Social cognition is fundamental in everyday life to understand “others’ behavior”, which is a key feature of social abilities. Previous studies demonstrated the efficacy of a rehabilitative intervention in semi-immersive virtual reality (VR) controlled by whole-body motion to improve the ability of patients with cerebellar disorders to predict others’ intentions (VR-SPIRIT). Patients with severe ataxia that have difficulties at multiple levels of social processing could benefit from this intervention in terms of improving their social prediction skills, but they may have difficulties in controlling VR with whole-body movements. Therefore, we implemented VR-SPIRIT on a wearable, affordable, and easy-to-use technology, such as the Oculus Quest, a head-mounted display. The aim of this work was to evaluate the usability and tolerability of this VR application. We recruited 10 patients (37.7 ± 14.8 years old, seven males) with different types of hereditary ataxia who performed a single VR-SPIRIT session using the Oculus Quest viewer. After the session, patients answered a series of questionnaires to investigate the overall usability of the system and its potential effects in terms of cyber sickness. The preliminary results demonstrated system usability and tolerability. Indeed, only three patients did not complete the session due to different problems (dizziness, nausea, and boredom). In future studies, more patients will be enrolled to assess the effectiveness of the application, paving the way for the implementation of social training that can also be delivered at home.

Objectives: To examine the emotional, cognitive and dispositional experience of children and adolescents undergoing Lokomat rehabilitation by integrating self-evaluation, therapist observations and physiological metrics across repeated sessions, with the aim of characterising how patient experience evolves throughout paediatric robot-assisted gait training. Design: Prospective observational study using a multidimensional assessment approach combining self-report, therapist ratings and physiological measures. Setting: Inpatients undergoing robot-assisted gait training (RAGT) with the Lokomat at the Scientific Institute Eugenio Medea in Bosisio Parini (Italy). Participants: 42 children and adolescents (N=42; mean age 11.66±5.59 years) undergoing RAGT. Interventions: Robot-assisted gait therapy with the Lokomat. Participants underwent 30-minute therapy sessions as per routine rehabilitation protocols, with treatment durations ranging from 15 to 20 sessions, as prescribed by their referring clinician. Primary and secondary outcome measures: Participants completed ad-hoc questionnaires about emotional, cognitive and dispositional factors before and after therapy; therapists provided structured assessments of patient engagement and psychological states. Physiological data, such as heart rate variability (HRV) and electrodermal activity (EDA), were recorded using wearable sensors to capture physiological correlates of emotional and cognitive engagement. Results: The results showed that by the end of Lokomat therapy, patients displayed increased cognitive engagement and better emotional regulation, along with higher vagal activity (normalised high-frequency) and increased phasic EDA responses. According to the therapists, patients appeared more confident, calm and cooperative. Sympathetic activation observed during satisfaction ratings reflected the involvement of the autonomic nervous system in positive emotional experiences. Conclusions: This study, therefore, emphasises a multidimensional approach to rehabilitation, which involves subjective patient self-assessments, therapist observations and physiological signals in an effort to capture a more comprehensive patient experience. The findings highlight the importance of personalised, patient-centred approaches and contribute new evidence on the psychological and physiological effects of RAGT in paediatric populations. Further research is warranted to confirm these results and explore their clinical implications. Trial registration number: NCT05767268 .

The new generation is growing up in a context where sustainability and climate change (CC) are considered the “issues of our time”. In line with this, education plays a crucial role in raising awareness of CC among young people. However, one of the main challenges is showing CC’s effects, as they are often perceived as temporally and spatially distant, and many individuals struggle to visualise the real impact that CC’s consequences will have on the future world. The present study describes the co-design of a 360° video showing the effects of CC in familiar environments, conducted with a class of pre-teens. Co-design is a method that enables end-users, who are not trained in design, to work alongside professionals in creative processes. Moreover, participating in collaborative workshops reduces the distance between users and the topic addressed, enhancing their engagement and awareness of it. The results show that participants were satisfied with the developed content and enjoyed taking part in the co-design process. These findings suggest the potential of participatory workshops for developing 360° videos with students and provide a foundation for future investigations about their educational impact.