Clinical Rehabilitation最新文献

{"title":"Conceptualisation of financial capability in adults with acquired cognitive impairment: A qualitative evidence synthesis.","authors":"Sarah Swan, Freyr Patterson, Terra M Bredy, Jennifer Fleming","doi":"10.1177/02692155251347766","DOIUrl":"https://doi.org/10.1177/02692155251347766","url":null,"abstract":"<p><p>ObjectiveTo explore definitions, theoretical models and conceptual frameworks related to financial capability in adults with acquired cognitive impairment from acquired brain injury or other neurological disease, including dementia.Data sourcesA systematic search of PubMed (inclusive of Medline), CINAHL, EMBASE, PsycINFO, ABI-inform, SCOPUS and the Cochrane database for papers published until May 2025.Review methodsA qualitative evidence synthesis approach was utilised in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Eligible papers articulated an original comprehensive definition and/or theoretical model or conceptual framework focused on financial capability in the target population. Papers were screened by two researchers, with methodological quality of included papers critically appraised. Data were extracted for tabulation and thematic synthesis, which was completed via coding and categorisation into descriptive and analytical themes.ResultsThe final analysis included 21 papers from the initial screening of 6516 papers. Fifteen discrete models were identified, with results indicating inconsistency in terminology use and meanings. Models that consider real-world performance within an individual's contextual environment are increasingly utilising economics related terminology such as financial capability. The majority of papers related to people with dementia and were multidisciplinary in authorship, or from the psychology literature. Themes found in the literature include the multi-dimensionality of financial capability, financial decision-making ability and exploitation risk for legal capacity, and the neuropathological cause of declining financial capability.ConclusionFurther research with the inclusion of the consumer lived experience is recommended to inform models of care for this complex area of practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251347766"},"PeriodicalIF":2.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of the My Therapy self-directed therapy program for rehabilitation patients: A stepped wedge cluster randomised trial.","authors":"Natasha K Brusco, Sara L Whittaker, Christina L Ekegren, Meg E Morris, Nicholas F Taylor, Annemarie L Lee, Lisa Somerville, Natasha A Lannin, Rania Abdelmotaleb, Libby Callaway, Keith D Hill","doi":"10.1177/02692155251347756","DOIUrl":"https://doi.org/10.1177/02692155251347756","url":null,"abstract":"<p><p>ObjectiveTo determine if the My Therapy self-management program could be implemented without increasing the rehabilitation admission cost, from a health service perspective.DesignEconomic evaluation, including a cost-effectiveness analysis.SettingAustralian rehabilitation wards (<i>n</i> = 9).ParticipantsRehabilitation inpatients with any diagnosis.InterventionMy Therapy: a self-directed therapy program shown to increase daily inpatient rehabilitation participation dosage time by 38%.Main MeasuresOutcomes included cost (rehabilitation admission and all-cause 30-day readmissions), and effect (minimal clinically important difference in functional independence (FIM^TM), and quality-adjusted life years (EQ-5D-5L)), to estimate incremental cost-effectiveness ratios (ICERs).ResultsThere were 2363 participants, with a mean age of 77 (SD 13) years, 62% female, and 27% with cognitive impairment. My Therapy costs $5 (SD $2) per patient/day to implement, excluding opportunity costs. Estimated differences in effect were non-significant for the proportion of participants achieving a minimal clinically important difference in function (control 31%, intervention 36%; OR: 1.08, 95% CI: 0.77, 1.53), and quality-adjusted life years (mean difference -0.01, 95% CI: -0.04 to 0.02). Estimated differences in cost were also non-significant (OR: 1.06, 95% CI: 0.97, 1.16). ICERs were also non-significant. Post hoc, it was determined that the cost/minute of daily therapy participation was $14/minute for control and $11/minute for intervention conditions.ConclusionsThe My Therapy self-management program was implemented without increasing rehabilitation admission and all-cause 30-day readmission costs. However, clinical differences were not detected. There may have been a small reduction in cost/minute for daily therapy participation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251347756"},"PeriodicalIF":2.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder irritability differs by standardised measures of movement-evoked pain.","authors":"Abigail W Anderson, William J Hanney","doi":"10.1177/02692155251348853","DOIUrl":"https://doi.org/10.1177/02692155251348853","url":null,"abstract":"<p><p>ObjectiveIrritability utilises pain behaviour during movement to inform examination and treatment intensity. Standardised measures of movement-evoked pain have not previously been applied to irritability. This study examined whether shoulder pain during standard movements differed by irritability category and level.DesignObservational studySettingResearch laboratoryParticipantsParticipants with shoulder pain (n=40)InterventionIrritability was assessed followed by psychological questionnaires (Fear of Pain Questionnaire, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Center for Epidemiologic Studies-Depression, State-Trait Anger Expression Inventory, Pain Anxiety Symptoms Scale, Pain Self-Efficacy Questionnaire), quantitative sensory testing (pressure pain threshold, heat pain threshold, conditioned pain modulation, temporal summation), and movement-evoked pain (lifting, functional movements, repetitive movements, self-selected task).Main measuresShoulder pain intensity was assessed before, during, and after each task. A t-test and ANOVA examined differences in each movement task by irritability.ResultsPain during the standardised lifting task was significantly higher in individuals categorised as irritable (p=0.03) than not irritable, as well as high irritability compared to moderate (p<0.01). Pain during functional movements was significantly higher in individuals categorised as irritable (p<0.01) compared to not, as well as high compared to low irritability (p<0.01). Performance on repetitive tasks did not significantly differ by irritability category (p=0.63) or level (p=0.44). Change in pain ratings during the self-selected task did not differ by irritability category (p=0.67) or level (p=0.95).ConclusionsPain during standardised, functional movements may differentiate irritability. Clinicians may want to consider functional testing in which pain is assessed during movement for patients with irritable shoulder pain.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251348853"},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study.","authors":"Kota Yamauchi, Shinichi Watanabe, Yuji Naito, Kei Goto, Shota Tanaka, Tokuaki Shinya, Yoshihisa Fujino, Kazuki Ogawa, Tomohiro Yoshikawa, Yoshie Hirota","doi":"10.1177/02692155251341555","DOIUrl":"https://doi.org/10.1177/02692155251341555","url":null,"abstract":"<p><p>ObjectiveThe rehabilitation of patients with disabilities post-intensive care unit (ICU) discharge is gaining importance and we aimed to identify factors associated with recovery in this study.DesignThis study was a secondary analysis of a multi-centre cohort study.SettingNine centres in Japan.ParticipantsA total of 121 patients admitted to the ICU who used an invasive ventilator for >48 h were the participants of this study.Main measuresThe relative functional gain and rehabilitation efficiency index, based on the Barthel Index, were calculated from the time of ICU discharge to hospital discharge. Factors related to the relative functional gain and rehabilitation efficiency index were analysed using multiple regression analysis.ResultsThe median relative functional gain value was 85% and the median rehabilitation efficiency index value was 1.61 points/day. Multiple regression analysis showed that relative functional gain was significantly associated with ventilator duration (β = -1.420, <i>p</i> < 0.001), the Medical Research Council score at ICU discharge (β = 1.557, <i>p</i> < 0.001), the Barthel Index at ICU discharge (β = 0.501, p < 0.001) and rehabilitation hours in general wards (β = 0.591, <i>p</i> = 0.008). The rehabilitation efficiency index was significantly associated with ventilator duration (β = -0.089, <i>p</i> = 0.022) and Medical Research Council score at ICU discharge (β = 0.098, <i>p</i> < 0.001).ConclusionsOur findings highlight the importance of post-ICU rehabilitation, particularly in patients with prolonged ventilation or reduced muscle strength, and support the clinical utility of rehabilitation impact indices in monitoring recovery trajectories.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251341555"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based self-training: A qualitative exploration of the experiences of individuals with chronic-stroke.","authors":"Khawla Loubani, Yishai Bachar Kirshenboim, Ruth Maman, Chedva Levin, Debbie Rand","doi":"10.1177/02692155251344850","DOIUrl":"https://doi.org/10.1177/02692155251344850","url":null,"abstract":"<p><p>ObjectiveTo explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training.DesignA qualitative study.SettingCommunity.SubjectsIndividuals with chronic-stroke.InterventionsParticipants underwent a structured 5-week home-based upper-extremity self-training via videogames or the Graded Repetitive Arm Supplementary Intervention which includes activities using everyday objects.Main measuresParticipants were interviewed following their participation in the self-training intervention, using a semi-structured interview. Interviews were transcribed verbatim and then analyzed using thematic analysis. Findings were validated through author discussions.ResultsTwenty-two participants (63% men) were included, aged 33 to 80, 6-36 months post-stroke. Participants had preserved cognitive ability, were mostly independent in daily living, and had a moderate upper-extremity motor ability (median (interquartile range (IQR)) Fugl-Meyer Motor Assessment score: 41 (29-47)/66 points). Three main themes were identified: 1) personal factors (e.g. devotion to perform self-training, commitment to the study, and personal roles), 2) self-training factors (e.g. experience and its influence on general condition), 3) environment-related factors (e.g. training equipment, home environment, and family support). The structured intervention and family support led to motivation and commitment. Challenges included time constraints, pain, and fatigue.ConclusionsThis qualitative study deepens understanding of home-based self-training experiences among individuals with chronic-stroke, highlighting how motivational, environmental, and self-training factors interact to shape long-term adherence. These insights can guide clinicians tailor interventions to promote long-term adherence and engagement by addressing individual, environmental, and task-related factors, and by identifying participants who may require additional support.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251344850"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility, validity and reliability of the IPad application for goal-setting: The aid for decision-making in occupation choice-2.","authors":"Kounosuke Tomori, Tatsunori Sawada, Yuho Okita, William Wmm Levack","doi":"10.1177/02692155251344860","DOIUrl":"https://doi.org/10.1177/02692155251344860","url":null,"abstract":"<p><p>ObjectiveTo evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred goal setting.DesignThis study consisted of two components: (1) The development and refinement of the ADOC2 application, focusing on user interface design and structured goal-setting functionality; and (2) the clinical evaluation of its utility, validity, and reliability.SettingEleven rehabilitation facilities in Japan (10 hospitals, 1 home-based setting).ParticipantsA total of 116 occupational therapy clients and 56 occupational therapists participated in the study.Main measuresClinical utility was assessed using a structured questionnaire previously validated for the original ADOC. Validity was examined through correlations with the Canadian Occupational Performance Measure (COPM) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Test-retest reliability of satisfaction and performance scores was analysed using weighted kappa coefficients.ResultsOver 90% of participants reported positive experiences with ADOC2 during the goal-setting process. The COPM scores showed strong correlations with ADOC2 ratings, while EQ-5D-5L scores showed weaker but expected correlations. Weighted kappa analyses indicated substantial to almost perfect agreement for test-retest reliability.ConclusionsADOC2 is a clinically useful, valid, and reliable tool for facilitating client-centred goal setting in occupational therapy practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251344860"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between frailty and stroke rehabilitation outcomes: A cohort study.","authors":"Tania Yeon Jung Cho, H Carl Hanger, Tim J Wilkinson","doi":"10.1177/02692155251336700","DOIUrl":"10.1177/02692155251336700","url":null,"abstract":"<p><p>ObjectiveTo assess the independent effect of pre-morbid frailty on stroke rehabilitation outcomes, including mortality, function, and discharge destination.DesignObservational cohort study.SettingInpatient stroke rehabilitation.ParticipantsTwo hundred consecutive stroke patients, 65 years or older, admitted during 2021.Main measuresLogistic regression models analysed binary outcomes (mortality, discharge destination, and significant functional gain), and multiple linear regression models analysed normally distributed continuous outcomes (function, measured by Functional Independence Measure (FIM)). The confounders of age, stroke severity, and pre-morbid dementia/cognitive impairment, were accounted for. Clinical Frailty Scale was the predictor (considered as categorical and dichotomous) for these models.ResultsAfter accounting for the confounders, increased frailty was independently associated with lower discharge FIM (B = -11.32; 95% confidence interval (CI) -14.46-8.18, p < 0.001), smaller FIM change (B = -4.21; 95% CI -6.58-1.84, p < 0.001) and smaller FIM improvements over time (B = -2.36; 95% CI -3.40-1.32, p < 0.001). Frailer patients were less likely to return home (Odds Ratio 0.26; 95% CI 0.17-0.41, p < 0.001). Most patients improved function, at all levels of frailty. Stroke severity (Odds Ratio 1.13; 95% CI 1.06-1.20, p < 0.001), but not frailty, was independently associated with 6-month mortality.ConclusionsPre-morbid frailty was independently associated with lower functional improvement and lower likelihood of discharge back home after stroke rehabilitation, but not with mortality up to 6 months. Measuring both pre-morbid frailty and stroke severity may be useful to provide prognostic information and set realistic expectations.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"830-841"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Modified Ashworth and Modified Tardieu Scales differ in their classification of lower limb spasticity.","authors":"J Beard, G Williams, M Kahn, M Banky","doi":"10.1177/02692155251337306","DOIUrl":"10.1177/02692155251337306","url":null,"abstract":"<p><p>ObjectiveTo investigate agreement in spasticity classification between the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS) when performed on four lower limb muscles in adults following neurological injury.DesignObservational trial.SettingInpatient and outpatient neurological rehabilitation unit.ParticipantsNinety adults with lower limb spasticity.Main MeasuresNinety participants underwent a spasticity assessment of their hamstrings at 40° and 90° of hip flexion, quadriceps, gastrocnemius and soleus using the MAS and MTS. Assessment findings were dichotomised into spastic (MAS ≥ 1 or MTS X ≥ 2) or not spastic (MAS = 0 or MTS X ≤ 1) categories. To evaluate agreement, 2 × 2 contingency tables were generated to calculate positive, negative and overall agreement. Statistical association was calculated using the Fisher's Exact Test.ResultsThe MAS classified the presence of spasticity more frequently than the MTS. The proportion of trials with agreement in spasticity classifications according to both scales and their Fishers exact test were hamstrings at 90° hip flexion (17.6%; p = 0.009); hamstrings at 40° hip flexion (75.0%; p = 0.166); quadriceps (67.1%; p = 0.020); gastrocnemius (77.9%; p = 0.586); and soleus (67.8%; p = 0.113).ConclusionThe MAS and MTS demonstrated a level of disparity in their classification of lower limb spasticity across all four muscles, particularly the more proximal muscle groups.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"761-769"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A technology-enriched approach to increasing rehabilitation dose after stroke: Clinical feasibility study.","authors":"Gillian Sweeney, Fiona Boyd, Maisie Keogh, Patrycja Lyczba, Elaine Forrest, Philip Rowe, Mark Barber, Andy Kerr","doi":"10.1177/02692155251333542","DOIUrl":"10.1177/02692155251333542","url":null,"abstract":"<p><p>ObjectiveTo assess the feasibility of a multi-technology, group based, approach to increasing rehabilitation dose early after stroke.MethodsMixed methods design reporting recruitment, dropout, safety, dose and acceptability.SettingAcute Hospital Stroke UnitParticipantsSixty stroke patients, 9.0 median (IQR 12.8) days after stroke, referred for rehabilitation, without contraindications to light exercise.InterventionPersonalised rehabilitation delivered in supervised groups, using a multi-technology rehabilitation gym, in addition to usual care.Main measuresFeasibility was based on achieving recruitment rates over 3.2 per month, dropout rates below 6%, absence of suspected unexpected serious adverse reactions and shoulder pain prevalence below 60%. Acceptability was derived from interviews with the clinical team. Dose (rehabilitation time) was recorded manually. Function was measured with the modified Rivermead Mobility Index and Therapy Outcome Measure.ResultsFeasibility was satisfactory with high recruitment rates (6 per month), low dropout (2%), no suspected unexpected serious adverse reactions and low prevalence (19%) of shoulder pain. Thematic analysis of interview data indicated the clinical team (n = 9) found the intervention acceptable and identified organisational constraints to higher doses. Participants attended an average of 9.1 (1-32) sessions during their hospital stay (23.0 days, SD 19.7), with sessions lasting 52 min (SD 15.7), on average. The modified Rivermead Mobility Index and Therapy Outcome Measure increased by 17.9 (SD 8.6) and 5.7 points (SD 2.4), respectively.ConclusionsStrong feasibility findings support future trials of multi-technology, group-based rehabilitation. This novel approach is an encouraging step toward achieving recommended doses of rehabilitation after stroke but needs further investigation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"740-749"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality as a complementary therapy in the rehabilitation of balance and gait disorders in patients with mild cognitive impairment and Alzheimer's disease: Systematic review.","authors":"Juan Rodríguez-Mansilla, Patricia Chamizo-Gallego, Blanca González-Sánchez, Elisa Maria Garrido-Ardila, Silvia Torres-Piles, Maria Jesús Rodríguez-Mansilla, Álvaro De Toro-García, María Jiménez-Palomares","doi":"10.1177/02692155251328619","DOIUrl":"10.1177/02692155251328619","url":null,"abstract":"<p><p>ObjectiveTo analyse the benefits of virtual reality in the management of balance and gait disorders in people with Alzheimer's disease and cognitive impairment.Data sourcesPubMed, PEDro, Cochrane Library, Science Direct, Google Scholar and Epistemonikos.Review methodThis study is a systematic review (PROSPERO Registration number: CRD42023486083). The inclusion criteria were: randomised, cross-sectional, quasi-experimental controlled clinical trials involving patients diagnosed with mild cognitive impairment, dementia and Alzheimer's disease with a score of ≤23 on the MMSE test and age ≥60 years, and interventions conducted with virtual reality and conventional physiotherapy for the treatment of balance and gait disorders. The methodological quality and risk of bias assessment was performed with the PEDro scale.Results12 studies were included in the review (<i>n</i> = 476). Three studies applied virtual reality to both experimental and control groups, six applied virtual reality to the experimental group and conventional physiotherapy to the control, and three investigations applied virtual reality to the experimental group and no treatment to the control group. Virtual reality based rehabilitation significantly improved balance and gait, as well as cognitive level, functionality, postural control and mood of the patients compared to those participants who received conventional physiotherapy or no treatment.ConclusionStudies suggest that interventions based on virtual environments in older adults with early Alzheimer's disease can improve balance and gait impairments, postural control and executive function, delaying the deterioration caused by the disease. Furthermore, this therapy has a positive impact on cognitive and motivational performance in these patients.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"728-739"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}