Search Results (242)

Background/Objectives: The aim of this systematic review was to compare the effectiveness of virtual reality (VR)-based training with conventional exercise programs in improving functional outcomes related to fall risk among older adults with various health conditions. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (registration number CRD42022345678). The databases Scopus, PubMed, Web of Science, and EBSCO were searched up to 31 March 2025. Randomized controlled trials (RCTs) were included if they involved participants aged ≥60 years, a VR intervention lasting ≥6 weeks, and a control group performing traditional exercises or receiving usual care. Methodological quality was assessed using the PEDro scale, and a narrative synthesis was performed across four outcome domains: balance, mobility, cognitive function, and fall risk. Results: Seven RCTs were included in the analysis (totaling 664 participants). VR training was found to be at least as effective as conventional exercise in improving balance (e.g., Berg Balance Scale) and mobility (e.g., Timed Up and Go), with some studies showing superior effects of VR. One RCT demonstrated that combining VR with balance exercises (MIX) yielded the greatest improvements in muscle strength and physical performance. Additionally, two studies reported cognitive benefits (e.g., MoCA) and a 42% reduction in fall incidence within six months following VR intervention. The methodological quality of the included studies was moderate to high (PEDro score 5–9/10). Conclusions: VR-based training represents a safe and engaging supplement to geriatric rehabilitation, effectively improving balance, mobility, and, in selected cases, cognitive function, while also reducing fall risk. Full article

This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article

Background/Objectives: Fatigue and cognitive impairment are common issues for People with Multiple Sclerosis (PwMS), affecting over 80% and 40–65%, respectively. The relationship between these two debilitating conditions is complex, with cognitive deficits exacerbating fatigue and vice versa. This study investigates the effects of a multimodal intervention combining cognitive rehabilitation and neuromodulation to alleviate fatigue and enhance cognitive performance in PwMS. Methods: The research employed multiple baselines across the subjects in a Single-Case Experimental Design (mbSCED) with a cohort of three PwMS diagnosed with Relapsing–Remitting MS. The intervention protocol consisted of a baseline phase followed by a four-week treatment involving transcranial direct current stimulation (tDCS) and cognitive training using RehaCom^® software (version 6.9.0). Fatigue levels were measured using the modified Fatigue Impact Scale (mFIS), while cognitive performance was evaluated through standardized neuropsychological assessments. Results: The multimodal protocol exhibited high feasibility and acceptability, with no dropouts. Individual responsiveness outcomes varied, with two PwMS showing significant decreases in fatigue and improvements in cognitive performance, particularly in the trained domains. Their motor performance and quality of life also improved, suggesting that the treatment had indirect beneficial effects. Conclusions: This study provides preliminary evidence for the potential benefits of integrating neuromodulation and cognitive rehabilitation as a personalized therapeutic strategy for managing fatigue and cognitive impairments in MS. Further research is needed to delineate the specific contributions of each intervention component and establish standardized protocols for clinical implementation. The insights gained may lead to more effective, tailored treatment options for PwMS. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

Extended reality (XR)-based rehabilitation is an emerging therapeutic approach that combines real and virtual environments to enhance patient engagement and promote motor and cognitive recovery. Its clinical utility in children with cerebral palsy (CP), particularly regarding gross motor skills, balance, and psychosocial well-being, remains underexplored. This preliminary study aimed to evaluate the potential effects of XR-based rehabilitation on gross motor function, balance, parental stress, and quality of life in children with cerebral palsy. Thirty children with cerebral palsy were randomly assigned to an extended reality training group (XRT, n = 15) or a conventional physical therapy group (CPT, n = 15). Both groups received 30 min sessions, three times per week for 6 weeks. Outcome measures included the Gross Motor Function Measure-88 (GMFM-88), Pediatric Balance Scale (PBS), Functional Independence Measure (FIM), Parenting Stress Index (PSI), and Pediatric Quality of Life Inventory (PedsQL), assessed pre- and post-intervention. A 2 (group) × 2 (time) mixed ANOVA was conducted. The XR group demonstrated improvements in GMFM-88, PBS, and FIM scores, with decreased PSI and increased PedsQL scores. Although most interaction effects were not statistically significant (GMFM-88: η² = 0.035, p = 0.329; PBS: η² = 0.043, p = 0.274), a marginal interaction effect was observed for PSI (p = 0.065, η² = 0.059), suggesting a potential benefit of XR-based rehabilitation in reducing parental stress. This preliminary study indicates that XR-based rehabilitation may provide beneficial trends in motor function and psychosocial health in children with CP, particularly in reducing parental stress. Further studies with larger sample sizes are needed to confirm these findings. Full article

Background/Objectives: Mild traumatic brain injury (mTBI) presents with persistent, heterogeneous symptoms requiring multifaceted care. Although interdisciplinary rehabilitation is increasingly recommended, implementation remains inconsistent. This study aimed to synthesize existing literature and clinician perspectives to construct a practice-informed conceptual framework for interprofessional mTBI rehabilitation. Methods: Structured interviews were conducted with 94 clinicians—including neurologists, neuropsychologists, optometrists, occupational and physical therapists, speech-language pathologists, neurosurgeons, and case managers—across academic, private, and community settings in the United States. Interviews followed a semi-structured format adapted for the NIH I-Corps program and were analyzed thematically alongside existing rehabilitation literature. Results: Clinicians expressed strong consensus on the value of function-oriented, patient-centered care. Key themes included the prevalence of persistent cognitive and visual symptoms, emphasis on real-world goal setting, and barriers such as fragmented communication, reimbursement restrictions, and referral delays. Disciplinary differences were noted in perceptions of symptom persistence and professional roles. Rehabilitation technologies were inconsistently adopted due to financial, training, and interoperability barriers. Equity issues included geographic and insurance-based disparities. A four-domain conceptual framework emerged: discipline-specific expertise, coordinated training, technological integration, and care infrastructure, all shaped by systemic limitations. Conclusions: Despite widespread clinician endorsement of interprofessional mTBI care, structural barriers hinder consistent implementation. Targeted reforms—such as embedding interdisciplinary models in clinical education, expanding access to integrated technology, and improving reimbursement mechanisms—may enhance care delivery. The resulting framework provides a foundation for scalable, patient-centered rehabilitation models in diverse settings. Full article

Background/Objective: Stroke is one of the leading causes of death and disability worldwide, with older survivors (aged > 65 years) bearing significant health and economic impacts, particularly in industrialized countries. While gait rehabilitation is a cornerstone in post-stroke recovery and robotic technologies offer promising tools to enhance its effectiveness, the existing literature has largely overlooked elderly populations. Most studies on robot-assisted gait training (RAGT)—which uses exoskeleton or end-effector devices to support and guide movement—either exclude older adults or do not analyze their outcomes separately. This review aims to critically evaluate the current evidence on RAGT in elderly post-stroke patients, addressing a significant gap in the literature and providing novel insights into the effectiveness and adaptability of RAGT for this specific population. Methods: The search included databases such as PubMed, Scopus, Embase, Web of Science, and ClinicalTrials. The inclusion criteria covered studies published up to March 2025, focusing on post-stroke individuals aged >65 years, who underwent RAGT. Results: 25 studies were included in the review, 21 involving exoskeleton and 4 end-effector devices. The primary focus was on motor outcomes, such as gait independence, gait parameters, and balance control. Only a few studies examined non-motor aspects, including cognitive and emotional functions, fatigue, pain, and neuroplasticity. Moreover, data on the long-term effects on the elderly population remain scarce. Conclusions: RAGT is an effective strategy for promoting motor recovery and improving functional outcomes, from independence in daily activities to quality of life, in the post-stroke elderly population. Early and high-intensity interventions are particularly useful with positive effects on neuronal plasticity, cognitive function, and well-being. Full article

Background: Transcranial direct current stimulation (tDCS) has exhibited potential in augmenting motor functions, neuroplasticity, and cognitive abilities within neurological rehabilitation contexts. Despite these promising outcomes, the utilization of tDCS in both research and clinical environments in Saudi Arabia remains relatively unexplored. Objective: This study aims to evaluate the knowledge, attitudes, and motivations of rehabilitation specialists in Saudi Arabia concerning tDCS. Methods: A cross-sectional observational study was conducted through an online questionnaire, involving 112 registered rehabilitation professionals. Results: While 58% of respondents acknowledged tDCS as a therapeutic tool, the overall knowledge level was modest, with a mean score of 3.0 ± 2.7 out of 9. Enhanced levels of knowledge were associated with individuals holding doctoral degrees (p = 0.02) and those with international training exposure (p = 0.03). Despite the limited knowledge base, an overwhelming 94.64% of participants displayed a neutral to positive attitude towards tDCS, with 52.7% recognizing its potential efficacy in neurological recovery. Principal obstacles to implementation included safety-related concerns (21.4%) and the need for specialized training (23.3%). Conclusions: Rehabilitation specialists in Saudi Arabia generally hold a favorable view of tDCS and demonstrate an eagerness to pursue further training. The results underscore the imperative for enhanced educational initiatives and practical training to address knowledge deficiencies and facilitate the seamless integration of tDCS into clinical routines. The implementation of structured training programs could not only reinforce adoption rates but also optimize the role of tDCS within rehabilitation. Full article

Background/Objectives: Mild Cognitive Impairment (MCI) represents a clinical syndrome characterized by cognitive decline greater than expected for an individual’s age and education level but not severe enough to significantly interfere with daily activities, with variable trajectories that may remain stable, progress to dementia, or occasionally revert to normal cognition. This systematic review examines neurotechnological approaches to cognitive rehabilitation in MCI populations, including neuromodulation, electroencephalography (EEG), virtual reality (VR), cognitive training, physical exercise, and artificial intelligence (AI) applications. Methods: A systematic review following PRISMA guidelines was conducted on 34 empirical studies published between 2014 and 2024. Studies were identified through comprehensive database searches and included if they employed neurotechnological interventions targeting cognitive outcomes in individuals with MCI. Results: Evidence indicates promising outcomes across multiple intervention types. Neuromodulation techniques showed beneficial effects on memory and executive function. EEG analyses identified characteristic neurophysiological markers of MCI with potential for early detection and monitoring. Virtual reality enhanced assessment sensitivity and rehabilitation engagement through ecologically valid environments. Cognitive training demonstrated the most excellent efficacy with multi-domain, adaptive approaches. Physical exercise interventions yielded improvements through multiple neurobiological pathways. Emerging AI applications showed potential for personalized assessment and intervention through predictive modeling and adaptive algorithms. Conclusions: Neurotechnological approaches offer promising avenues for MCI rehabilitation, with the most substantial evidence for integrated interventions targeting multiple mechanisms. Neurophysiological monitoring provides valuable biomarkers for diagnosis and treatment response. Future research should focus on more extensive clinical trials, standardized protocols, and accessible implementation models to translate these technological advances into clinical practice. Full article

Background/Objectives: Individuals with chronic stroke often experience various impairments, including poor balance, reduced mobility, limited physical activity, and difficulty performing daily tasks. In the context of the COVID-19 pandemic, telerehabilitation (TR) can overcome the barriers of geographical and physical distancing, time, costs, and travel, as well as the anxiety about contracting COVID-19. In this retrospective case-control study, we aim to evaluate the motor and cognitive effects of balance TR training carried out with a sensor-based non-immersive virtual reality system compared to conventional rehabilitation in chronic stroke patients. Methods: Twenty chronic post-stroke patients underwent evaluation for inclusion in the analysis through an electronic recovery data system. The patients included in the study were divided into two groups with similar medical characteristics and duration of rehabilitation training. However, the groups differed in the type of rehabilitation approach used. The experimental group (EG) received TR with a sensor-based VR device, called VRRS—HomeKit (n. 10). In contrast, the control group (CG) underwent conventional home-based rehabilitation (n. 10). Results: At the end of the training, we observed significant improvements in the EG in the 10-m walking test (10MWT) (p = 0.01), Timed-Up-Go Left (TUG L) (p = 0.01), and Montreal Cognitive Assessment (MoCA) (p = 0.005). Conclusions: In our study, we highlighted the potential role of sensor-based virtual reality TR in chronic stroke patients for improving lower limb function, suggesting that this approach is feasible and not inferior to conventional home-based rehabilitation. Full article

Background and Objectives: Brain-computer interface (BCI) technology is revolutionizing stroke rehabilitation by offering innovative neuroengineering solutions to address neurological deficits. By bypassing peripheral nerves and muscles, BCIs enable individuals with severe motor impairments to communicate their intentions directly through control signals derived from brain activity, opening new pathways for recovery and improving the quality of life. The aim of this study was to explore the beneficial effects of BCI system-based interventions on upper limb motor function and performance of activities of daily living (ADL) in stroke patients. We hypothesized that integrating BCI into occupational therapy would result in measurable improvements in hand strength, dexterity, independence in daily activities, and cognitive function compared to baseline. Materials and Methods: An observational study was conducted on 56 patients with subacute stroke. All patients received standard medical care and rehabilitation for 54 days, as part of the comprehensive treatment protocol. Patients underwent BCI training 2–3 times a week instead of some occupational therapy sessions, with each patient completing 15 sessions of BCI-based recoveriX treatment during rehabilitation. The occupational therapy program included bilateral exercises, grip-strengthening activities, fine motor/coordination tasks, tactile discrimination exercises, proprioceptive training, and mirror therapy to enhance motor recovery through visual feedback. Participants received ADL-related training aimed at improving their functional independence in everyday activities. Routine occupational therapy was provided five times a week for 50 min per session. Upper extremity function was evaluated using the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and dynamometry to assess gross manual dexterity, fine motor skills, and grip strength. Independence in daily living was assessed using the Functional Independence Measure (FIM). Results: Statistically significant improvements were observed across all the outcome measures (p < 0.001). The strength of the stroke-affected hand improved from 5.0 kg to 6.7 kg, and that of the unaffected hand improved from 29.7 kg to 40.0 kg. Functional independence increased notably, with the FIM scores rising from 43.0 to 83.5. Cognitive function also improved, with MMSE scores increasing from 22.0 to 26.0. The effect sizes ranged from moderate to large, indicating clinically meaningful benefits. Conclusions: This study suggests that BCI-based occupational therapy interventions effectively improve upper extremity motor function and daily functions and have a positive impact on the cognition of patients with subacute stroke. Full article

Introduction: Virtual Reality (VR) training has potential evidence for reducing the risks of falls of older adults with mild cognitive impairment (MCI). There are indications of a positive training effect of a cognitive-motor intervention method to improve the postural balance and cognition for safer walking. This study aimed to evaluate the training effects of VR training for reducing the risks of falls among older adults with mild cognitive impairment (MCI). Methods: An experimental design was employed to evaluate how the participants attended a full-immersive VR Cave Automatic Virtual Environment (CAVE) training program. Fifty-five participants were randomly assigned to the VR group or the control group. The VR group received 16 training sessions over 8–10 weeks, while the control group received a non-VR falls prevention program. The primary outcome assessed any falls after the study, and the secondary outcomes assessed changes in cognition and executive function, walk speed and balance performances, and the psychological factor such as fear of falling relating to the risk factors of fall. Results: The VR group showed significantly greater improvement than the control group in terms of measures of cognitive-motor performance across group and time interaction. However, there were inconsistent results in functional mobility and fall efficacy between the two groups. Conclusion: This study provides promising evidence on the VR CAVE training for reducing the risks of falls among older adults with MCI from Hong Kong. VR technology-based applications are an emerging area in current aged care and rehabilitation services. Full article

Sexual dysfunction following abdominal or pelvic surgery is a significant concern that impacts the quality of life (QoL) for both men and women. This paper explores the multifaceted challenges and re-educational strategies associated with post-surgical sexual dysfunction. It highlights the physical and psychological repercussions of surgeries such as hysterectomies, pelvic organ prolapse repairs, radical prostatectomies, and rectal cancer resections. These procedures often lead to complications like dyspareunia, erectile dysfunction, and altered body image, necessitating comprehensive re-educational approaches. The review emphasizes the importance of tailored interventions, including pelvic floor muscle training (PFMT), biofeedback, manual therapy, and advanced techniques like botulinum toxin injections and sacral neuromodulation. For men, strategies such as phosphodiesterase type 5 inhibitors (PDE5i), vacuum erection devices (VEDs), intracavernosal injections, and penile prostheses are explored for their efficacy in restoring erectile function. Psychological support, including cognitive–behavioral therapy and couples counseling, is underscored as essential to addressing emotional and relational aspects of recovery. A multidisciplinary approach involving physiatrists, urologists, gynecologists, physiotherapists, psychologists, and sexual health counselors is advocated for to optimize outcomes. Integrating physical therapy modalities, as well as psychological and relational therapies, into individual rehabilitation projects is crucial for improving sexual function and overall QoL post-surgery. Future research should focus on refining these established strategies and investigating the potential of innovative therapeutic modalities. Full article

The adoption of immersive technologies, such as virtual reality (VR) and augmented reality (AR), is transforming sectors like healthcare, education, entertainment, and retail by offering innovative, simulated experiences. These technologies provide significant benefits, such as enhanced learning, improved patient outcomes, and innovative rehabilitation tools. However, their use also raises concerns about user comfort and potential health impacts. This systematic literature review examines the positive and negative health implications of immersive technologies, drawing insights from 104 peer-reviewed articles. The findings highlight therapeutic and rehabilitation benefits, such as treating anxiety and improving motor skills, alongside physical health concerns like eye strain and cybersickness, and mental health challenges, including cognitive overload and addiction. The study identifies key demographics most susceptible to these effects, such as children, the elderly, and individuals with pre-existing health conditions. Recommendations for mitigating risks include ergonomic device design, synchronized sensory inputs, and user training. This research underscores the need for the responsible and ethical development of immersive technologies, ensuring they enhance real-world experiences without compromising user well-being. Future studies should focus on long-term health implications, inclusive design, and establishing guidelines to maximize benefits while minimizing risks. Full article

Background/Objectives: Rett Syndrome (RTT) is a rare neurodevelopmental disorder that causes the loss of motor, communicative, and cognitive skills. While no cure exists, rehabilitation plays a crucial role in improving quality of life. Virtual Reality (VR) has shown promise in enhancing motor function and reducing stereotypic behaviors in RTT. This study aims to assess the impact of VR training on upper limb motor skills in RTT patients, focusing on reaching and hand-opening tasks, as well as examining its role in motivation and engagement during rehabilitation. Methods: Twenty RTT patients (aged 5–33) were randomly assigned to an experimental group (VR training) and a control group (standard rehabilitation). Pre- and post-tests evaluated motor skills and motivation in both VR and real-world contexts. The VR training involved 40 sessions over 8 weeks, focusing on fine motor tasks. Non-parametric statistical methods were used to analyze the data. Results: Results indicated significant improvements in the experimental group for motor parameters, including reduced stereotypy intensity and frequency, faster response times, and increased correct performance. These improvements were consistent across VR and ecological conditions. Moreover, attention time increased, while the number of aids required decreased, highlighting enhanced engagement and independence. However, motivation levels remained stable throughout the sessions. Conclusions: This study demonstrates the potential of VR as a tool for RTT rehabilitation, addressing both motor and engagement challenges. Future research should explore the customization of VR environments to maximize the generalization of skills and sustain motivation over extended training periods. Full article