Various studies have proven the utility of immersive virtual reality (VR) as a complementary approach to conventional neurorehabilitation therapy for improving neuromuscular and cognitive outcomes in several neurological diseases. We hereby report findings from a single-case experience of a 21-year-old woman affected by juvenile Huntington’s disease (HD) who underwent a targeted rehabilitative approach using an advanced Computer Assisted Rehabilitation Environment (CAREN) with a three sessions/week schedule for six months. At the end of the program, a manifested improvement was noticed in the Falls Efficacy Scale International score, in the Tinetti Scale, in the Berg Balance score and in the lower limb strength (MRC scale). Minor although tangible improvements were also noticed in some physical performance tests (10 m walking test, time up and go test). Findings reported, although preliminary, extend for the first time the usefulness of neurorehabilitation using innovative VR technologies also to juvenile HD, a condition for which common rehabilitation strategies bring only marginal physical benefits in the majority of cases. Future, controlled studies are awaited for generalizing these observations to larger populations and for clarifying whether such benefits may persist also in the long-term.

Background: Gait and balance alterations in post-stroke patients are one of the most disabling symptoms that can persist in chronic stages of the disease. In this context, rehabilitation has the fundamental role of promoting functional recovery, mitigating gait and balance deficits, and preventing falling risk. Robotic end-effector devices, like the G-EO system (e.g., G-EO system, Reha Technology, Olten, Switzerland), can be a useful device to promote gait recovery in patients with chronic stroke. Materials and Methods: Twelve chronic stroke patients were enrolled and evaluated at baseline (T0) and at post-treatment (T1). These patients received forty sessions of robotic gait training (RGT) with the G-EO system (experimental group, EG), for eight weeks consecutively, in addition to standard rehabilitation therapy. The data of these subjects were compared with those coming from a sample of twelve individuals (control group, CG) matched for clinical and demographic features who underwent the same amount of conventional gait training (CGT), in addition to standard rehabilitation therapy. Results: All patients completed the trial, and none reported any side effects either during or following the training. The EG showed significant improvements in balance (p = 0.012) and gait (p = 0.004) functions measured with the Tinetti Scale (TS) after RGT. Both groups (EG and CG) showed significant improvement in functional independence (FIM, p < 0.001). The Fugl-Meyer Assessment—Lower Extremity (FMA-LE) showed significant improvements in motor function (p = 0.001, p = 0.031) and passive range of motion (p = 0.031) in EG. In EG, gait and balance improvements were influenced by session, age, gender, time since injury (TSI), cadence, and velocity (p < 0.05), while CG showed fewer significant effects, mainly for age, TSI, and session. EG showed significantly greater improvements than CG in balance (p = 0.003) and gait (p = 0.05) based on the TS. Conclusions: RGT with end-effectors, like the G-EO system, can be a valuable complementary treatment in neurorehabilitation, even for chronic stroke patients. Our findings suggest that RGT may improve gait, balance, and lower limb motor functions, enhancing motor control and coordination.

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.

Background: Informal caregivers of individuals with mild cognitive impairment (MCI) experience high levels of psychological and physical stress, with limited access to supportive interventions and time constraints. Virtual Reality (VR) technologies may provide brief and accessible opportunities to support caregiver well-being, particularly during waiting periods in clinical settings. This pilot study aimed to explore the potential of a semi-immersive VR intervention to enhance psychological well-being in informal caregivers. Methods: This non-randomized pilot study investigated the effects of a semi-immersive VR-based physical training program (K-HERO^®) on psychological well-being and coping strategies in informal caregivers. Participants were recruited from January to May 2025 at the IRCCS Centro Neurolesi “Bonino-Pulejo” (Messina, Italy), and the intervention was delivered individually in a dedicated room within the rehabilitation facility, while caregivers accompanied their relatives to treatment sessions. Ten caregivers completed six sessions (30–40 min each). The study was conducted in accordance with TREND reporting guidelines. Pre- and post-intervention assessments included the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), COPE Inventory, Caregiver Burden Inventory (CBI), and International Physical Activity Questionnaire (IPAQ). Visual Analog Scales and instrumental data from the VR system were used to monitor physical performance and user experience. Non-parametric statistics were applied. Results: Significant reductions were observed in avoidance (p = 0.033) and social support-based (p = 0.023) coping strategies. Differences emerged based on caregiver-patient relationships: parental caregivers showed increased anxiety, while offspring caregivers showed improvements. The intervention was well tolerated, with high usability and no adverse events reported. Conclusions: A short, structured, VR-based intervention delivered during clinical waiting periods may effectively reduce maladaptive coping strategies and support emotional well-being in informal caregivers. These findings highlight the potential of brief digital interventions in real-world care contexts. Larger randomized studies are needed to validate these preliminary findings and personalize interventions to different caregiver profiles.

Background and Objective: Fatigue represents a hallmark symptom in Multiple Sclerosis (MS), but its diagnosis and clinical evaluation is difficult because it is described as a subjective feeling of exhausted physical and mental sensation. Studies have also shown that approaches based on assisted therapies and robotics, as well as the use of vibration, which are used to improve sensory integration, reduce fatigue. The primary outcome in this study is to evaluate the effects of the application of focal vibrations on the reduction in fatigue, muscle strength, and endurance in MS patients with moderate disability. The secondary outcome is to assess the effects on quality of life, cognitive status, and mood. Methods: We enrolled 40 MS patients. The study was designed as a parallel randomized controlled trial: 20 patients were assigned to the experimental group (EG), who received vibration training, and 20 to the control group (CG), who received traditional physical exercise. Results: We found significant differences in the EG in fatigue, motor, and cognitive outcome and improvement of some aspects of quality of life (QoL). There are correlations between perceived multidimensional fatigue and cadence, step length, and health quality of life composite. Conclusions: Our study demonstrated the potential effectiveness of vibration training in balance, walking endurance, and reduction in the risk of falls in patients with Multiple Sclerosis. In addition, we added evidence about fatigue, non-motor outcomes, in particular promoting mental and physical QoL and individual life satisfaction. The name of the registry is clinicaltrial.gov; the number of registration id NCT05783999; and the date of registration is 14 March 2023.

Background: Post-stroke pain (PSP), particularly shoulder pain, is frequent and often underdiagnosed, limiting rehabilitation adherence and functional recovery. Current pharmacological and physical treatments offer only partial relief. Robotic-assisted therapy (RAT), such as the gravity-supporting Armeo^® Spring exoskeleton, delivers intensive, task-specific training with visual 2D feedback that may also alleviate PSP while enhancing motor outcomes. This study investigates whether RAT performed with the Armeo^® Spring reduces upper-limb PSP in chronic stroke patients versus conventional therapy and evaluates its effects on motor function and functional independence. Methods: In this retrospective parallel group study, 32 chronic post-stroke patients (8 females and 24 males with a mean age of 57 ± 11.74) were allocated to two groups: 16 received upper-limb RAT with the Armeo^® Spring, a gravity-supporting exoskeleton, (RAT group) and 16 underwent conventional rehabilitation (CR). The RAT group completed one-hour sessions 6 days/week for 8 weeks, performing 2D/3D gamified tasks targeting shoulder, elbow and forearm movements. The CR group received an equivalent amount of standard therapy, including passive/active-assisted mobilization, Bobath-based neuromuscular facilitation and reaching exercises. Results: Both the Armeo^® Spring and conventional therapy groups showed significant reductions in post-stroke pain (RAT p < 0.001 and conventional rehabilitation p = 0.004) and improvements in upper-limb motor function and functional independence (both p ≤ 0.002). Spasticity in the impaired limb decreased modestly in the RAT group (p = 0.031), with no significant between-group differences in pain or spasticity change (p = 0.437; p > 0.05, respectively). Conclusions: Gravity-support exoskeleton training reduced upper-limb spasticity, and no statistically significant between-group differences were observed compared with conventional physiotherapy for pain, mobility, and functional independence. Although clinical outcomes improved, health-related quality-of-life domains showed heterogeneous trajectories, underscoring the complexity of perceived health changes during chronic stroke rehabilitation. Larger randomized controlled trials incorporating neurophysiological and kinematic endpoints and longer follow-up are warranted to confirm effectiveness, particularly in chronic stroke and durability.