Introduction: The use of virtual reality (VR) in physiotherapy is expanding across various fields; however, while extensively researched in neurology, its application in musculoskeletal (MSK) disorders remains underexplored. This review aims to evaluate the effectiveness of VR in pain management across different anatomical regions.Materials and Methods: The research was conducted using the MEDLINE (via PubMed), Cochrane Library, Scopus, Web of Science, and Embase databases, including randomized controlled trials that evaluated the effectiveness of VR interventions, encompassing immersive VR, specialised non‐immersive VR, and gaming platforms. The primary outcomes focused on pain reduction. Data were extracted from the included studies, and methodological quality was assessed using the Revised Cochrane risk‐of‐bias tool for Randomized Trials (RoB 2). A meta‐analysis was conducted using both fixed‐ and random‐effects models to synthesise the findings.Results: From 1265 records, 27 articles met the eligibility criteria, comprising a total of 1191 participants. Of these, 20 studies contributed data to the meta‐analyses. Significant findings were observed for pain relief in the knee region (SMD = − 0.33; 95% CI: − 0.55 to − 0.10; I² = 13%, p < 0.004), with particularly notable effects within the subgroup utilising specialised non‐immersive VR (SMD = − 0.32; 95% CI: − 0.62 to − 0.03; I² = 10%, p < 0.003). For other anatomical regions, the heterogeneity was substantial, limiting the strength of recommendations for these areas.Conclusions: VR shows potential for managing pain in MSK disorders, particularly knee conditions, with significant effectiveness using specialised non‐immersive VR. However, high heterogeneity across other regions limits broader recommendations.

Dizziness can be a debilitating condition with various causes, with at least one episode reported in 17% to 30% of the international adult population. Given the effectiveness of rehabilitation in treating dizziness and the recent advancements in telerehabilitation, this systematic review aims to investigate the effectiveness of telerehabilitation in the treatment of this disorder. The search, conducted across Medline, Cochrane Central Register of Controlled Trials, and PEDro databases, included randomized controlled trials assessing the efficacy of telerehabilitation interventions, delivered synchronously, asynchronously, or via tele-support/monitoring. Primary outcomes focused on dizziness frequency/severity and disability, with secondary outcomes assessing anxiety and depression measures. Seven articles met the eligibility criteria, whereas five articles contributed to the meta-analysis. Significant findings were observed regarding the frequency and severity of dizziness (mean difference of 3.01, p < 0.001), disability (mean difference of −4.25, p < 0.001), and anxiety (standardized mean difference of −0.16, p = 0.02), favoring telerehabilitation. Telerehabilitation shows promise as a treatment for dizziness, aligning with the positive outcomes seen in traditional rehabilitation studies. However, the effectiveness of different telerehabilitation approaches requires further investigation, given the moderate methodological quality and the varied nature of existing methods and programs.

Motor recovery after stroke is highly variable and closely linked to the extent of corticospinal tract (CST) damage. Neurophysiological biomarkers, such as motor evoked potentials (MEPs) and structural imaging markers, including CST lesion load and fractional anisotropy (FA), show promise for predicting motor outcomes. This scoping review evaluated the prognostic value of these biomarkers and the utility of multimodal models for individualized rehabilitation. A systematic search (April 2024) in PubMed, the Cochrane Library, and Scopus identified empirical studies examining biomarkers predictive of post-stroke motor recovery. Biomarkers were primarily derived from magnetic resonance imaging (resting-state functional connectivity and diffusion-weighted imaging) and transcranial magnetic stimulation. Nineteen studies (1219 patients) met the inclusion criteria. Structural biomarkers, particularly lower CST FA and higher weighted lesion load, were generally associated with poorer motor recovery. Combining neurophysiological measures, such as MEP status, with functional imaging and artificial intelligence-based analyses may improve prognostic precision. Multimodal approaches appeared promising in some studies, but evidence remains limited and heterogeneous. Integrating diverse biomarkers into multimodal prognostic models may enhance the prediction of motor recovery and support personalized rehabilitation after stroke, although heterogeneity in study design and outcome assessment highlights the need for standardized, large-scale longitudinal studies to enable clinical implementation.

Background and Objectives: The aging population and the COVID-19 pandemic have led to a rise in severe conditions, including musculoskeletal (MSK) disorders. Although MSK conditions are often managed in primary care, they may sometimes mask serious illnesses requiring urgent diagnosis. The red flag (RF) concept is essential for identifying signs and symptoms of potentially severe disease. However, RF criteria vary across clinical guidelines and lack consistency. With the growing role of direct access to physiotherapy—bypassing physician referral—physiotherapists must develop strong differential diagnostic skills to identify serious pathologies that mimic MSK disorders. This review aims to systematically map how RFs are defined in MSK clinical practice guidelines (CPGs), supporting the move toward a standardized definition for clinical and research use. Materials and Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane databases. Included studies were CPGs and systematic reviews (SRs) of CPGs addressing MSK disorders and incorporating the RF concept. Data extraction followed a rigorous process, and RF definitions were synthesized and compared in table format. Results: Out of thirteen-thousand three-hundred and ninety-three articles identified, fourteen met inclusion criteria (seven CPGs and seven SRs of CPGs), spanning both physiotherapy and medical fields. All definitions described RFs as signs or symptoms indicating possible serious pathology requiring further investigation or referral. Some definitions referred broadly to “patterns of signs or symptoms”, while others offered more precise criteria. Conclusions: This review highlights the lack of a standardized RF definition in MSK care, leading to inconsistencies in clinical decision-making and diagnosis. To improve patient safety and guide clinicians—especially in direct-access contexts—a unified, internationally recognized definition of RFs is needed in future guidelines.

Background and Objectives: In patients with multiple sclerosis (MS), a decrease in muscle strength can lead to limitations in pulmonary functions, potentially causing respiratory complications. To address these challenges, the lung volume recruitment (LVR) maneuver has emerged as a potential intervention. This study sought to evaluate the impact of a four-week LVR protocol on respiratory function in secondary progressive MS patients. Materials and Methods: In a quasi-randomized pre/post-controlled trial, 24 patients with secondary progressive MS were recruited. Participants aged 20–70 years with an EDSS score of 2 to 9 were alternately allocated to intervention (n = 12) or control groups (n = 12). The intervention group underwent a 4-week respiratory rehabilitation training focused on LVR, using a standardized cough machine treatment protocol twice daily. The control group received no respiratory intervention. Outcomes measured included forced vital capacity (FVC), maximal insufflation capacity (MIC), and peak cough flow (PCF), using turbine spirometry and other associated equipment. All measurements were taken at baseline (T₀) and after 4 weeks (T₁) by a blinded assessor. Results: For the intervention group, the mean difference pre/post-treatment in MIC (mL) was 0.45 (SD 1.13) (p = 0.02), and in MIC (%), it was 0.13 (SD 0.24) (p = 0.03). Compared to the control group (n = 10), the between-group mean difference for MIC (mL) was 0.54 (p = 0.02), and for MIC (%), it was 0.15 (p = 0.02). Conclusions: The short-term daily LVR protocol notably improved passive lung capacity, despite minimal changes in active lung capacity or cough force. The LVR maneuver offers promise for enhancing respiratory function, especially passive lung capacity, in secondary progressive MS patients. Further research should explore optimal treatment durations and frequencies for more extensive respiratory gains.

Technological innovation has revolutionized healthcare, particularly in neurological rehabilitation, where it has been used to address chronic conditions. Smart home and building automation (SH&BA) technologies offer promising solutions for managing chronic disabilities associated with such conditions. This single group, pre-post longitudinal pilot study, part of the H2020 HosmartAI project, aims to explore the integration of smart home technologies into neurorehabilitation. Eighty subjects will be enrolled from IRCCS San Camillo Hospital (Venice, Italy) and will receive rehabilitation treatment through virtual reality (VR) and robotics devices for 15 h per day, 5 days a week for 3 weeks in the HosmartAI Room (HR), equipped with SH&BA devices measuring the environment. The study seeks to optimize patient outcomes and refine rehabilitation practices. Findings will be disseminated through peer-reviewed publications and scientific meetings, contributing to advancements in neurological rehabilitation and guiding future research.