Interventions
24/24h, cognitive and motor activities
In both conditions, ABILITY and TAU, rehabilitation adopted a multidimensional approach to promote well-being, cognition, motor, and functional skills in a social environment. In detail, both cognitive and motor activities were included in the rehabilitation program. The cognitive activities were focused on several cognitive domains, such as attention, reasoning, procedural, semantic, and autobiographical memory, executive functions, and visual-spatial skills. The motor activities included motor exercises adapted to be executed at home and aerobic activities to be carried out outside the home to train physical capabilities (for further details, see the study protocol [The main differences between the ABILITY and the TAU intervention consisted of the tools included in the delivery modality of the rehabilitation at home. The TAU intervention was carried out in a standard manner, and participants received paper and pencil activities for cognitive exercises and written instruction for motor activities. Instead, in the ABILITY group, the intervention was delivered through a digital telerehabilitation platform (see The ABILITY telerehabilitation system: architecture and functionality. DHC: Digital Health Contents for rehabilitation.The TAU and the ABILITY treatment were different also for the management of activities’ difficulty level: the ABILITY rehabilitation presented an adaptive incremental difficulty level of cognitive activities based on the subject’s performance plus the subject’s reported perceived difficulties (ABILITY); the TAU provided a fixed incremental difficulty level over time independently from the subject’s performance and perspective. In detail, for both ABILITY and TAU treatment, each activity was structured into five levels of difficulty. For the ABILITY cognitive activity, a specific criterium to advance to the next level was set by an algorithm considering both i) the subject’s performances (i.e. the number of errors, the time spent to perform the activity) and ii) the level of perceived difficulties reported by the patient at the end of each activity. For the TAU rehabilitation, the level of difficulty incremented each week in a standard modality.Another difference between the ABILITY and TAU was the instructions for the physical activities, which consisted of video tutorials for the ABILITY, versus written instructions for the TAU.Finally, only the ABILITY treatment provided telemonitoring of vital parameters (body weight, oxygen blood level, blood pressure, and heart rate) by biometric devices (a sphygmomanometer for blood pressure measurement, a pulse oximeter for recording oxygen blood level and heart rate, a scale for measurement of body weight to be used once a day, and a wearable device to track the physical and sleep activity for the entire period of the trial), integrated into the ABILITY platform to be constantly monitored from the clinic. Once a week, an alert on the tablet was set to remind the ABILITY group to measure the vital parameters. The TAU intervention included a paper-and-pencil diary to be filled by the subject with data on vital parameters.Only the ABILITY group was instructed to wear an activity tracker 24/24h for the whole treatment period, except for 2 h per week (time to recharge the device).