Teleneurotraining Using the VRRS HomeKit
motor and cognitive tasks, brain injury, Tele-Cockpit
The experimental training was conducted using the VRRS HomeKit (Teleneuro-VRRS sessions included the stimulation of specific cognitive domains, such as attention, verbal and visuospatial memory, and executive functions, as well as motor function training, using the advanced system, the VRRS HomeKit. The exercises were presented with increasing difficulty and implemented according to the patient’s response to the treatment (ie, when 9 of 10 answers were correct) and the number of errors (errors<1). Additionally, the therapists could also select the duration of each virtual exercise to better personalize both motor and cognitive tasks according to patients’ abilities, attention levels, and needs.Each session lasted about 1 hour (the same as the URTRs), although some extra time (less than 15 minutes) was also necessary for technology issues, including low bandwidth, content glitches, and comfort with the system linked to the distance of the user or the height at which the device is placed in the home setting.The VRRS HomeKit allows nonimmersive virtual exercises where the patient interacts with 2D scenarios and objects through the touch screen or through particular sensors: a K-wand equipped with light recognition technology used for movement tracking and orientation, which is handled by the patient during catching and reaching virtual exercises for the upper limbs, and a K-sensor consisting of a set of sensors placed on wearable strips of different sizes, which is used to carry out full-body motor teletraining activities. This means that although nonimmersive VR is in both cases represented on the same flat screen, the upper and lower limbs can move in the 3 dimensions of the space while interacting with the virtual environment. The entire cost of the system (Tele-Cockpit plus HomeKit) was €36,000 (USD 39,508): each home kit cost €8000 (USD 8780), and we bought 4 of them to ensure proper study training); see The VRRS HomeKit used to train patients with SABI in TR modality. SABI: severe acquired brain injury; TR: telerehabilitation; VRRS: virtual reality rehabilitation system.