PMID- 33897579
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230920
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 12
DP  - 2021
TI  - Virtual Reality for Motor and Cognitive Rehabilitation From Clinic to Home: A 
      Pilot Feasibility and Efficacy Study for Persons With Chronic Stroke.
PG  - 601131
LID - 10.3389/fneur.2021.601131 [doi]
LID - 601131
AB  - Aims: Continuity of care is an important issue in healthcare for persons after 
      stroke. The present multi-center pilot study investigates the feasibility and 
      efficiency of an innovative approach, the Human Empowerment Aging and Disability 
      (HEAD), for digital-health motor and cognitive rehabilitation. The approach is 
      explored within an in-clinic context (ClinicHEAD) and in continuity of care 
      (HomeHEAD) for persons after chronic stroke. Methods: Thirty-four outpatients 
      with chronic stroke (mean age 55 years, SD 13.7) participated. The HEAD VR 
      protocol was administered in two consecutive phases: Phase I in clinic 
      (ClinicHEAD) consisting of 4 weeks of 12 supervised HEAD rehabilitation sessions 
      (45-min), including motor, cognitive and dual task for all participants; Phase II 
      at home (HomeHEAD) consisted of 60 sessions of the same VR activities, 5 
      times/week for 3 months. All participants in the ClinicHEAD were allocated (ratio 
      1:2) to continue with tele-monitored home rehabilitation (HH, N = 11) or to 
      follow usual care (UC, N = 23). Blind evaluation was carried out at baseline, 
      after ClinicHEAD, after 3 months of HomeHEAD and at 3 months Follow-up. Primary 
      outcomes were functional mobility [2-min Walking Test (2MWT)] and cognition 
      [Montreal Cognitive Assessment (MoCA)]. Feasibility and acceptance were assessed 
      with adherence to treatment and the System Usability Satisfaction. Within group 
      analyses were done with dependent samples t-tests, and between groups HomeHEAD 
      comparisons were carried out on change scores with independent samples t-test (p 
      = 0.05, two tailed). Results: The HEAD protocol was feasible with good adherence 
      both in the ClinicHEAD phase (92%) and HomeHEAD (89%) phase, along with good 
      perceived system satisfaction. ClinicHEAD resulted in a significant increase in 
      functional mobility (2MWT, p = 0.02) and cognition (MoCA, p = 0.003) and most 
      secondary outcome variables. At 3 months follow up of HomeHEAD the HH_group 
      showed a further significantly greater maintenance of functional mobility with 
      respect to UC_group (p = 0.04). Conclusion: The HEAD VR protocol was feasible in 
      clinical and at home tele-rehabilitation for persons in the chronic phase after 
      stroke. In clinic the approach was effective in augmenting motor and cognitive 
      abilities and at home it was effective in longterm maintenance of functional 
      mobility, indicating its usefulness in continuity of care. Clinical Trial 
      Registration: ClinicalTrials.gov, NCT03025126.
CI  - Copyright (c) 2021 Jonsdottir, Baglio, Gindri, Isernia, Castiglioni, Gramigna, 
      Palumbo, Pagliari, Di Tella, Perini, Bowman, Salza and Molteni.
FAU - Jonsdottir, Johanna
AU  - Jonsdottir J
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Baglio, Francesca
AU  - Baglio F
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Gindri, Patrizia
AU  - Gindri P
AD  - Ospedale San Camillo, Turin, Italy.
FAU - Isernia, Sara
AU  - Isernia S
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Castiglioni, Carlotta
AU  - Castiglioni C
AD  - Ospedale San Camillo, Turin, Italy.
FAU - Gramigna, Cristina
AU  - Gramigna C
AD  - Ospedale Valduce, Villa Beretta, Costa Masnaga, Italy.
FAU - Palumbo, Giovanna
AU  - Palumbo G
AD  - Ospedale Valduce, Villa Beretta, Costa Masnaga, Italy.
FAU - Pagliari, Chiara
AU  - Pagliari C
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Di Tella, Sonia
AU  - Di Tella S
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Perini, Gloria
AU  - Perini G
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Bowman, Thomas
AU  - Bowman T
AD  - IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
FAU - Salza, Marco
AU  - Salza M
AD  - Ospedale San Camillo, Turin, Italy.
FAU - Molteni, Franco
AU  - Molteni F
AD  - Ospedale Valduce, Villa Beretta, Costa Masnaga, Italy.
LA  - eng
SI  - ClinicalTrials.gov/NCT03025126
PT  - Journal Article
DEP - 20210407
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC8058210
OTO - NOTNLM
OT  - cognition
OT  - continuity of care
OT  - hemiplegia after stroke
OT  - mobility
OT  - rehabilitation
OT  - stroke
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- 2021/04/27 06:00
MHDA- 2021/04/27 06:01
PMCR- 2021/04/07
CRDT- 2021/04/26 05:49
PHST- 2020/08/31 00:00 [received]
PHST- 2021/03/08 00:00 [accepted]
PHST- 2021/04/26 05:49 [entrez]
PHST- 2021/04/27 06:00 [pubmed]
PHST- 2021/04/27 06:01 [medline]
PHST- 2021/04/07 00:00 [pmc-release]
AID - 10.3389/fneur.2021.601131 [doi]
PST - epublish
SO  - Front Neurol. 2021 Apr 7;12:601131. doi: 10.3389/fneur.2021.601131. eCollection 
      2021.