe I (INFARMED e EUDAMED) cobre o produto base e diz respeito a conformidade regulamentar, não a desempenho clínico. As decisões sobre o plano de cuidados são sempre da equipa clínica. ::: O RVer é um sistema de realidade virtual para uso clínico concebido para ambientes de saúde, cujo produto base está registado como Dispositivo Médico Classe I no INFARMED (CDM 94571546) e na EUDAMED (Basic UDI-DI 56006195127RVERTZ), e ostenta marcação CE ao abrigo do MDR 2017/745. Os módulos RVer Motion, RVer Neuro e RVer Exposure estão em desenvolvimento e não estão abrangidos por esse registo. Q: Como se avalia o retorno de um investimento em realidade virtual em saúde? A: Começando pelo contexto, porque as alavancas mudam: num hospital contam tempo de procedimento, sedação e faltas; num lar conta sobretudo a ocupação e o tempo de equipa por atividade. Em qualquer dos casos, a métrica que melhor prevê o valor é o número de sessões realizadas por semana: um equipamento pouco usado tem retorno zero. Q: O custo é apenas o preço do serviço? A: Não. Além do preço do serviço há quatro linhas recorrentes: tempo de equipa por sessão (a maior de todas), higiene entre utilizações, formação inicial, e espaço e logística. Quanto maior o atrito em cada uma, maior o custo real, independentemente do preço na fatura. Q: Posso contar com poupança em medicação ou menos quedas? A: Não. Não há ensaios que sustentem essas linhas para o nosso produto. Em outubro de 2026, dos 130 estudos da nossa biblioteca pública, oito são de custos e retorno, e todos de contextos muito específicos. Apresentar poupança clínica num caderno de encargos constrói um caso que não sobrevive à primeira pergunta difícil. Q: Como evitar que o equipamento se torne um custo sem retorno? A: Reduzindo o atrito de uso e medindo. O conteúdo fica no equipamento e não depende da rede, a rotina de higiene é curta, e um piloto de três meses com quatro métricas (sessões realizadas, quem passou a participar, tempo real da equipa e recusas) mostra em pouco tempo se entrou na rotina. Q: E se não houver orçamento este ano? A: O RVer é um serviço anual e não exige investimento inicial. As vias (orçamento corrente, acordos de cooperação, mecenato, prémios de fundações, autarquias) estão na página Como financiar e contratar. Vale a pena perceber as opções antes de assumir que o projeto fica para o ano seguinte. ### Realidade virtual na reabilitação após AVC: mais tempo de terapia URL: https://rver.pt/blog/realidade-virtual-reabilitacao-avc/ Date: 4 June 2026 Recuperar movimento após um AVC é um trabalho de repetição e tempo. A realidade virtual entra aqui com um papel claro: aumentar e enriquecer esse tempo de terapia, com evidência a apoiá-lo. A recuperação após um acidente vascular cerebral (AVC) depende, em grande medida, de uma coisa: **repetição**. Reaprender a mover um braço ou uma mão exige praticar movimentos vezes sem conta, ao longo de semanas e meses. O problema é que a repetição é cansativa e desmotivante, e é exatamente aqui que a realidade virtual encontra o seu papel mais sólido. ## O papel claro: aumentar e enriquecer o tempo de terapia A realidade virtual não veio substituir o fisioterapeuta. O seu contributo é mais específico e mais valioso do que isso: **tornar a prática mais envolvente** e permitir fazer mais. - **Mais repetições**: transformar o exercício num jogo ou tarefa imersiva ajuda o doente a fazer mais movimentos sem desistir. - **Feedback imediato**: o ambiente responde a cada movimento, orientando a execução. - **Motivação**: a imersão combate o tédio da repetição, um dos maiores obstáculos à reabilitação. ## O que diz a evidência A reabilitação após AVC é uma das aplicações da RV com base de evidência mais robusta: - A revisão **Cochrane** sobre realidade virtual na reabilitação do AVC, atualizada em 2025 com **190 ensaios** e **7188 participantes**, encontrou evidência de certeza moderada a baixa de um benefício **ligeiro** na função do membro superior, e um benefício **mais claro quando a RV é acrescentada** aos cuidados habituais para **aumentar o tempo total de terapia** do que quando os substitui. - Meta-análises mais recentes reforçam ganhos na função motora do membro superior, na independência funcional e na destreza, com melhores resultados em intervenções mais longas (acima de seis semanas) e iniciadas cedo após o AVC. > A mensagem da evidência é precisa: a realidade virtual não substitui a reabilitação: multiplica-a. O valor está em acrescentar tempo e qualidade à prática. ## Os limites que é honesto referir - O benefício é mais claro como **complemento**, não como terapia isolada. - A evidência é mais forte para o **membro superior**; para marcha e equilíbrio há resultados positivos noutras revisões, e para qualidade de vida é menos conclusiva. - O tipo de sistema e a duração influenciam muito os resultados. :::note **Nota importante:** a realidade virtual na reabilitação após AVC é uma abordagem **complementar**, integrada num plano de reabilitação definido e supervisionado por profissionais de saúde. Não substitui a fisioterapia nem a avaliação clínica. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi pensado para ser simples de usar pelas equipas e confortável para o doente, sem recolha de dados clínicos do paciente. A leitura das seis revisões mais recentes, incluindo a Cochrane de 2025, está em [AVC e realidade virtual: o que a evidência mostra](/blog/avc-realidade-virtual-o-que-diz-a-evidencia/). Na reabilitação após AVC, a evidência aponta um caminho honesto: usar a imersão para tornar o longo trabalho de recuperação mais envolvente e produtivo, sempre ao lado, e nunca em vez, da terapia convencional. O módulo de movimento guiado, [RVer Motion](/modulos/motion/), está em desenvolvimento e não está abrangido pelo registo Classe I. ## Referências Estudos independentes sobre realidade virtual e reabilitação após AVC (investigação geral, não específica de qualquer produto): - [Realidade virtual na reabilitação do AVC: revisão *Cochrane* (Laver et al., 2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12178777/) - [Treino com RV na função do membro superior após AVC: meta-análise, *JMIR* (2025)](https://www.jmir.org/2025/1/e66802) Q: A realidade virtual ajuda na recuperação depois de um AVC? A: Sim, sobretudo como complemento. A revisão Cochrane (atualizada em 2025, com 190 ensaios e 7188 participantes) concluiu que a realidade virtual pode ser benéfica para a função do membro superior e para as atividades da vida diária quando usada em acréscimo à terapia habitual, aumentando o tempo total de reabilitação. Meta-análises mais recentes reforçam o benefício na função motora. Q: A RV substitui a fisioterapia convencional? A: Não. A evidência mostra que a realidade virtual funciona melhor como complemento da terapia convencional, não como substituto. O seu valor está em acrescentar tempo de prática, motivação e repetição, sempre integrada no plano de reabilitação definido pelos profissionais. Q: Porque é que a realidade virtual ajuda na reabilitação? A: Torna os exercícios repetitivos mais motivadores e envolventes, oferece feedback imediato e permite aumentar o número de repetições: fatores associados a melhor recuperação. A imersão ajuda o doente a manter-se empenhado num processo que é, por natureza, longo e exigente. ### Estimulação cognitiva com realidade virtual em lares e na demência URL: https://rver.pt/blog/estimulacao-cognitiva-idosos-realidade-virtual/ Date: 4 June 2026 Para uma pessoa com demência, um campo florido ou uma rua familiar pode fazer mais do que entreter: pode evocar uma memória, trazer calma num momento de agitação e devolver, por instantes, uma sensação de lugar. O envelhecimento e as doenças neurodegenerativas trazem desafios que vão além do físico: perda de memória, desorientação, isolamento e agitação. A estimulação cognitiva é uma das abordagens não farmacológicas mais valorizadas para apoiar estes doentes, e a realidade virtual abre-lhe novas possibilidades. ## Estímulo rico, sem sair da sala Muitos utentes, sobretudo em lares ou unidades de saúde, têm mobilidade reduzida. O mundo deles encolhe para o espaço de um quarto. A realidade virtual oferece algo raro nesse contexto: **um estímulo rico e variado, sem riscos de deslocação**. Um passeio por um jardim, uma vista do mar, uma rua de uma cidade conhecida: ambientes imersivos ativam a atenção, a perceção espacial e a memória de uma forma que um ecrã plano não consegue. ## Reminiscência: memórias que voltam A **terapia de reminiscência** usa estímulos do passado para evocar memórias e promover a comunicação. A RV é uma ferramenta natural para isto: um cenário que recorde a terra natal, uma época ou um lugar significativo pode despertar recordações e abrir conversa. Como se faz, passo a passo, está em [voltar a um lugar familiar](/blog/reminiscencia-lugares-familiares-realidade-virtual/). > Para um doente com demência, reconhecer um lugar pode ser um momento de clareza e ligação, e esses momentos têm valor real. ## O que a RV pode apoiar Em contexto geriátrico, a RV para uso clínico pode contribuir para: - **Estimulação cognitiva**: atenção, memória e orientação. - **Momentos de agitação**: cenários calmos podem ajudar a gerir momentos de inquietação. - **Bem-estar e presença**: experiências significativas para quem tem mobilidade reduzida. - **Comunicação**: abrir conversa a partir do que o doente vê e reconhece. :::note **Nota importante:** o uso de RV com pessoas mais velhas e doentes com demência é feito com cenários calmos, sessões curtas e sempre sob avaliação e supervisão da equipa de saúde. É uma abordagem **complementar e não farmacológica**: não substitui o acompanhamento clínico nem o tratamento definido. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual para uso clínico, **Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED** (MDR 2017/745). Foi pensado para ser simples de usar pelas equipas de [lares](/solucoes/lar-residencial/) e unidades geriátricas, confortável para o utente e **sem recolha de dados clínicos do paciente**. A ideia não é substituir o cuidado humano, mas dar às equipas mais uma forma de trazer estímulo, calma e momentos significativos ao dia a dia de quem cuidam. Sobre os limites cognitivos e de segurança, por extenso, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Se está a comparar com uma sala multissensorial, ver [Snoezelen ou realidade virtual](/blog/sala-snoezelen-ou-realidade-virtual-lares/). Q: Como é que a realidade virtual estimula a cognição em idosos? A: A RV apresenta ambientes ricos e multissensoriais que estimulam a atenção, a memória e a orientação. Em terapia de reminiscência, cenários familiares podem evocar memórias e promover a comunicação. É usada como apoio não farmacológico, sob supervisão de profissionais. Q: É segura para doentes com demência? A: A RV para uso clínico é usada com cenários calmos e sessões curtas, sempre sob avaliação e supervisão da equipa de saúde, que adapta o uso a cada doente. Não substitui o acompanhamento clínico. Q: Que benefícios pode trazer em contexto de lar ou unidade geriátrica? A: Pode apoiar a estimulação cognitiva, ajudar a gerir momentos de agitação, promover o bem-estar e oferecer experiências significativas a quem tem mobilidade reduzida, sempre conforme a avaliação clínica. ### Realidade virtual na demência: reminiscência, calma e momentos de presença URL: https://rver.pt/blog/realidade-virtual-demencia-alzheimer/ Date: 4 June 2026 Na demência, o presente pode ser confuso e o passado distante mais nítido. A realidade virtual para uso clínico pode oferecer um lugar calmo onde estar, e, por vezes, uma ponte para memórias antigas. Cuidar de alguém com demência é, em grande parte, cuidar de momentos. Não há cura a oferecer, mas há qualidade de presença a proteger: ajudar a gerir a agitação, trazer calma, criar instantes de reconhecimento e de paz. É neste registo, o do momento e do bem-estar, que a realidade virtual para uso clínico pode ter um papel. ## Ambientes calmos como âncora A agitação na demência surge muitas vezes de um ambiente que confunde ou sobrecarrega: ruído, estímulos imprevisíveis, sensação de não saber onde se está. Um ambiente imersivo calmo faz o oposto: substitui o caos por um cenário simples, previsível e suave. - **Estímulos controlados**: em vez de uma sala agitada, uma paisagem tranquila e estável. - **Ritmo lento**: sem exigências nem surpresas, apenas um lugar onde estar. - **Foco suave**: algo agradável para onde olhar, que ajuda a acalmar. > O objetivo não é "fazer" nada. Por vezes, basta oferecer um lugar tranquilo onde a pessoa possa simplesmente estar. ## Reminiscência: o passado pode estar mais perto Na demência, memórias antigas resistem frequentemente mais do que as recentes. Ambientes ligados a tempos ou lugares familiares (uma praia, um campo, uma cena do quotidiano de outra época) podem despertar reconhecimento, conversa e emoção positiva. É o princípio da **terapia de reminiscência**, aqui apoiada pela imersão. Quando funciona, não é a "tecnologia" que importa para a pessoa: é o instante de ligação a algo conhecido. ## Cuidado e suavidade acima de tudo A demência exige prudência redobrada. A imersão tem de ser sempre suave, breve e atenta à reação da pessoa. - Sessões **curtas**, com conteúdos familiares e sem sobressaltos. - Atenção constante a sinais de desconforto, parando de imediato se surgirem. - Adequação individual: o que conforta uma pessoa pode não servir outra. :::note **Nota importante:** a realidade virtual para uso clínico na demência é uma abordagem **complementar**, sempre sob supervisão de profissionais de saúde e adaptada a cada pessoa. Não substitui a avaliação clínica, a medicação nem o acompanhamento humano, e deve ser interrompida perante qualquer sinal de desconforto. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de usar pelas equipas e confortável para a pessoa, sem recolha de dados clínicos do paciente. Na demência, o valor mede-se em momentos: um pouco mais de calma, um instante de reconhecimento, uma presença mais serena. É isso que esta ferramenta procura apoiar. Para aprofundar: a [terapia de reminiscência](/blog/reminiscencia-lugares-familiares-realidade-virtual/), passo a passo; a [estimulação cognitiva](/blog/estimulacao-cognitiva-idosos-realidade-virtual/) em lar; o que muda conforme os [tipos de demência](/blog/tipos-de-demencia-o-que-muda-numa-sessao/); e como o RVer se usa em [lares e ERPI](/solucoes/lar-residencial/). Quando a pessoa não pode consentir, o circuito é outro: [é preciso consentimento?](/blog/consentimento-informado-realidade-virtual-saude/). Sobre a inquietação que aparece ao fim da tarde, ver [o que a equipa pode mudar no ambiente](/blog/agitacao-fim-da-tarde-demencia-sundowning/). Q: Como pode a realidade virtual ajudar pessoas com demência? A: Através de ambientes imersivos calmos e familiares, a realidade virtual para uso clínico pode ajudar a gerir momentos de agitação e proporcionar momentos de tranquilidade. Cenários ligados a memórias antigas podem ainda estimular a reminiscência e o reconhecimento, sempre de forma suave e supervisionada. Q: A realidade virtual é adequada em fases avançadas de demência? A: A adequação depende sempre de cada pessoa e deve ser avaliada por profissionais de saúde. Em qualquer fase, as sessões devem ser curtas, com conteúdos suaves e familiares, e interrompidas se houver qualquer sinal de desconforto. Q: Isto substitui a medicação ou o acompanhamento na demência? A: Não. É uma abordagem complementar e não farmacológica, usada como parte do plano de cuidados definido pela equipa clínica, nunca em substituição da avaliação, da medicação ou do acompanhamento humano. ### Privacidade e RGPD na realidade virtual em saúde: porque é que não recolher dados é uma decisão de design URL: https://rver.pt/blog/privacidade-rgpd-realidade-virtual-saude/ Date: 4 June 2026 Em saúde, cada dado recolhido é uma responsabilidade. A abordagem mais robusta à privacidade começa por uma pergunta simples: este dado precisa mesmo de existir? Em saúde, a conversa sobre proteção de dados costuma centrar-se em como guardar a informação de forma segura: encriptação, controlos de acesso, registos de auditoria. Tudo isto é necessário. Mas há uma abordagem ainda mais robusta, e frequentemente esquecida: **não recolher o dado de todo**. É um princípio que o próprio RGPD consagra: a **minimização de dados**. E na realidade virtual para uso clínico, é possível aplicá-lo de forma quase total. ## O dado mais seguro é o que não existe Cada dado pessoal recolhido cria obrigações: justificar a base legal, garantir segurança, definir prazos de conservação, responder a pedidos de acesso ou eliminação, e gerir o risco de uma eventual violação. Os dados de saúde acrescentam ainda mais exigência, por serem uma **categoria especial** de dados ao abrigo do RGPD. Por isso, a pergunta certa no início de qualquer projeto não é "como vamos proteger este dado?", mas sim "**precisamos mesmo de o recolher?**". Sempre que a resposta é não, todo o risco a jusante desaparece. > Não há fuga possível de um dado que nunca foi recolhido. A minimização não é só conformidade: é a forma mais simples de gestão de risco. [Image: O que a aplicação Companion regista de cada sessão, e o que a RVer deliberadamente não faz com esse registo.] ## A função terapêutica não precisa de identificar o doente O valor de uma sessão de realidade virtual para uso clínico (distração, relaxamento, conforto) não depende de saber quem é o paciente nem de registar os seus dados de saúde. A experiência imersiva funciona da mesma forma sem essa recolha. A gestão operacional necessária (saber que equipamentos existem, em que estado estão, em que serviço se encontram) pode ser feita ao nível do **dispositivo e do serviço**, não do indivíduo. Separar a gestão da frota da identidade do paciente é o que permite manter a solução útil sem a tornar um repositório de dados clínicos. ## O que isto simplifica na prática - **Menor superfície de risco**: menos dados pessoais significa menos pontos de exposição numa eventual violação. - **Conformidade mais simples de demonstrar**: a minimização de dados é um princípio explícito do RGPD, não uma exceção. - **Confiança mais fácil de conquistar**: para o serviço e para o doente, "não recolhemos os seus dados clínicos" é uma garantia clara e verificável. :::note **Nota importante:** a conformidade com o RGPD é uma responsabilidade partilhada entre o fornecedor da solução e a instituição de saúde que a utiliza. A abordagem aqui descrita reduz o risco na origem, mas não dispensa as obrigações organizacionais de cada instituição quanto ao tratamento de dados. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para funcionar **sem recolha de dados clínicos do paciente**: uma escolha de design que coloca a privacidade no centro, em vez de a tratar como um acréscimo posterior. Em saúde, a tecnologia mais responsável é, muitas vezes, a que pede menos. Proteger os dados do doente começa por decidir, à partida, não os recolher. As perguntas que o departamento de informática costuma juntar a estas estão em [«As oito perguntas da informática»](/blog/informatica-hospital-perguntas-realidade-virtual/). Sobre a parte do consentimento propriamente dito, ver [é preciso consentimento?](/blog/consentimento-informado-realidade-virtual-saude/). Q: O RVer recolhe dados clínicos dos pacientes? A: Não. O RVer foi desenhado para funcionar sem recolher dados clínicos do paciente. Esta é uma decisão de design deliberada: ao não recolher dados clínicos pessoais, elimina-se na origem grande parte do risco associado ao seu tratamento e armazenamento. Q: Porque é que não recolher dados ajuda na conformidade com o RGPD? A: O RGPD aplica-se ao tratamento de dados pessoais. Quanto menos dados pessoais (e em particular dados de saúde, que são categoria especial) uma solução trata, menor é a superfície de risco e mais simples se torna demonstrar conformidade. A minimização de dados é, aliás, um princípio central do próprio RGPD. Q: Um dispositivo médico de RV pode mesmo funcionar sem dados do paciente? A: Sim. A função terapêutica (proporcionar uma experiência imersiva de distração ou relaxamento) não depende de identificar o paciente nem de recolher os seus dados de saúde. A gestão operacional do equipamento pode ser feita ao nível do dispositivo e do serviço, não do indivíduo. ### Higiene e segurança do equipamento de realidade virtual em ambiente hospitalar URL: https://rver.pt/blog/higiene-seguranca-equipamento-realidade-virtual/ Date: 4 June 2026 Em ambiente hospitalar, qualquer equipamento partilhado é também uma questão de controlo de infeção e de conforto. A realidade virtual para uso clínico não é exceção. Levar realidade virtual para junto da cama de um doente levanta as mesmas questões de qualquer equipamento partilhado em saúde: como se mantém limpo, como se garante o conforto e como se assegura que o seu uso é seguro. Resolver isto bem é o que separa uma boa ideia de uma prática sustentável. ## Controlo de infeção: rotina simples e consistente Um equipamento que passa de doente em doente precisa de uma rotina de higiene clara, e, sobretudo, **fácil de cumprir**. Quanto mais simples a rotina, maior a probabilidade de ser seguida sempre. - **Superfícies de contacto** limpas entre utilizações, com produtos compatíveis com os materiais. - **Atenção às zonas que tocam a pele**, normalmente as que mais exigem cuidado. - **Proteções higiénicas substituíveis** quando aplicável, reduzindo o contacto direto. A rotina deve sempre alinhar-se com os **protocolos de controlo de infeção** da própria instituição, não substituí-los. ## Conforto: sessões curtas por princípio O conforto não é um detalhe: é parte da segurança. Sessões longas aumentam o risco de fadiga visual, cansaço ou desconforto. Por isso a regra de base é simples: **sessões curtas**, ajustadas a cada doente, e sempre interrompíveis. > Ao primeiro sinal de desconforto, tonturas ou náusea, a sessão para. Sem exceções. ## Segurança: supervisão e adequação individual Nem toda a gente, nem todo o momento, é adequado para uma sessão de RV. A adequação deve ser avaliada caso a caso por profissionais de saúde, tendo em conta o estado do doente. A presença e supervisão da equipa durante a sessão é parte essencial do uso seguro. ## Logística que sustenta a prática Higiene e segurança só se mantêm se a logística as tornar fáceis: um local definido para o equipamento, responsabilidade clara pela limpeza e pelo carregamento, e materiais de higiene sempre à mão. Sem isto, a boa prática esmorece com o tempo. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar**, usada sob supervisão de profissionais de saúde e integrada no plano de cuidados. As rotinas de higiene e segurança devem seguir sempre os protocolos de controlo de infeção e as normas da instituição. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi pensado para uso clínico partilhado: simples de manter e operar pelas equipas, confortável para o doente e sem recolha de dados clínicos do paciente. Em saúde, segurança e higiene não são acessórios à tecnologia: são a condição para que ela possa, de facto, ser usada junto de quem precisa. A higiene é uma das perguntas de segurança que nos fazem. As outras estão em [«A realidade virtual faz mal?»](/blog/realidade-virtual-faz-mal-efeitos-secundarios/). Q: Como se limpa um equipamento de realidade virtual entre doentes? A: Com uma rotina simples e consistente: superfícies de contacto limpas com produtos compatíveis com o material, atenção especial às zonas que tocam a pele, e quando aplicável o uso de proteções higiénicas substituíveis. A rotina deve respeitar os protocolos de controlo de infeção da instituição. Q: Quanto tempo deve durar uma sessão para ser confortável? A: As sessões devem ser curtas e ajustadas a cada doente. Sessões breves reduzem o risco de desconforto, fadiga visual ou cansaço, e a sessão deve ser interrompida perante qualquer sinal de mal-estar. Q: Há contraindicações para usar realidade virtual? A: A adequação deve ser sempre avaliada por profissionais de saúde caso a caso. Em qualquer situação de desconforto, tonturas ou náusea, a sessão deve ser interrompida de imediato. O uso é sempre supervisionado e integrado no plano de cuidados. ### Realidade virtual para uso clínico na perspetiva da enfermagem: uma ferramenta ao lado da cama URL: https://rver.pt/blog/enfermagem-realidade-virtual-terapeutica/ Date: 4 June 2026 É a enfermagem que está ao lado da cama nos momentos difíceis. Uma ferramenta que ajude a acalmar o doente, sem acrescentar carga, vale-lhe diretamente. A enfermagem ocupa um lugar único no cuidado: é quem está fisicamente presente nos momentos em que o doente mais sente ansiedade ou desconforto. É quem faz o penso, a punção, quem acompanha a espera tensa antes de um procedimento. Por isso, qualquer ferramenta que ajude a acalmar o doente nesses momentos, sem lhe acrescentar trabalho, fala diretamente ao trabalho de enfermagem. ## O problema concreto: momentos difíceis à cabeceira Muitos procedimentos de enfermagem são curtos, mas geram ansiedade e desconforto desproporcionais à sua duração. Um doente tenso é mais difícil de cuidar, e o próprio momento torna-se mais penoso para todos. Acalmar não é só gentileza: facilita o trabalho clínico. ## Como a RV entra no fluxo da enfermagem A realidade virtual para uso clínico capta a atenção do doente num ambiente imersivo, reduzindo a atenção disponível para o desconforto. Aplicada pela enfermagem, encaixa-se em momentos que já existem: - Durante **procedimentos de curta duração**, como pensos ou punções. - Na **espera ansiosa** antes de uma intervenção. - Em **momentos de agitação ou desconforto** durante o internamento. > Um doente mais calmo torna o procedimento mais fácil de conduzir, e isso é tempo e tensão poupados a quem está à cabeceira. ## A condição: não pode pesar no dia a dia A enfermagem não adota ferramentas que acrescentam fricção. Para ser usada, a RV tem de ser **rápida de iniciar e simples de operar**: sem fluxos técnicos, sem configurações demoradas, sem formação longa. Se exigir mais do que poucos passos, fica no armário. Por isso, a simplicidade não é um luxo: é o que decide se a ferramenta chega ou não ao doente. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar**, usada sob supervisão de profissionais de saúde e integrada no plano de cuidados. Não substitui a avaliação clínica, a medicação nem o juízo da equipa de enfermagem sobre o que é adequado a cada doente. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para ser simples de operar pelas equipas (incluindo a enfermagem na linha da frente), confortável para o doente e sem recolha de dados clínicos do paciente. Para quem está ao lado da cama, o valor é concreto: um doente mais calmo, um momento difícil mais tolerável, sem mais um peso no turno. Para saber à cabeça que utentes conseguem participar, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Q: Como pode a realidade virtual apoiar o trabalho de enfermagem? A: Ao captar a atenção do doente num ambiente imersivo, a realidade virtual para uso clínico pode reduzir a ansiedade e o desconforto durante procedimentos de enfermagem, como pensos ou punções, tornando esses momentos mais calmos para o doente e mais fáceis de conduzir para a equipa. Q: Acrescenta trabalho ao dia a dia da enfermagem? A: Não deve. Uma ferramenta concebida para contexto clínico tem de ser rápida de iniciar e simples de operar. Bem desenhada, encaixa-se em momentos que já existem (uma espera ou um procedimento), sem criar tarefas adicionais relevantes. Q: A enfermagem precisa de formação especializada para a usar? A: Não é necessária formação especializada. Com uma orientação breve e prática, qualquer enfermeiro pode iniciar e acompanhar uma sessão, sempre dentro do plano de cuidados e dos protocolos da instituição. ### Como integrar a realidade virtual para uso clínico no fluxo de trabalho clínico URL: https://rver.pt/blog/integrar-realidade-virtual-fluxo-clinico/ Date: 4 June 2026 A melhor ferramenta clínica é inútil se ninguém tiver tempo para a usar. A adoção da realidade virtual para uso clínico depende menos da tecnologia e mais de como encaixa no fluxo de trabalho real. A maior barreira à adoção de uma nova tecnologia em saúde raramente é a tecnologia em si. É o tempo. Equipas já sobrecarregadas não adotam ferramentas que acrescentam fricção, por melhores que sejam. Por isso, integrar a realidade virtual para uso clínico com sucesso é, sobretudo, um exercício de **encaixe no fluxo de trabalho**. ## Comece por encontrar os momentos certos A realidade virtual para uso clínico não cria um novo bloco na agenda: encaixa-se em momentos que já existem e que hoje são "tempo morto" ou tempo difícil: - A **espera** antes de um procedimento, carregada de ansiedade. - O **próprio procedimento** de curta duração, em que a distração ajuda. - Momentos de **desconforto ou agitação** durante o internamento. Identificar estes momentos no percurso do doente é o primeiro passo. A ferramenta entra onde já há uma necessidade, não onde é preciso inventar espaço. [Image: Os quatro passos de uma sessão RVer. Os passos 3 e 4 são opcionais: uma sessão corre sem eles.] ## Mantenha simples quem opera Se usar o sistema exigir um técnico dedicado, a adoção morre. O objetivo é que **qualquer membro da equipa**, enfermagem, auxiliares, terapeutas, possa iniciar uma sessão com formação mínima. > Regra prática: se for preciso um manual para começar uma sessão, a ferramenta é demasiado complexa para o terreno. ## Sessões curtas, encaixadas no real Intervenções longas competem com tudo o resto e perdem. Sessões curtas, ajustadas ao doente e ao momento, encaixam-se sem desorganizar a rotina. O melhor desenho é aquele que se adapta ao fluxo existente, em vez de exigir que o fluxo se adapte a ele. ## Higiene e logística previsíveis Para usar entre doentes, o equipamento precisa de uma rotina de limpeza simples e clara e de uma logística previsível: onde fica, quem o carrega, como se prepara. Sem isto, mesmo uma boa ferramenta acaba esquecida num armário. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar**, integrada no plano de cuidados e usada sob supervisão de profissionais de saúde. A sua adoção deve respeitar os protocolos clínicos e de controlo de infeção de cada instituição. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado precisamente com a adoção em mente: simples de operar pelas equipas, confortável para o doente e sem recolha de dados clínicos do paciente. A tecnologia certa em saúde não é a mais sofisticada: é a que a equipa consegue, de facto, usar todos os dias. A pergunta que vem a seguir ao fluxo é quem o executa: [quem pode conduzir uma sessão](/blog/quem-pode-conduzir-sessao-realidade-virtual-utentes/). Para testar o fluxo antes de o adotar, ver [como correr um piloto](/blog/piloto-realidade-virtual-hospital-como-correr/). Q: Quem opera a realidade virtual para uso clínico numa equipa? A: Não é necessário um técnico especializado. Com formação mínima, qualquer membro da equipa, enfermagem, auxiliares ou terapeutas, pode iniciar e acompanhar uma sessão. O sistema deve ser simples o suficiente para isso. Q: Quanto tempo demora uma sessão típica? A: As sessões são tipicamente curtas, ajustadas ao contexto e ao doente. Em vez de longas intervenções, encaixam-se em momentos já existentes do percurso do doente, como uma espera ou um procedimento de curta duração. Q: É preciso muita formação para começar? A: Não. Uma ferramenta concebida para contexto clínico deve exigir apenas uma formação breve e prática. Se a curva de aprendizagem for demasiado exigente, a adoção falha: por isso a simplicidade é um requisito, não um extra. ### Realidade virtual contra o burnout dos profissionais de saúde URL: https://rver.pt/blog/realidade-virtual-burnout-profissionais-saude/ Date: 4 June 2026 O burnout esgota quem cuida. Entre as abordagens estudadas para o reduzir, a realidade virtual de relaxamento, em pausas curtas durante o turno, começa a mostrar resultados encorajadores. O burnout deixou de ser um problema individual para se tornar uma questão estrutural nas equipas de saúde. Esgotamento emocional, despersonalização e perda de realização afetam quem cuida, e, por consequência, a qualidade do cuidado. Procuram-se abordagens que ajudem, e a realidade virtual de relaxamento é uma das que tem sido estudada, com uma lógica simples: criar um momento de recuperação no meio do turno. ## A ideia: uma pausa que realmente desliga Numa jornada exigente, "fazer uma pausa" raramente significa desligar. A sala de descanso continua cheia de estímulos, conversas e lembretes do trabalho. A realidade virtual oferece algo diferente: durante poucos minutos, o profissional é transportado para um ambiente calmo (uma paisagem natural, por vezes com respiração guiada) que substitui por completo o campo de visão e isola dos estímulos do serviço. O objetivo não é resolver o turno, mas dar ao corpo e à mente uma janela real de recuperação. ## O que dizem os estudos A investigação é recente, sobretudo estudos de viabilidade, mas os sinais são consistentes: - Um estudo com profissionais de **saúde mental** observou, ao longo de 5 semanas com sessões de relaxamento em RV, melhorias no bem-estar subjetivo, no stress percebido, na preocupação, em indicadores de **burnout** e na qualidade do sono. - Um ensaio-piloto com profissionais de saúde durante a pandemia registou reduções significativas no **stress, ansiedade e sintomas depressivos** após intervenção em RV. - Em enfermeiros de cuidados intensivos, pausas curtas de relaxamento em RV reduziram o stress percebido imediato durante turnos exigentes. > O padrão é coerente: pausas curtas de relaxamento imersivo, repetidas ao longo do tempo, podem aliviar o stress e o esgotamento de quem trabalha em saúde. ## Os limites que é honesto referir - A maior parte da evidência vem de **estudos de viabilidade** e amostras pequenas; faltam ensaios de maior escala. - Os efeitos medidos são sobretudo de **curto prazo**. - E o mais importante: a RV atua no **indivíduo**, não nas causas organizacionais do burnout. Carga de trabalho, falta de pessoal e exigência emocional exigem respostas estruturais. :::note **Nota importante:** a realidade virtual de relaxamento é um apoio **complementar** ao bem-estar individual. Não substitui as mudanças organizacionais necessárias para prevenir o burnout, nem o acompanhamento de profissionais quando o esgotamento é intenso ou persistente. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. A sua simplicidade (usar em poucos minutos, sem fluxos técnicos e sem recolha de dados clínicos do paciente) torna-o adequado também a pausas de recuperação das próprias equipas. Cuidar de quem cuida é parte de um sistema de saúde sustentável. A realidade virtual de relaxamento não resolve o burnout, mas pode ser uma ferramenta útil, acessível e validada para aliviar o seu peso no dia a dia. ## Referências Estudos independentes sobre realidade virtual e stress/burnout em profissionais de saúde (investigação geral, não específica de qualquer produto): - [Relaxamento em RV multissessão para equipas de saúde mental: estudo de viabilidade (2025)](https://www.sciencedirect.com/science/article/pii/S2212657025000182) - [Programa de redução de stress em RV para profissionais de saúde: ensaio-piloto](https://pmc.ncbi.nlm.nih.gov/articles/PMC12022780/) - [Relaxamento em RV em enfermeiros de cuidados intensivos (*Frontiers in Psychology*, 2021)](https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.706527/full) Q: A realidade virtual ajuda a reduzir o burnout? A: Estudos preliminares apontam nesse sentido. Pausas curtas de relaxamento em realidade virtual durante o turno associaram-se a reduções no stress percebido, na ansiedade e em indicadores de burnout em profissionais de saúde. A evidência é ainda inicial, sobretudo estudos de viabilidade, mas consistente. Q: Como é que funciona na prática? A: O profissional faz uma pausa breve, tipicamente cerca de 10 minutos, imerso num ambiente calmo de realidade virtual, por vezes com respiração guiada. O objetivo é uma recuperação rápida durante a jornada, criando um momento de desligar mesmo num ambiente exigente. Q: Isto resolve as causas do burnout? A: Não. O burnout tem causas organizacionais (carga de trabalho, falta de recursos, exigência emocional) que nenhuma tecnologia resolve. A realidade virtual de relaxamento é um apoio ao bem-estar individual, complementar, não um substituto das mudanças organizacionais necessárias. ### Realidade virtual na dor crónica: o que a evidência mostra URL: https://rver.pt/blog/realidade-virtual-dor-cronica/ Date: 4 June 2026 A dor crónica funciona de forma diferente da dor aguda, e exige abordagens diferentes. A realidade virtual surge aqui não só como distração, mas como parte de uma estratégia mais ampla, com evidência crescente. A dor crónica não é simplesmente uma dor aguda que se prolongou. É um fenómeno distinto, em que o sistema nervoso se mantém em estado de alerta mesmo quando a lesão inicial já sarou: um processo por vezes descrito como **sensibilização central**. Por isso, as ferramentas que ajudam na dor aguda nem sempre se aplicam da mesma forma. A realidade virtual é uma das que tem vindo a ser estudada também neste contexto mais complexo. ## Dor aguda vs. dor crónica: porque o mecanismo muda Na **dor aguda** (um penso, uma punção) a realidade virtual atua sobretudo por **distração imediata**: ocupa a atenção durante o procedimento e reduz a dor percebida nesse momento. Na **dor crónica**, o objetivo é mais amplo. Não se trata de atravessar um momento, mas de viver melhor com uma condição prolongada. Aqui a RV combina vários elementos: - **Distração e relaxamento**, para baixar a tensão e a hipervigilância à dor. - **Regulação fisiológica**, por vezes através de *biofeedback*: o doente vê e aprende a influenciar sinais como a respiração ou a variabilidade cardíaca. - **Redução do impacto na vida diária**, mais do que a eliminação da dor em si. ## O que dizem os ensaios clínicos A investigação é recente mas encorajadora, sobretudo em duas condições muito procuradas: - **Fibromialgia**: um ensaio controlado e aleatorizado publicado na *ACR Open Rheumatology* (2025) testou realidade virtual imersiva combinada com biofeedback multissensorial. O grupo de tratamento apresentou dor significativamente menor (P = 0,011) e melhoria no questionário de impacto da fibromialgia (P = 0,018), acompanhadas de melhorias fisiológicas (variabilidade cardíaca, ritmo respiratório, condutância da pele) e elevada satisfação, sem problemas de segurança. - **Lombalgia crónica**: uma revisão sistemática com meta-análise concluiu que a reabilitação baseada em realidade virtual está associada a redução significativa da dor em pessoas com dor lombar. > O padrão é consistente: a realidade virtual, sobretudo combinada com relaxamento e biofeedback, pode reduzir a intensidade da dor crónica e o seu impacto, como parte de uma abordagem mais ampla. ## Os limites que é honesto referir - Muitos estudos são ainda **ensaios-piloto**, com amostras pequenas; faltam ensaios de maior escala. - O efeito tende a ser **pequeno a moderado** e varia entre pessoas e condições. - A dor crónica exige uma abordagem **multidisciplinar**; a RV é um complemento, não o centro do tratamento. :::note **Nota importante:** a realidade virtual é uma abordagem **complementar** e não farmacológica. A dor crónica deve ser avaliada e acompanhada por profissionais de saúde, no âmbito de um plano multidisciplinar. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Atua pela imersão, relaxamento e conforto: simples de usar pelas equipas e sem recolha de dados clínicos do paciente. Na dor crónica, a promessa honesta não é "acabar com a dor", mas oferecer uma ferramenta validada que ajude a reduzir o seu peso no dia a dia, sempre integrada no plano definido pelos profissionais de saúde. ## Referências Estudos independentes sobre realidade virtual e dor crónica (investigação geral, não específica de qualquer produto): - [Immersive VR + biofeedback na fibromialgia: ensaio aleatorizado, *ACR Open Rheumatology* (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12080186/) - [Reabilitação por RV na lombalgia: revisão sistemática e meta-análise](https://pmc.ncbi.nlm.nih.gov/articles/PMC9958662/) Q: A realidade virtual ajuda na dor crónica? A: A evidência aponta nesse sentido. Ensaios clínicos em condições como fibromialgia e lombalgia crónica associaram a realidade virtual, frequentemente combinada com biofeedback, a reduções significativas da intensidade da dor e do impacto na vida diária. É uma área promissora, ainda em consolidação, e usada como complemento ao plano clínico. Q: Qual a diferença entre RV na dor aguda e na dor crónica? A: Na dor aguda, a RV atua sobretudo por distração imediata durante um procedimento. Na dor crónica, o foco alarga-se: além da distração, procura-se relaxamento, regulação fisiológica (por exemplo, através de biofeedback) e reduzir o impacto da dor na qualidade de vida ao longo do tempo. Q: A realidade virtual substitui o tratamento da dor crónica? A: Não. A dor crónica exige uma abordagem multidisciplinar definida por profissionais de saúde. A realidade virtual é uma ferramenta complementar e não farmacológica, integrada nesse plano: nunca um substituto da avaliação, da medicação ou do acompanhamento clínico. ### Realidade virtual para dormir melhor: o que dizem os estudos sobre RV e insónia URL: https://rver.pt/blog/realidade-virtual-dormir-melhor-insonia/ Date: 4 June 2026 Quem dorme mal procura respostas. Entre as abordagens não farmacológicas estudadas para o sono, a realidade virtual de relaxamento começa a reunir evidência (promissora, ainda que inicial). Dormir mal é uma das queixas de saúde mais comuns, e uma das mais procuradas online. Entre as abordagens não farmacológicas que a investigação tem explorado para o sono, a **realidade virtual de relaxamento** é uma das mais recentes. Vale a pena olhar para o que os estudos mostram, sem exageros nem ceticismo automático. ## O mecanismo plausível: relaxar antes de dormir A dificuldade em adormecer está muitas vezes ligada a um estado de **ativação fisiológica**: a mente acelerada, o corpo tenso. Qualquer abordagem que ajude a baixar essa ativação cria condições mais favoráveis ao sono. É aqui que entra a realidade virtual de relaxamento: ambientes imersivos calmos, por vezes combinados com respiração guiada ou *biofeedback*, procuram induzir um estado de tranquilidade antes de deitar. Não é um sedativo: é um apoio ao relaxamento. ## O que dizem os estudos A investigação é recente, mas já existem ensaios clínicos: - Um **ensaio controlado e aleatorizado** publicado no *Journal of Medical Internet Research* (2025), com 118 participantes ao longo de 4 semanas, observou melhorias na qualidade do sono medida pelo **PSQI** (no grupo de RV, a pontuação global desceu de 9,70 para 7,20), a par de redução de sintomas depressivos e de ansiedade. - Um ensaio aleatorizado publicado na *Sleep Medicine* (2024) testou RV de relaxamento usada em casa, à noite, durante 6 semanas, em doentes com **insónia crónica**, com melhorias associadas na qualidade do sono. > O sinal é consistente: ambientes imersivos de relaxamento podem apoiar o sono. Mas a evidência é ainda inicial, com amostras pequenas e poucos estudos de longo prazo. ## Os limites que é honesto referir - A literatura reconhece que a evidência sobre RV para perturbações do sono é **limitada e ainda inconclusiva**. - A insónia persistente tem uma abordagem de primeira linha bem estabelecida, a **terapia cognitivo-comportamental para a insónia (TCC-I)**, que a RV não substitui. - O efeito provém do relaxamento, não de uma propriedade "mágica" da tecnologia. :::note **Nota importante:** a realidade virtual de relaxamento é uma abordagem **complementar**. A insónia persistente deve ser avaliada por profissionais de saúde. Este artigo é informativo e não constitui aconselhamento clínico nem dispensa o acompanhamento adequado. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. O seu foco é o relaxamento e o conforto através da imersão: usado sob supervisão de profissionais e sem recolha de dados clínicos do paciente. A leitura honesta da evidência é também a mais útil: a realidade virtual de relaxamento é um apoio promissor ao sono, não um substituto do que já está comprovado. ## Referências Estudos independentes sobre realidade virtual e sono (investigação geral, não específica de qualquer produto): - [Impact of Virtual Reality–Based Biofeedback on Sleep Quality: RCT, *JMIR* (2025)](https://www.jmir.org/2025/1/e65772) - [Virtual reality improves sleep quality in chronic insomnia: *Sleep Medicine* (2024)](https://www.sciencedirect.com/science/article/abs/pii/S1389945724003988) Q: A realidade virtual ajuda mesmo a dormir melhor? A: Há estudos que apontam nessa direção. Em ensaios clínicos, a realidade virtual de relaxamento associou-se a melhorias na qualidade do sono, medida por escalas como o PSQI. A evidência é promissora mas ainda inicial, e os resultados variam entre estudos e pessoas. Q: Como é que a realidade virtual poderia favorecer o sono? A: Atua sobretudo pelo relaxamento: ambientes imersivos calmos ajudam a reduzir a ativação fisiológica (a 'aceleração' antes de dormir), criando condições mais favoráveis ao adormecer. Não é um sedativo: é um apoio ao relaxamento. Q: A RV substitui o tratamento da insónia? A: Não. A insónia persistente deve ser avaliada por profissionais de saúde, e a terapia cognitivo-comportamental para a insónia (TCC-I) continua a ser a abordagem de primeira linha mais sustentada. A realidade virtual de relaxamento é, quando muito, um complemento. ### Realidade virtual em lares de idosos e em hospitais: o mesmo princípio, contextos diferentes URL: https://rver.pt/blog/realidade-virtual-lares-idosos-vs-hospital/ Date: 4 June 2026 Hospital e lar partilham o princípio, imersão para conforto e bem-estar, mas vivem ritmos diferentes. Perceber a diferença é o que torna o uso eficaz em cada um. A realidade virtual para uso clínico assenta num princípio único: usar a imersão para promover conforto, calma e bem-estar. Mas o mesmo equipamento vive de forma muito diferente consoante o lugar. Um hospital e um lar de idosos partilham o princípio, e divergem quase em tudo o resto: ritmo, objetivos e necessidades. ## O hospital: o momento agudo No hospital, o tempo é marcado por eventos clínicos. A RV para uso clínico entra sobretudo em **momentos pontuais e agudos**: - A ansiedade antes de um procedimento. - O desconforto durante uma intervenção de curta duração. - A espera tensa, carregada de incerteza. O uso é **orientado ao evento**: surge quando há uma necessidade clínica concreta e termina com ela. A cadência é irregular, ditada pelo percurso de cada doente. ## O lar: o bem-estar continuado Num lar de idosos, a lógica inverte-se. Não há tanto o "momento agudo", mas sim a **vida do dia a dia** ao longo do tempo. Aqui, a RV para uso clínico serve outro propósito: - **Estímulo e quebra da rotina**, contra a monotonia que pesa. - **Ambientes calmantes**, para momentos de agitação ou inquietação. - **Reminiscência**, ligando o residente a tempos e lugares familiares. A cadência é mais **regular e programada**, parte de uma rotina de bem-estar, não de uma resposta a um evento clínico isolado. > No hospital, a RV responde a um momento. No lar, acompanha um percurso. O equipamento é o mesmo; o propósito muda. ## O que se mantém em ambos Apesar das diferenças, duas exigências são comuns e inegociáveis: - **Simplicidade de operação**: em qualquer contexto, se for difícil de usar, não é usada. - **Higiene e adequação individual**: rotinas de limpeza claras e conteúdos ajustados a cada pessoa, sempre sob supervisão. :::note **Nota importante:** em qualquer contexto, a realidade virtual para uso clínico é uma abordagem **complementar**, usada sob supervisão de profissionais e adaptada a cada pessoa. Não substitui a avaliação clínica nem o acompanhamento humano, e deve ser interrompida perante qualquer sinal de desconforto. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. Foi desenhado para servir tanto o ritmo agudo do hospital como o bem-estar continuado do lar: simples de operar pelas equipas, confortável para a pessoa e sem recolha de dados clínicos do paciente. Um princípio, dois mundos: o valor está em adaptar o uso ao contexto, mantendo a mesma simplicidade e o mesmo cuidado em ambos. Sobre que utentes conseguem mesmo usar, e onde a resposta é não, ver [acessibilidade em realidade virtual](/blog/acessibilidade-realidade-virtual-quem-pode-usar/). Sobre como isto entra no plano semanal, ver [onde a realidade virtual encaixa no plano de atividades](/blog/plano-de-atividades-lar-idosos-realidade-virtual/). Q: A realidade virtual para uso clínico é usada da mesma forma em lares e em hospitais? A: O princípio é o mesmo, usar a imersão para promover conforto e bem-estar, mas o contexto difere. No hospital, tende a focar-se em momentos agudos, como procedimentos ou esperas ansiosas. No lar, o foco é mais o bem-estar continuado, o estímulo e a quebra da rotina ao longo do tempo. Q: Que vantagens traz a RV num lar de idosos? A: Num lar, a realidade virtual para uso clínico pode oferecer momentos de estímulo, ambientes calmantes, reminiscência e quebra da monotonia, contribuindo para o bem-estar dos residentes. É sempre usada de forma suave, adaptada a cada pessoa e sob supervisão dos profissionais. Q: As necessidades técnicas são diferentes entre os dois contextos? A: Em ambos, a simplicidade de operação e as rotinas de higiene são essenciais. O que mais muda é a cadência de uso (pontual e ligada a eventos clínicos no hospital, mais regular e programada no lar) e o tipo de conteúdos privilegiados em cada um. ### Realidade virtual nas perturbações de ansiedade: o que mostra a investigação clínica URL: https://rver.pt/blog/realidade-virtual-perturbacoes-ansiedade/ Date: 4 June 2026 Uma coisa é acalmar a ansiedade de um momento; outra é tratar uma perturbação de ansiedade. Também aqui a realidade virtual tem sido estudada, com evidência crescente e um papel bem definido. Há uma diferença importante entre **acalmar a ansiedade de um momento** (a espera antes de um exame, por exemplo) e **tratar uma perturbação de ansiedade**, uma condição clínica persistente. A realidade virtual tem sido estudada nos dois planos. Aqui falamos do segundo: o seu papel no tratamento clínico, conduzido por profissionais. ## A lógica: um ambiente seguro e controlável A peça central é a **terapia de exposição em realidade virtual**. Na psicoterapia, a exposição gradual a situações temidas é uma das abordagens mais eficazes para a ansiedade. A realidade virtual acrescenta-lhe vantagens práticas: - **Segurança e controlo**: a situação ansiogénica acontece num ambiente virtual, ajustável pelo profissional. - **Reprodutibilidade**: a mesma cena pode repetir-se e graduar-se tantas vezes quanto necessário. - **Acessibilidade**: permite recriar situações difíceis de organizar na vida real. Tudo isto **ao serviço da psicoterapia**, conduzido por um profissional de saúde mental, e não como uma ferramenta autónoma. ## O que diz a evidência Esta é uma das áreas da RV em saúde com base de evidência mais consolidada: - Uma **meta-análise** (2018), com 23 estudos, concluiu que as intervenções em realidade virtual são significativamente mais eficazes do que a ausência de tratamento na redução de sintomas de **ansiedade e depressão**, com efeitos comparáveis aos da terapia de exposição convencional. - Uma revisão **Cochrane** (2019) encontrou evidência de **qualidade moderada** da eficácia da realidade virtual nas perturbações de ansiedade. - Uma meta-análise mais recente (2026), com 26 ensaios aleatorizados e 1649 participantes, registou efeitos significativos na redução da ansiedade e de sintomas associados. > A evidência é consistente: a realidade virtual é uma ferramenta eficaz no tratamento da ansiedade, desde que integrada numa intervenção clínica conduzida por profissionais. ## Os limites que é honesto referir - A evidência mais forte refere-se a **fobias e ansiedade** específicas; noutras perturbações (como o stress pós-traumático) os dados são mais **inconclusivos**. - A RV é um **meio ao serviço da psicoterapia**, não um tratamento que dispense o profissional. - A qualidade e o desenho dos estudos variam, e nem todos os sistemas são equivalentes. :::note **Nota importante:** a realidade virtual no tratamento das perturbações de ansiedade é uma ferramenta de uso **clínico**, conduzida por profissionais de saúde mental. Não substitui a avaliação, a psicoterapia ou a medicação. Este artigo é informativo e não constitui aconselhamento clínico; perante ansiedade persistente, procure um profissional. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. O seu foco está na imersão para conforto e relaxamento, simples de usar pelas equipas e sem recolha de dados clínicos do paciente. A leitura honesta da evidência distingue os planos: a realidade virtual tem um papel comprovado no tratamento da ansiedade quando integrada na intervenção clínica, e um papel complementar no conforto e no relaxamento do dia a dia em saúde. ## Referências Estudos independentes sobre realidade virtual e ansiedade (investigação geral, não específica de qualquer produto): - [Eficácia da RV em sintomas de ansiedade e depressão: meta-análise, *Scientific Reports* (2018)](https://www.nature.com/articles/s41598-018-28113-6) - [Terapia de exposição em RV para ansiedade e PTSD: meta-análise de ensaios aleatorizados, *JOGH* (2026)](https://jogh.org/2026/jogh-16-04090/) Q: A realidade virtual ajuda a tratar a ansiedade? A: A investigação aponta nesse sentido. Meta-análises mostram que intervenções baseadas em realidade virtual são mais eficazes do que a ausência de tratamento na redução de sintomas de ansiedade e depressão, com efeitos comparáveis à terapia de exposição convencional. Uma revisão Cochrane encontrou evidência de qualidade moderada de eficácia nas perturbações de ansiedade. Q: O que é a terapia de exposição em realidade virtual? A: É uma abordagem em que o doente é exposto, de forma gradual e controlada, a situações que provocam ansiedade, dentro de um ambiente virtual seguro e conduzido por um profissional. Permite trabalhar o medo num contexto reproduzível e ajustável, como parte de uma psicoterapia. Q: A RV substitui o acompanhamento psicológico? A: Não. A realidade virtual é uma ferramenta ao serviço da intervenção clínica, usada por profissionais de saúde mental dentro de um plano terapêutico. Não substitui a avaliação, a psicoterapia nem a medicação quando indicada. ### Realidade virtual no tratamento de fobias: a evidência mais forte de todas URL: https://rver.pt/blog/realidade-virtual-tratamento-fobias/ Date: 4 June 2026 Se há um domínio em que a realidade virtual já é um tratamento estabelecido, é o das fobias. A terapia de exposição em RV iguala (e por vezes supera) o padrão de referência. Se há uma área em que a realidade virtual deixou de ser promessa para se tornar **tratamento estabelecido**, é o tratamento de fobias. Aqui a evidência não é apenas encorajadora: é das mais fortes de toda a investigação sobre RV em saúde. ## A lógica: exposição gradual, em segurança O tratamento mais eficaz para as fobias é a **exposição gradual**: enfrentar o medo de forma controlada, passo a passo, até a resposta de medo diminuir. O problema prático é organizar essa exposição: nem sempre é fácil (ou seguro) levar alguém a um avião, a um terraço alto ou junto de uma aranha. A **terapia de exposição em realidade virtual (TERV)** resolve isso. Recria a situação temida num ambiente virtual seguro, ajustável e repetível, sempre conduzida por um profissional de saúde mental: - **Gradação precisa**: a intensidade aumenta ao ritmo do doente. - **Segurança total**: o medo é enfrentado sem risco real. - **Repetição ilimitada**: a cena pode repetir-se as vezes necessárias. ## O que dizem as meta-análises Os números falam por si: - Uma **meta-análise** de ensaios aleatorizados que compararam diretamente a exposição em RV com a exposição na vida real (o padrão de referência) encontrou um **efeito grande** a favor da TERV face aos controlos (Hedge's g ≈ 1,08), com eficácia comparável (e por vezes ligeiramente superior) à exposição real, em fobias específicas, agorafobia e fobia social. - As fobias específicas são descritas como o domínio **mais maduro** da investigação em TERV, apoiado por um vasto conjunto de ensaios aleatorizados (alturas, aranhas, voar, medo de agulhas). - Uma meta-análise recente (2026), com 26 ensaios e 1649 participantes, confirmou efeitos significativos e clinicamente relevantes na redução dos sintomas de fobia. > Para as fobias específicas, a terapia de exposição em realidade virtual é hoje um tratamento baseado em evidência, comparável ao padrão de referência. ## Os limites que é honesto referir - A evidência mais forte é para **fobias específicas**; noutras condições (como o stress pós-traumático) os dados são mais inconclusivos. - A TERV é **psicoterapia conduzida por um profissional**, e não uma autoaplicação sem acompanhamento. - O resultado depende de um plano terapêutico bem estruturado, não apenas da tecnologia. :::note **Nota importante:** a terapia de exposição em realidade virtual é uma intervenção **clínica**, conduzida por profissionais de saúde mental. Não é uma ferramenta de autotratamento e não substitui a avaliação ou a psicoterapia. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. O seu foco está na imersão para conforto e relaxamento, simples de usar pelas equipas e sem recolha de dados clínicos do paciente. O tratamento de fobias mostra até onde a realidade virtual em saúde pode chegar quando a evidência amadurece: de apoio promissor a tratamento estabelecido, sempre ao serviço da intervenção clínica. ## Referências Estudos independentes sobre realidade virtual e fobias (investigação geral, não específica de qualquer produto): - [TERV vs. exposição na vida real em fobias: revisão sistemática e meta-análise (*Frontiers in Psychology*, 2019)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6746888/) - [Terapia de exposição em RV para ansiedade e PTSD: meta-análise de ensaios aleatorizados, *JOGH* (2026)](https://jogh.org/2026/jogh-16-04090/) Q: A realidade virtual é eficaz no tratamento de fobias? A: Sim, e esta é uma das aplicações da RV em saúde com evidência mais forte. Meta-análises mostram efeitos grandes no tratamento de fobias específicas, comparáveis ou ligeiramente superiores à exposição na vida real. Para fobias específicas, a terapia de exposição em realidade virtual é considerada um tratamento baseado em evidência. Q: O que é a terapia de exposição em realidade virtual? A: É uma forma de psicoterapia em que o doente enfrenta, de forma gradual e controlada, aquilo que teme (alturas, voar, aranhas, falar em público) dentro de um ambiente virtual seguro, conduzido por um profissional de saúde mental. A repetição controlada ajuda a reduzir a resposta de medo. Q: É melhor do que enfrentar o medo na vida real? A: A evidência mostra eficácia comparável e, em alguns estudos, ligeiramente superior. A grande vantagem da RV é prática: permite criar e graduar situações difíceis ou impossíveis de organizar na realidade, em total segurança e de forma repetível. ### O que diz a evidência científica sobre a realidade virtual em saúde URL: https://rver.pt/blog/evidencia-cientifica-realidade-virtual-saude/ Date: 4 June 2026 A realidade virtual em saúde não é nem milagre nem moda. A leitura honesta da evidência fica num lugar mais útil: promissora em áreas concretas, ainda em consolidação noutras. Sempre que uma tecnologia entra na saúde, surgem duas reações simétricas e igualmente erradas: o entusiasmo que a trata como milagre e o ceticismo que a descarta como moda. A realidade virtual para uso clínico não escapa a isto. A leitura útil, e honesta, fica no meio, e exige olhar para a evidência com cuidado. ## O que está mais estabelecido A aplicação mais estudada da realidade virtual em saúde é a **distração para a gestão da dor e da ansiedade**. O mecanismo é plausível e bem descrito: a atenção é um recurso finito, e um ambiente imersivo ocupa-a, deixando menos capacidade para processar a dor ou a ansiedade. Existe um corpo crescente de investigação que aponta para benefícios deste efeito de distração em vários contextos clínicos: procedimentos de curta duração, ansiedade associada à espera, desconforto. É uma das áreas onde a evidência é mais consistente. > Que a distração imersiva ajuda a reduzir a dor e a ansiedade percebidas é dos pontos mais sustentados pela investigação atual. ## O que ainda está em consolidação Nem todas as aplicações estão no mesmo nível. Muitas estão em fases mais iniciais, com estudos mais pequenos ou menos conclusivos. Aqui é preciso prudência: - A robustez varia muito **entre aplicações**: o que vale para a dor aguda não se transfere automaticamente para outros usos. - Muitos estudos têm **amostras reduzidas** ou desenhos que limitam conclusões fortes. - Faltam, em várias áreas, estudos de maior escala e a longo prazo. Reconhecer isto não enfraquece a tecnologia: torna o discurso credível. ## Como ler a evidência sem cair em extremos Alguns princípios práticos para interpretar afirmações sobre RV em saúde: - **Desconfie de absolutos.** "Cura" ou "elimina a dor" são sinais de alarme, não de ciência. - **Distinga aplicações.** Uma afirmação só vale para o contexto em que foi estudada. - **Valorize a prudência.** Quem reconhece os limites da evidência costuma ser mais fiável do que quem promete tudo. - **Remeta a decisão para a clínica.** A interpretação dos resultados e a decisão de uso cabem aos profissionais de saúde. :::note **Nota importante:** a realidade virtual para uso clínico é uma abordagem **complementar** e não farmacológica, apresentada com base na evidência disponível e usada sob supervisão de profissionais de saúde. Não substitui tratamentos comprovados, avaliação clínica ou prescrição médica. Este artigo é informativo e não constitui aconselhamento clínico. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. O registo e a marcação CE atestam conformidade regulamentar e segurança para o uso a que se destina, e a postura é deliberadamente prudente: oferecer uma ferramenta validada e complementar, sem prometer aquilo que a evidência ainda não sustenta. A abordagem honesta à ciência não é a que promete mais: é a que distingue com clareza o que já se sabe daquilo que ainda está a ser estudado. Q: Existe evidência científica de que a realidade virtual ajuda na saúde? A: Existe um corpo crescente de investigação sobre a realidade virtual como ferramenta de distração para a gestão da dor e da ansiedade, com resultados promissores em vários contextos. Como em qualquer área em desenvolvimento, a robustez da evidência varia entre aplicações, e a interpretação deve ser sempre feita por profissionais de saúde. Q: A realidade virtual é uma terapia comprovada ou ainda experimental? A: Depende da aplicação. O efeito de distração na dor e na ansiedade é dos mais estudados e estabelecidos; outras aplicações estão em fases mais iniciais de investigação. Por isso a RV para uso clínico é apresentada como uma abordagem complementar, não como um substituto de tratamentos comprovados. Q: Como devo interpretar afirmações sobre os benefícios da realidade virtual? A: Com sentido crítico. Desconfie de promessas absolutas ou de 'curas'. A leitura correta da evidência reconhece benefícios concretos em áreas específicas, mantém-se prudente onde a investigação ainda é limitada, e remete sempre a decisão clínica para os profissionais de saúde. ### Gerir a ansiedade em ambiente hospitalar com Realidade Virtual URL: https://rver.pt/blog/reduzir-ansiedade-com-realidade-virtual/ Date: 4 June 2026 A espera por um procedimento, o ruído de uma sala de tratamentos, a incerteza: o ambiente hospitalar gera ansiedade. A realidade virtual para uso clínico oferece uma forma de levar o doente para um lugar mais calmo, sem sair da cadeira. A ansiedade em contexto de saúde não é um detalhe menor. Aumenta a perceção de dor, dificulta a colaboração do doente em procedimentos e torna a experiência de cuidados mais difícil para todos. Gerir esse estado emocional é parte de cuidar bem, e nem sempre a resposta tem de ser medicação. ## De onde vem a ansiedade hospitalar Três fatores costumam alimentar a ansiedade num ambiente clínico: - **Incerteza**: não saber o que vai acontecer ou quanto tempo vai durar. - **Perda de controlo**: estar num espaço estranho, dependente de outros. - **Estímulos do ambiente**: sons clínicos, luzes e a antecipação do desconforto. A realidade virtual atua sobre os três ao mesmo tempo: substitui o ambiente, devolve uma sensação de escolha e oferece um foco de atenção tranquilizador. ## Como a imersão acalma Ambientes virtuais calmos (uma praia, uma floresta, uma paisagem serena) combinados com som ambiente e ritmo suave, podem ajudar a baixar o estado de alerta. Ao envolver a atenção do doente, a RV reduz o espaço mental dedicado à preocupação e à antecipação negativa. > Não se trata de fingir que o procedimento não existe: trata-se de dar ao doente um lugar mais confortável onde estar enquanto ele acontece. ## Momentos em que faz diferença - **Antes de um procedimento:** reduzir a ansiedade antecipatória durante a preparação ou a espera. - **Durante tratamentos prolongados:** tornar sessões longas mais toleráveis. - **Em internamento:** oferecer momentos de pausa e bem-estar. - **Em populações sensíveis:** apoio ao conforto, sempre conforme a avaliação clínica. :::note **Nota importante:** a RV para uso clínico é um apoio **complementar e não farmacológico**. Não substitui a avaliação clínica nem o acompanhamento de profissionais de saúde, e é utilizada sob a sua supervisão. ::: ## RVer: conforto desenhado para o contexto clínico O **RVer** é um sistema de realidade virtual para uso clínico, **Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED** (MDR 2017/745). Foi pensado para ser fácil de integrar no fluxo de trabalho das equipas e confortável para o doente, e **não recolhe dados clínicos do paciente**, respeitando a privacidade desde o desenho. Q: A realidade virtual ajuda a reduzir a ansiedade antes de um procedimento? A: A RV para uso clínico pode ajudar a desviar a atenção da fonte de stress e a induzir um estado mais relaxado através de ambientes calmos e imersivos. É usada como apoio não farmacológico, sob supervisão de profissionais de saúde. Q: Quem pode beneficiar da RV para a ansiedade? A: Doentes em espera, antes de procedimentos, durante tratamentos prolongados ou em contextos de internamento podem beneficiar, sempre de acordo com a avaliação da equipa clínica. Q: A RV para uso clínico recolhe dados do doente? A: O RVer não recolhe dados clínicos do paciente. Foi concebido com foco na privacidade e na conformidade enquanto dispositivo médico registado. ### Videochamadas com a família em realidade virtual: partilhar a experiência à distância URL: https://rver.pt/blog/videochamadas-familia-realidade-virtual/ Date: 4 June 2026 O isolamento é um dos custos menos visíveis de um internamento prolongado. A realidade virtual pode aproximar quem está longe, não apenas com uma chamada, mas com uma experiência partilhada. Num internamento prolongado, a tecnologia já resolveu parte do problema da distância: uma videochamada permite ver e ouvir quem está longe. Mas continua a faltar algo: a **experiência partilhada**. Falar é diferente de fazer algo *em conjunto*. A realidade virtual para uso clínico abre uma possibilidade nova: a família não fica apenas a olhar para o rosto do doente, mas partilha o mesmo ambiente imersivo, em tempo real. ## Como funciona a experiência partilhada O modelo é simples e assenta em dois lados complementares: - **Do lado do doente**: usa o equipamento de realidade virtual e, através da câmara, vê a família com quem está a falar. - **Do lado da família**: a partir de um navegador comum, vê em tempo real aquilo que o doente está a experienciar no ambiente imersivo. O resultado não é uma chamada onde cada um descreve o que vê. É uma vivência comum: ambos olham para o mesmo lugar e podem comentá-lo, recordar e conversar a partir dele. > A diferença entre "estou a ver o mar" e "estamos a ver o mar juntos" é exatamente a diferença que esta funcionalidade procura criar. ## Porque é que isto importa clinicamente O isolamento social não é apenas uma questão emocional. Está associado a maior ansiedade, pior adesão e uma experiência de cuidado mais difícil. Manter o vínculo familiar tem valor real no bem-estar do doente. - **Reduz o sentimento de isolamento** em situações de internamento longo ou de isolamento clínico. - **Dá à família um papel ativo**, em vez do papel passivo de quem só pode esperar por notícias. - **Cria momentos positivos partilhados**, que ajudam a equilibrar a experiência hospitalar. ## Simples para a família, simples para a equipa Para que uma ferramenta seja usada, tem de ser fácil. A família participa a partir do telemóvel, tablet ou computador, sem instalar nada. A equipa clínica inicia a sessão sem fluxos técnicos complexos. :::note **Nota importante:** esta funcionalidade é um complemento ao cuidado e ao contacto humano, não um substituto das visitas presenciais nem do acompanhamento clínico. É sempre utilizada sob a supervisão dos profissionais de saúde e integrada no plano de cuidados. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual concebido para ambientes de saúde e registado como **Dispositivo Médico Classe I (produto base) no INFARMED e na EUDAMED**, com marcação CE ao abrigo do MDR 2017/745. A funcionalidade de videochamada com a família foi desenhada para ser simples de ambos os lados, e sem recolha de dados clínicos do paciente. O objetivo é claro: usar a tecnologia para aproximar pessoas, tornando a experiência de cuidados mais humana mesmo quando a distância impõe limites. Q: Como funciona a videochamada com a família no RVer? A: O doente usa o equipamento de realidade virtual enquanto a família participa numa videochamada. O doente vê a família através da câmara do dispositivo, e a família vê em tempo real o ambiente imersivo que o doente está a experienciar, podendo conversar sobre ele. Q: A família precisa de equipamento especial? A: Não. A família participa a partir de um navegador no telemóvel, tablet ou computador. Não é necessário instalar aplicações nem ter um dispositivo de realidade virtual do lado da família. Q: Isto substitui as visitas presenciais? A: Não. É um complemento que ajuda a manter o vínculo familiar quando a visita presencial não é possível ou é limitada: por distância, isolamento clínico ou horários restritos. ### Reabilitação motora com Realidade Virtual: mais adesão, melhores resultados URL: https://rver.pt/blog/reabilitacao-motora-com-realidade-virtual/ Date: 4 June 2026 O maior obstáculo da reabilitação não é a dificuldade dos exercícios: é a repetição. A realidade virtual transforma esses exercícios em tarefas com propósito, e isso muda a forma como o doente se compromete com a recuperação. A reabilitação funciona à base de repetição. Para recuperar movimento, força e coordenação, o doente precisa de repetir os mesmos gestos dezenas de vezes, sessão após sessão. O problema raramente é a capacidade: é a **motivação para manter a repetição** ao longo de semanas. É aqui que a realidade virtual para uso clínico faz diferença. ## O problema da adesão A literatura é consistente num ponto: o sucesso da reabilitação depende fortemente da **adesão** do doente ao plano. Exercícios saltados, sessões abandonadas e desmotivação são as principais razões para recuperações incompletas. E os exercícios tradicionais não ajudam: são repetitivos, abstratos e dão pouco feedback imediato. O doente não vê o progresso ao fim de cada repetição: apenas cansaço. ## Como a RV muda a equação A realidade virtual reformula o exercício como uma **tarefa com propósito**. Em vez de "levante o braço 20 vezes", o doente alcança objetos, segue trajetórias ou completa um objetivo dentro de um cenário imersivo. O movimento é o mesmo: a experiência é completamente diferente. Três mecanismos explicam o interesse: - **Objetivo claro**: cada movimento serve um propósito visível dentro da tarefa. - **Feedback imediato**: o doente vê o resultado de cada gesto em tempo real. - **Envolvimento**: a imersão desvia o foco do esforço e do desconforto para a tarefa. > Quando o exercício deixa de parecer exercício, a repetição deixa de ser um fardo, e a adesão aumenta naturalmente. ## Contextos de aplicação A reabilitação assistida por RV tem aplicação em vários contextos: - **Reabilitação neurológica**: recuperação motora após AVC ou lesão. - **Reabilitação ortopédica**: recuperação de amplitude e força após cirurgia ou trauma. - **Manutenção funcional**: em doentes que beneficiam de estímulo motor regular. :::note **Nota importante:** a RV para uso clínico é um complemento ao plano de reabilitação. Não substitui o fisioterapeuta nem a avaliação clínica, e é utilizada sob a supervisão da equipa de saúde, integrada no programa definido para cada doente. ::: ## O papel do RVer O **RVer** é um sistema de realidade virtual para uso clínico, **Dispositivo Médico Classe I (produto base) registado no INFARMED e na EUDAMED** (MDR 2017/745). Foi concebido para integrar-se no trabalho das equipas de reabilitação: fácil de usar, confortável para o doente e **sem recolha de dados clínicos do paciente**. O objetivo é simples: tornar a reabilitação mais consistente, ajudando o doente a manter-se comprometido com a recuperação até ao fim. Para uma condição concreta e o que a investigação lhe dedica, ver [realidade virtual e doença de Parkinson](/blog/realidade-virtual-doenca-de-parkinson/). :::note No RVer, o exercício guiado em realidade virtual é o RVer Motion, um módulo em desenvolvimento que não está abrangido pelo registo de dispositivo médico Classe I. O registo cobre o produto base, a biblioteca de vídeo 360°. ::: Q: Como é que a realidade virtual ajuda na reabilitação motora? A: A RV transforma exercícios repetitivos em tarefas envolventes com objetivos claros e feedback imediato. Isto aumenta a motivação e a adesão do doente, fatores determinantes para o sucesso da reabilitação. É usada como complemento ao plano de fisioterapia, sob supervisão profissional. Q: Que tipo de doentes pode beneficiar? A: Doentes em recuperação motora após AVC, lesão, cirurgia ortopédica ou em contexto de reabilitação neurológica podem beneficiar, sempre conforme a avaliação da equipa de reabilitação. Q: A RV substitui o fisioterapeuta? A: Não. A RV para uso clínico é uma ferramenta complementar que apoia o trabalho do fisioterapeuta. O profissional define, supervisiona e ajusta o plano: a RV ajuda a torná-lo mais motivador e consistente.