Procedures
cardiorespiratory instability, spasticity, cognitive and behavioral impairments, traumatic
EVENT, SPONTANEOUS FRACTURE
Patients’ inclusion criteria were (1) a diagnosis of SABI (vascular or traumatic etiology) in the subacute/chronic phase (ie, at least 6 months after the event), (2) age range between 18 and 75 years, (3) the presence of a stable internet connection, and (4) the presence of a caregiver able to use simple digital devices.Patients’ exclusion criteria were (1) severe cognitive and behavioral impairments, (2) cardiorespiratory instability or other medical illness potentially interfering with treatment, (3) severe limb spasticity (Modified Ashworth Scale [MAS] score>3), and (4) a high risk of spontaneous fracture.Patients were randomly assigned to 1 of 2 groups using a web-based application for block randomization. We used the block randomization method (block size=4) to ensure balance in the sample size across groups over time. Clinical evaluations were performed by therapists different from those who administered the treatments.In both groups, each treatment (cognitive or motor or both as per patients’ functional status) lasted about 1 hour/day, 5 days/week, for 12 weeks.The teleneuro-VRRS group received advanced motor and cognitive training at home with the VRRS HomeKit device, with the caregivers acting as cotherapists, whereas the control group was administered usual territorial rehabilitative treatment (UTRT, physical) and cognitive training at home. Before discharge, patients and caregivers were instructed on the use of the VRRS HomeKit device, and the training section was simulated within the hospital setting to find out potential problems and assess usability [