Efficacy and feasibility of virtual reality-based cognitive tele-rehabilitation in Parkinson's disease: A pilot randomized controlled trial on patients and caregivers.

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ObjectiveParkinson's disease (PD) is a progressive neurodegenerative disorder that not only impairs motor functions but also may lead to significant cognitive decline, greatly affecting the quality of life for both patients and their caregivers. This study aims to evaluate the feasibility and potential effectiveness of cognitive tele-rehabilitation (TR) plus virtual reality (VR), compared to traditional home-based rehabilitation methods, focusing on cognitive outcomes, quality of life, usability, and the impact on caregiver strain in patients with PD.MethodsIn this pilot randomized controlled trial, 20 PD patients and their primary caregivers were randomly assigned to either a control group (CG) receiving traditional cognitive training or an experimental group (EG) undergoing cognitive TR using a VR rehabilitation system, with assessments conducted before and after the 8-week intervention.ResultsTR was rated as highly usable (System Usability Scale mean score: 84.3 ± 9.5). Post-intervention analyses showed significant improvements in global cognitive functioning (Montreal Cognitive Assessment (MoCA): p = 0.002) and quality of life (Parkinson's Disease Questionnaire (PDQ)-8: p = 0.002) in the EG. The CG also showed improvements in MoCA (p = 0.008) and PDQ-8 (p = 0.016), although to a lesser extent than the EG. A reduction in caregiver burden was observed in both groups but did not reach statistical significance. Analysis of Δ scores revealed a significantly greater MoCA improvement in the EG compared to the CG (p = 0.019). Statistically significant differences were found between the groups in the Family Strain Questionnaire and PDQ-8 Δ scores.ConclusionThese findings suggest that cognitive TR, particularly when integrated with VR, might be useful in improving cognitive function and quality of life in PD patients and could play a key role in future PD management strategies, potentially easing the burden on caregivers.

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