PMID- 33519699
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210202
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 11
DP  - 2020
TI  - A Multidimensional Virtual Reality Neurorehabilitation Approach to Improve 
      Functional Memory: Who Is the Ideal Candidate?
PG  - 618330
LID - 10.3389/fneur.2020.618330 [doi]
LID - 618330
AB  - Aims: We aimed to identify the significant predictors of ecological memory 
      amelioration after the Human Empowerment Aging and Disability (HEAD) 
      rehabilitation program, a multidimensional treatment for chronic neurological 
      diseases. Materials and Methods: Ninety-three patients with Parkinson disease (n 
      = 29), multiple sclerosis (n = 26), and stroke (n = 38) underwent a 
      multidimensional rehabilitation. We focused on changes after treatment on 
      ecological memory (outcome measure) evaluated by Rivermead Behavioral Memory 
      Test, Third Edition (RBMT-3). Minimal clinically important difference (MCID) 
      after treatment were calculated for RBMT-3. The change score on RBMT-3 was 
      categorized in positive effect, stabilization, or no effect of the treatment. 
      Random forest classification identified who significantly benefited from 
      treatment against who did not in terms of ecological memory functioning. 
      Accordingly, logistic regression models were created to identify the best 
      predictors of the treatment effect. A predicted probability value was derived, 
      and the profile of the ideal candidate of HEAD protocol was shown by combining 
      different ranks of significant predictors in a 3 x 3 matrix for each pair of 
      predictors. Results: A significant number of cases reported positive effect of 
      the treatment on ecological memory, with an amelioration over the MCID or a 
      stabilization. The random forest analysis highlighted a discrete accuracy of 
      prediction (>0.60) for all the variables considered at baseline for identifying 
      participants who significantly benefited and who did not from the treatment. 
      Significant logistic regression model (Wald method) showed a predictive role of 
      Montreal Cognitive Assessment (MoCA; p = 0.007), 2-Minute Walk Test (2MWT; p = 
      0.038), and RBMT-3 (p < 0.001) at baseline on HEAD treatment effect. Finally, we 
      observed a high probability of success in people with higher residual cognitive 
      functioning (MoCA; odds ratio = 1.306) or functional mobility (2MWT; odds ratio = 
      1.013). Discussion: The HEAD program is a rehabilitation with effects on multiple 
      domains, including ecological memory. Residual level of cognitive and/or motor 
      functioning is a significant predictor of the treatment success. These findings 
      confirm the intrinsic relationship subsisting between motor and cognitive 
      functions and suggest the beneficial effects of physical activity on cognitive 
      functions and vice versa.
CI  - Copyright (c) 2021 Di Tella, Isernia, Pagliari, Jonsdottir, Castiglioni, Gindri, 
      Gramigna, Canobbio, Salza, Molteni and Baglio.
FAU - Di Tella, Sonia
AU  - Di Tella S
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Isernia, Sara
AU  - Isernia S
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Pagliari, Chiara
AU  - Pagliari C
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Jonsdottir, Johanna
AU  - Jonsdottir J
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Castiglioni, Carlotta
AU  - Castiglioni C
AD  - Fondazione Opera San Camillo Presidio Sanitario San Camillo, Turin, Italy.
FAU - Gindri, Patrizia
AU  - Gindri P
AD  - Fondazione Opera San Camillo Presidio Sanitario San Camillo, Turin, Italy.
FAU - Gramigna, Cristina
AU  - Gramigna C
AD  - Villa Beretta Rehabilitation Center, Ospedale Valduce, Como, Italy.
FAU - Canobbio, Samuela
AU  - Canobbio S
AD  - Villa Beretta Rehabilitation Center, Ospedale Valduce, Como, Italy.
FAU - Salza, Marco
AU  - Salza M
AD  - Fondazione Opera San Camillo Presidio Sanitario San Camillo, Turin, Italy.
FAU - Molteni, Franco
AU  - Molteni F
AD  - Villa Beretta Rehabilitation Center, Ospedale Valduce, Como, Italy.
FAU - Baglio, Francesca
AU  - Baglio F
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210114
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC7840659
OTO - NOTNLM
OT  - Parkinson disease
OT  - cognition
OT  - digital health
OT  - multiple sclerosis
OT  - rehabilitation
OT  - stroke
OT  - telerehabilitation
OT  - virtual reality
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/02/02 06:00
MHDA- 2021/02/02 06:01
PMCR- 2021/01/14
CRDT- 2021/02/01 05:55
PHST- 2020/10/16 00:00 [received]
PHST- 2020/12/07 00:00 [accepted]
PHST- 2021/02/01 05:55 [entrez]
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2021/02/02 06:01 [medline]
PHST- 2021/01/14 00:00 [pmc-release]
AID - 10.3389/fneur.2020.618330 [doi]
PST - epublish
SO  - Front Neurol. 2021 Jan 14;11:618330. doi: 10.3389/fneur.2020.618330. eCollection 
      2020.