4. Discussion
NDC, post-stroke cognitive impairments, Alzheimer’s dementia, EG-DC
ADVERSE EVENTS, VASCULAR DEMENTIA
In our previous study [To the best of our knowledge, no previous study has compared the outcomes of VR-based FLS training in patients with M-NCD due to DC or NDC. Recent studies and reviews on VR-based rehabilitation have shown promising results for some cognitive functions in neurodegenerative conditions (especially executive and visuospatial abilities), as well as in post-stroke cognitive impairments [With reference to the first objective of the present study, both EG-DC and EG-NDC improved in all of the variable VRT scores—correct responses, missing responses, number of clues, and total execution time—except for the number of errors (With reference to the second objective of our study—i.e., the spontaneous skill transfer from the virtual environment to the real environment—both EG-DC and EG-NDC increased their correct responses in the natural environment after VRT (intragroup analysis) (As already described in the As in our previous study, the ecological validity of the VRT here seems to be verified, due to the spontaneous transfer of the relearned skills from the virtual setting to the natural life environment. VRT is based on “learning by doing”, which activates reasoning and intuition [Regarding the satisfaction questionnaires, moderate-to-high satisfaction was found in both VRT groups, and no problems or adverse events were reported, confirming previous data [Our study presents some strengths and limitations. Among the strengths, some recommendations by Moreno et al. [The limitations include the small sample sizes and the prevalence of Alzheimer’s dementia in the DC groups and vascular dementia in the NDC groups. Future studies should include a broader representation of the other etiological categories. We did not provide data on the FLS execution at home, but only in environments arranged at our institute. Due to the lack of follow-up, no information was collected on the maintenance of relearned FLSs over time. Patients were not randomly assigned to the groups, but since our study included a rehabilitative activity, our ethical choice was to provide the VRT to all patients who expressed their acceptance. Finally, our next objective is to increase the sample size in order to be able to use parametric statistics and to thoroughly analyze the effects of the group factor on the time and accuracy variables, under both natural and laboratory conditions. 