Virtual Reality for rehabilitation in clinic and in continuity of care, Protocollo HEAD - Multicenter study: feasibility and efficacy for persons with Multiple Sclerosis.

Continuity of care is an issue in health care for persons with Multiple Sclerosis(PwMS). The present multi-center study investigates the feasibility and efficacy of an innovative approach(Human Empowerment Aging and Disability-HEAD) based on virtual reality with short video clips of RAI programs within the context of neuromotor rehabilitation in clinic(Clinic-HEAD) and in continuity of care(Home-HEAD) for persons with Multiple Sclerosis, Stroke and Parkinson. Within the HEAD multicenter study 26 PwMS(mean age 51.3+16.4, EDSS range 3-6) were recruited during recovery(Clinic-HEAD). Clinic-HEAD consisted of 12 sessions of 1-hour-HEAD rehabilitation, including motor, cognitive and dual task activities in a virtual reality environment incorporated into short video clips. At discharge from the clinic half of the participants brought the system home and continued with tele-monitored rehabilitation(Home-HEAD) 5 days per week for 3 months. Evaluation of motor, cognitive and participation factors was carried out at baseline(T0), following ClinicHEAD(T1), and following three months of Home-HEAD(T2). Analysis of outcome of Berg Balance Scale, 2-Minutes Walking Test(2MWT), 10-Meters Walking Test, Box and Block Test(BBT) and SF-12 was done using Wilcoxon tests (.05, two tailed) at T0 and T1 for all PwMS, and at T1 and T2 for the Home-HEAD group. Clinic-HEAD resulted in a significant increase in gait resistance(2MWT, p<.05) and a trend for improved dexterity(BBT, p=.10). As for continuity of care, so far 7 PwMS have finished the Home-HEAD protocol with maintenance of results obtained in the clinic. Preliminary data supported the feasibility of the HEAD virtual reality protocol in rehabilitation and in continuity of care in PwMS. Acknowledgments This research was supported by Fondazione Cariplo. We thank the all the HEAD consortium